3. Results
mental illness, blindness, intellectual disability, telephone/SMS, menorrhagia, trauma
ENDOMETRIAL CANCER, BLINDNESS, CERVICAL CANCER, HSIL, MENORRHAGIA
Two hundred and fifty-six current clients aged between 25 and 74 who were due for cervical screening were included. Eight women were excluded due to previous hysterectomies or current referrals.The age range of participants was 25–74 years, with a median age of 43 years (letter arm 44 years, telephone/SMS arm 40.5 years). All but two women identified as Aboriginal and/or Torres Strait Islander, with those who were not Aboriginal or Torres Strait Islander both in the letter arm. Non-Aboriginal family members of Aboriginal clients were routinely included in service data collection. Clients had previously received between 0 and 12 reminders for cervical screening (via various methods, including letters, phone calls, SMS, or opportunistic reminder). Of the participants, 120 were randomised by letter and 136 to phone call/SMS. Fifteen women (12.5%) attended CST within 3 months following a letter, and 24 women (17.6%) after a phone call/SMS reminder; while numerically more women responded to SMS, this difference was not significant (Eight women in the letter arm responded after the first reminder, and others took further reminders to present. Only one woman in the letter arm booked and did not attend an appointment. Twenty women in the telephone/SMS groups responded after the first reminder and completed CST, with a further 10 booking in but not attending. All of those who did not attend were given additional reminders to book.There were a range of reasons for not attending screening noted by clinic staff. One woman had had a cervical cancer screening test performed elsewhere in the period between contact with the Register and a reminder letter being received. One woman with intellectual disability and blindness had no telephone, and no street address. One woman had a lengthy intensive care unit admission during the study period. One had a hysterectomy for menorrhagia during the study period, and another woman was referred to a gynaecologist for symptoms suggestive of endometrial cancer. Two had moved to residential aged care and had new medical providers. Four others had moved, and street addresses or phone numbers were incorrect. An additional four women were homeless and had no street address or phone. Staff noted that many women who did not attend had serious mental illness or a history of trauma. Two women were not contactable as they were incarcerated. One person, unbeknownst to the team, was deceased at the commencement of the study, and another woman passed away during the study.Three clients actively declined CST, including one client (letter arm) who had HSIL in the past (with clear CST since HSIL diagnosis) who actively declined CST follow-up, despite lengthy counselling. Reminders continued after the intervention period as part of routine clinical activities. Two women in the phone call/SMS arm actively declined CST. 