Exploring How Small Changes Can Increase Participation in Cancer Screening Programs

Author
Labs of Latvia

April 10, 2026

Cancer is one of the leading causes of death worldwide, and early detection is often crucial. For this reason, cancer screening programs play a vital role as one of the most important tools in disease prevention. Although screening programs are available, participation rates in many places remain insufficient, which negatively affects public health and leads to significant socioeconomic consequences.

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Līga Pūce, doctoral student in the joint study program “Economics and Entrepreneurship” of Ventspils University of Applied Sciences, Vidzeme University of Applied Sciences, and RTU Rēzekne Publicity image
How can people be encouraged to participate in cancer screening? Can seemingly small changes in invitations, the way information is presented, or the organization of appointment booking lead to higher response rates?

These questions have been explored by Līga Pūce, a doctoral student in the joint study program “Economics and Entrepreneurship” run by Ventspils University of Applied Sciences, Vidzeme University of Applied Sciences, and RTU Rēzekne. Together with one of her PhD supervisors, Associate Professor Vineta Silkāne, she has published a scientific article entitled “Pavirzīšanas metožu izmantošana vēža skrīninga aptveres palielināšanai: empīrisko pētījumu pārskats” (Nudging to Increase the Uptake of Cancer Screening: A Scoping Review of Empirical Studies). The article has been published in the international academic journal Taylor & Francis.

“This scientific article can serve as a foundation both for further academic research and for the development of evidence-based public health policy solutions. At the same time, it is clear that additional research is needed in this field to more precisely determine which approaches are most effective in different situations and for different target groups,” notes L. Pūce.

At the core of the study are nudging methods from behavioral economics—small, targeted changes in the choice environment that do not restrict an individual’s freedom of choice but can help make decisions that are beneficial for both the individual and society. In the context of cancer screening, nudging in practice may include reminder text messages, changes in the wording of invitations to more clearly highlight benefits or risks, involving healthcare professionals as trusted sources of information, or simplifying the appointment-booking process. Such approaches are particularly important in promoting cancer screening, as non-participation is often not due to unwillingness but rather everyday factors such as overly complex information, uncertainty about next steps, procrastination, forgetfulness, or difficulties in scheduling an appointment.

The scientific article analyzes empirical studies published between 2008 and 2025 that assessed the effectiveness of various nudging interventions in increasing cancer screening uptake. The results show that such approaches can positively influence participation in screening, although their impact varies significantly across studies—from statistically insignificant changes to increases of several tens of percentage points. The largest observed increase in screening uptake reached as high as 65.1%.

The findings indicate that changes in invitation wording and reminders can lead to increases of several percentage points in screening coverage. However, particularly promising were solutions that reduced the effort required to book an examination and offered specific appointment times.

Greater effectiveness was also more frequently observed when healthcare professionals were involved and when the interventions were more resource-intensive.

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