A randomised controlled trial of strategies to prompt attendance for a Pap smear

J Med Screen. 1995;2(4):211-8. doi: 10.1177/096914139500200408.


Objective: To assess the comparative efficacy, by randomised controlled trial, of three interventions designed to encourage "at risk" women to have a Pap smear: an educational pamphlet; letters inviting attendance at a women's health clinic; and letters from physicians.

Methods: Subjects at risk for cervical cancer who had not been adequately screened were identified by a random community survey and randomly allocated to one of the intervention groups or a control group. Six months after intervention implementation, a follow up survey assessed subsequent screening attendance. Self report was validated by comparison with a national screening data base.

Results: A significantly greater proportion of women (36.9%) within the group receiving a physician letter reported screening at follow up than in any other group (P = 0.012). The variables most strongly predicting screening attendance were: age, perceived frequency of screening required, use of oral contraceptives, and allocation to receive the physician letter intervention.

Conclusions: The relative efficacy of the GP letter in prompting screening attendance shows that this strategy is worthy of further investigation. There remains a need to examine the barriers to screening for older women, and to develop tailored strategies for this population.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Australia
  • Correspondence as Topic
  • Data Collection
  • Female
  • Follow-Up Studies
  • Health Education
  • Humans
  • Mass Screening*
  • Middle Aged
  • Papanicolaou Test*
  • Patient Compliance*
  • Primary Health Care
  • Risk Factors
  • Sampling Studies
  • Uterine Cervical Neoplasms / prevention & control*
  • Vaginal Smears*
  • Women's Health Services