Improving cervical cancer screening attendance in Finland

Area of Science:

• Public Health
• Gynecologic Oncology
• Health Services Research

Background:

• Cervical cancer screening program attendance in Finland is suboptimal at 70%.
• Opportunistic screening complicates organized program efficiency and cost-effectiveness.
• Optimizing attendance is crucial for maximizing screening impact and minimizing harm.

Purpose of the Study:

• To evaluate the impact of reminder letters and self-sampling kits on cervical cancer screening program attendance.
• To identify socioeconomic factors associated with screening non-attendance.
• To assess the yield of high-grade cervical lesions (CIN3+) from previously non-attending individuals.

Main Methods:

• A study involving 31,053 screening invitees across 31 Finnish municipalities.
• Intervention included a reminder letter for non-attendees, followed by a self-sampling option for further non-attendees.
• Socioeconomic data from Statistics Finland were integrated with screening data.

Main Results:

• Reminder letters increased participation from 72.6% to 79.2%.
• Self-sampling further raised attendance to 82.2%.
• Screening previously non-attending individuals increased CIN3+ lesion detection by 24%.

Conclusions:

• An organized cervical cancer screening program with strategic reminders and self-sampling can achieve over 80% attendance.
• Reminder letters with scheduled appointments were more effective than open invitations.
• Non-attendance is linked to younger age, immigrant status, lower education, and never being married.