MASS MAILING CAMPAIGNS TO PROMOTE SCREENING FOR CERVICAL-CANCER - DO THEY WORK, AND DO THEY CONTINUE TO WORK

Campaigns involving sending personally addressed fetters to encourage women to have Pap smears increase Pap smear rates. The aim of this stu dy was to assess whether this effect is maintained when campaigns are repeated regularly. In October 1992, a letter reminding women of the i mportance of screening was mailed to all women in three New South Wale s postcode regions where a similar letter had been sent three years pr eviously. The response was compared to the response in three regions r eceiving no earlier letter. The number of women attending for cervical screening during the three months after distribution of the letters w as assessed from Health Insurance Commission claims for cervical cytol ogy. These attendances were compared with expected attendances based o n the attendance patterns over 28 pre-intervention quarters. Significa nt postintervention increases in attendance were observed in all three regions receiving an initial letter. However, in one region, the incr ease in attendances, around 1 per cent of eligible women, was not sign ificantly greater than the increase in the control region (z = 0.15, P = 0.88). The second letter campaign had no measurable effect on atten dances. No significant increase in screenings was observed in two of t he towns. A significant increase was observed in one region, but this was not significantly greater than the increase in the control region (z = -0.05, P = 0.96). These results suggest that repeated direct-mail campaigns to promote screening for cervical cancer may be of no benef it. A one-off campaign may result in an increase in screenings in the short term.