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Half of all cases of cervical cancer in the UK are diagnosed in women who aren’t up to date in their screening. But the numbers of those turning up for screening have been falling since 2005, and covid has caused further disruption. The NHS has trialled posting DIY human papillomavirus (HPV) testing kits directly to “non responders,” and the question is whether it would be a good strategy for everyone whose screening is due. This study of over 31 000 women aged 30-64 years who were due for screening randomly allocated them to usual care (reminders to patients and alerts on the health record), education (usual care and a leaflet), direct mail (education and a DIY kit), or opt-in (education and the option to be sent a kit on request). Direct mailing a DIY kit was a success in boosting response rates among the screening-compliant women (whose screening was due in the next three months) compared with education or being offered the chance to opt in (61.7% v 47.6% v 51.1%). Direct m

United kingdomAnn robinsonIntern medEnglj med