Call and recall for cervical cancer screening in a developing country: A randomised field trial

Abstract

A randomised field trial was used to assess Mexican women's response to a mailed invitation for a Papanicolaou test. A sample of 4,802 women, 20 to 64 years old, chosen at random from the Mexican Social Security Institute Register were randomly assigned to an intervention and to a control group. A letter of invitation and a reminder were sent to the intervention group. A letter was also sent to the control group at the end of the follow‐up period (8.5 weeks) in order to compare the response among women who received a letter in both groups. Cumulative incidence and incidence rates were used to determine the response and the speed of response, respectively. The response among women who had received the letter was 33.5% (efficacy) in the intervention group, while 5.9% (p<0.001) in the control group attended a Papanicolaou test. For the total of women invited, the response was 20.1% (effectiveness) and 3.3% (p<0.001), respectively. The response was greater in rural areas (rural vs. urban/suburban; p = 0.002) and eldest women (50–64 vs. 20–49; p = 0.02). The response rate was 7 times grater in the intervention than in the control group (RR = 7.1; 95% CI 5.4–9.4; p < 0.001). A mailed invitation to have a Papanicolaou test substantially increases attendance by women who receive it. A mailed reminder improves results. This strategy could be implemented in addition to the ones already in use, mainly among rural and elderly women. Int. J. Cancer 87:869–873, 2000. © 2000 Wiley‐Liss, Inc.

Efficacy of patient letter reminders on cervical cancer screening

“…Three articles were excluded because they evaluated combinations of interventions and did not examine letter reminders separately 7–9 . Three papers were not analyzed because the study population was not restricted to those due for Pap smear screening 10–12 . Inquiries for any unpublished studies on the subject were made of authors whose names were obtained from the literature review.…”

Evaluation of a Worksite Cervical Screening Initiative to Increase Pap Smear Uptake in Malaysia: A Cluster Randomized Controlled Trial

“…Two previous studies conducted in Sweden [19] and Mexico [20] have reported the proportion of women attending cervical screening following an invitation and/or reminder to be in the order of 31%. Sample size was calculated using OpenEpi v.2.3.1 [21]; based on a 1 : 1 ratio of case to control participants, the study would need approximately 200 participants (inclusive of an additional 20% to account for non-respondents and design effect of two [22]) in the intervention and comparator arm to have over 80% power at the 95% confidence level (alpha 0.05, two sided) to detect an effect size of 31%.…”

The Effect of One Versus Two Nights of In-Laboratory Continuous Positive Airway Pressure Titration on Continuous Positive Airway Pressure Compliance

“…A rural individual's need to drive may have been an added motivation to use the CPAP machine to maintain their driver's licenses. Previous studies have also suggested that people living in rural areas are more responsive (Torres-Mejia et al, 2000) and compliant (Ramaiah et al, 2000) to treatment than people who live in urban centers. Consequently, the results in this study may have been influenced by the rural location of our study sample and may reflect a novel finding in this regard.…”