Increasing cervical cancer screening rates

  • Two women die from cervical cancer every three days in Australia [1]

  • Regular Pap tests can reduce the risk of cervical cancer by 96 per cent [2]

  • Women aged 18 to 69 are recommended to get a Pap test every two years

The Cancer Institute NSW sends out 368,000 letters to women each year, to remind them it has been 27 months since their last Pap test. However, less than 30 per cent of women make an appointment after receiving the reminder letter.

The Cancer Institute NSW wanted to see if behavioural insights could be used to improve the 27 month reminder letter. They partnered with us to explore ways to do this. 

Redesigning the reminder letter

With the Cancer Institute NSW we developed four new versions of the reminder letter. All of the four letters:

  • highlighted the benefits of getting a Pap test

  • presented information in a clear and simple way

Three letters also included one of the following: 

  • additional messages about how Pap tests reduced cervical cancer risks and the short time that it took to get tested

  • a case study of a woman who beat cervical cancer through early detection

  • a section where women could write down the details of their appointment and put it on the fridge to remind them

We conducted a randomised controlled trial over three months where women received one of the five versions of the reminder letter, the four new versions and the original one. At the end of the three months, the team assessed which letter was most successful.

Trial results

All of the new reminder letters were more effective at getting women to have a Pap test than the original one. The letter with the section for women to write down the details of their appointment had the largest response rate. By simply changing a reminder letter 7,500 more women a year will get a potentially lifesaving Pap test.

Following the trial, the Cancer Institute NSW changed their 27 month reminder letter to incorporate the findings of the trial.

Read more in Spotlight on Health Results: Behavioural Insights Short Report (PDF, 507 KB)


  1. Cancer Australia (2016). Retrieved from: Cervical Cancer Statistics.
  2. Cancer Institute NSW (2016). Retrieved from: Cervical Screening NSW.