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Giorgi Rossi P.,Agency for Public Health | Marsili L.M.,Local Health Unit ASL RMC | Camilloni L.,Agency for Public Health | Iossa A.,Cancer Prevention and Research Institute | And 16 more authors.
British Journal of Cancer | Year: 2011

Background: In Italy, cervical cancer screening programmes actively invite women aged 25-64 years. Programmes are hindered by low participation. Methods: A sample of non-responder women aged 35-64 years, belonging to three different programmes (in Rome, Florence and Teramo), was randomly split into four arms: two control groups received standard recall letters to perform either Pap-test (first group) or human papillomavirus (HPV) test (second group) at the clinic. A third arm was sent letters offering a self-sampler for HPV testing, to be requested by phone, whereas a fourth group was directly sent the self-samplers home. Results: Compliance with standard recall was 13.9% (N = 619). Offering HPV test at the clinic had a nonsignificant effect on compliance (N = 616, relative risk (RR)1.08; 95% CI = 0.82-1.41). Self-sampler at request had the poorest performance, 8.7% (N = 622, RR = 0.62; 95% CI = 0.45-0.86), whereas direct mailing of the self-sampler registered the highest compliance: 19.6% (N = 616, RR = 1.41; 95% CI = 1.10-1.82). This effect on compliance was observed only in urban areas, Florence and Rome (N = 438, RR = 1.69; 95% CI = 1.24-2.30), but not in Abruzzo (N = 178, RR = 0.95; 95% CI = 0.61-1.50), a prevalently rural area.Conclusions:Mailing self-samplers to non-responders may increase compliance as compared with delivering standard recall letters. Nevertheless, effectiveness is context specific and the strategy costs should be carefully considered. © 2011 Cancer Research UK All rights reserved.

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