Can an Appointment-letter Intervention Increase Pap Smear Screening in Samliem, Khon Kaen , Thailand ?


Our objective was to assess the efficiency of an appointment-letter intervention aimed to increase uptake ofcervical cancer screening in women between 35 and 65 years of age. From January, 2007, we randomly recruited320 women, not screened for at least 5 years, from the Samliem inner-city community, Khon Kaen, NortheastThailand. A total of 150 women 35, 40, 45, 50, 55, 60 and 65 years of age were assigned to the intervention groupaccording to Thai National Cancer Institute’s ( TNCI) strategy. A further 170 women between 36-39, 41-44, 46-49, 51-54, 56-59 and 61-64 years of age were assigned to the control group. Baseline interviews were conductedfor all women in both groups by one of the researchers in January, who also provided culturally-sensitive healtheducation emphasizing the need for screening. Then appointment letters were sent only to women in theintervention group in February, with the last date for an appointment being March 31st. In April of 2007,immediately post-intervention, screening-coverage interviews were performed in both groups for comparison.There was a significant increase in the Pap smear screening-coverage rate in the intervention group comparedwith the control group (44.67% vs. 25.88%, p=0.001). Therefore, the appointment-letter intervention produceda significant effect on increasing Pap smear coverage in this group of women.