Evaluation of Recall and Reminder Letters on Retention Rates in an Organized Cervical Screening Program

It is key for women to return to screening at regular intervals to ensure the effectiveness of early detection and protective effects of the Pap test. A correspondence program was initiated in Ontario in 2013 to implement a recall and reminder letter sent to women 2.9 years from their prior normal Pap test. This study sought to evaluate the impact of the recall letter and reminder on retention rates for cervical screening.

A cohort study with a historical control was carried out with an exposed group, defined as women receiving a letter for recall in the week of November 21-27, 2013, and a non-exposed, control arm of women who did not receive the letter but who would have been eligible for correspondence in the same time period in 2012.

The study population comprised 5182 women in the exposed group and 4223 women in the non-exposed group. Women receiving the letter were more likely to return to screening, with an aOR of 1.82 (95% CI 1.66-1.99). Other significant factors included being registered with a Patient Enrolment Model family physician and having a series of prior Pap tests in the past screening history.

A correspondence program benefits the retention of women in organized cervical screening programs.