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Characteristics of the women not included in the pregnancy cohort were analysed from letters sent to 1000 women, who had not responded to the primary invitation, inviting them to answer a number of general health questions.
The estimate was calculated assuming 70%% attendance rate by primary invitation, use of Pap-smear as a primary screening test and current national detection rates of CIN lesions among screening participants as baselines [ 1].
In Finland, offering self-sampling to non-attendees after primary invitation (i.e. as a first reminder) increased total attendance by 17%% and the yield of detected moderate or more severe cervical intraepithelial lesions (CIN2+) by 13%% [ 12].
The second study assessed the effect of using self-sampling as a second reminder (i.e. among non-attendees after a primary invitation and a reminder letter) in a non-randomized setting in 31 Finnish municipalities in 2011 2012 [ 14].
The first study was conducted in a setting where original attendance with primary invitation was lower (63%%) and the second one in a setting with higher (73 %) level of attendance than the national average of 70%%.
When self-sampling was offered as a second reminder after two invitation letters (primary invitation and a reminder letter), it increased total attendance by 4%%, CIN2+ yield by 8%%, and yield of severe cervical lesions or cancer (CIN3+) by 9 % [ 14].
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Based on these records, about 5 million primary invitations were sent to the eligible individuals who were living within a reasonable travelling distance from the assessment centres (see Additional file 1: Figure S1).
Here we estimated differences in the program costs of using self-sampling vs. using a reminder letter as a first reminder for non-attendees after primary invitations, and further, what could be the cost of using self-sampling as a second reminder after two invitation letters.
The cost of a primary screening invitation includes the costs of identifying the screening population from the Population Register Centre and cost of the letter itself.
Uptake of faecal occult blood test (FOBT) within 6 months of mailed invitation (primary) and uptake of FOBT or colonoscopy within 6 months of mailed invitation (secondary).
Although expansion will be a primary topic, no invitations are expected to be issued.
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