Grant: Operating Grant: Population Health Intervention Research

Background: Cervical cancer is the second most common cancer among women worldwide. In Canada, screening allows for the early detection and treatment of abnormalities, thus cervical cancer is much less common. However, social inequalities related to cervical cancer screening exist. Low income women, immigrant women, and women living in deprived neighborhoods are less likely to receive sufficient screening, leaving them vulnerable to developing cervical cancer. Strategies like sending reminder letters directly to women to inform them it is time for them to be screened can increase screening in the general population. However, the influence of sending letters to women on cervical cancer screening inequalities in Canada is not well understood. Objective: The aims of this research project are to 1) examine the impact of sending letters to women on screening rates in the general Canadian population, 2) examine the impact of sending letters to women on inequalities in screening in Canada, 3) explore the reasons why women do not participate in screening, and 4) based on the results, engage in targeted dissemination of the research findings with policy-makers. Method: We propose to link several waves of data from the Canadian Community Health Survey (CCHS) with The National Household Survey. Using statistical techniques, we will compare changes in screening rates in Ontario before and after a 2013 campaign was implemented to send letters to women reminding them it is time to be screened, to changes in screening rates in other Canadian provinces where this type of campaign was not instituted. Impact and relevance: This study will fill an important gap in the literature on the influence of reminder letter campaigns on inequalities in cancer screening, cervical and otherwise. Our findings will be transferred to policy-makers and knowledge-users in Ontario, Quebec, and across Canada to help adapt and develop more efficient and equitable evidence-based screening interventions