title: A prospective randomized study of two reminding strategies: telephone versus mail in the screening of cervical cancer in women who did not initially respond.
abstract: OBJECTIVE
  To compare the efficacy and cost-effectiveness of two reminding strategies addressed to women who did not respond to a first invitation to undergo cervical cancer screening.
  
  
  METHODS
  A randomized study was carried out by a programme created in Alsace to organize cervical cancer screening. In total, 10,662 women who did not have a smear test 1 year after a first notice was sent, were randomly allocated to receive either a new letter with a reply coupon or a telephone call. The uptake of screening was measured using routine data. Efficacy and direct costs of the two methods were compared.
  
  
  RESULTS
  Uptake at 8 months was 6.3% [95% confidence interval (CI) 5.6-7.0%] for telephone calls and 5.8% (95% CI 5.2-6.4%) for letters. The difference was not significant. More information was collected through telephone calls than by letters, but with less reliability. Furthermore, telephone calls were more costly.
  
  
  CONCLUSIONS
  We found that in our region, a mail reminder was as effective as, and less expensive than, a telephone call; moreover, it was applicable to the whole population, including patients without a telephone.
authors.affiliation: Association Eve, Illkirch-Graffenstaden, France.
authors.forename: D
authors.initials: D
authors.lastname: Heranney
authors.forename: M
authors.initials: M
authors.lastname: Fender
authors.forename: M
authors.initials: M
authors.lastname: Velten
authors.forename: J J
authors.initials: JJ
authors.lastname: Baldauf
mesh_terms: D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D010358:Patient Participation; D011177:Postal Service; D011379:Prognosis; D011446:Prospective Studies; D017010:Reminder Systems; D013689:Telephone; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000191:economics / Q000517:prevention & control*