Elfström KM, et al. - Given the significance of high levels of screening participation for ideal prevention of cervical cancer, four strategies with regard to participation were evaluated in this randomized health services study. They randomized 8,000 long-term non-attenders to either 1) a human papillomavirus (HPV) self-sampling kit sent directly 2) an invitation to order a HPV self-sampling kit using a new open source eHealth web application 3) an invitation to call a coordinating midwife with questions and concerns; or 4) the standard annual renewed invitation letter with pre-booked appointment time (normal practice). Overall participation, by arm, was: 1) 18.7%; 2) 10.7%; 3) 1.9%; and 4) 1.7%. The findings favor sending or offering the opportunity to order self-sampling kits to women with a history of not being screened to further improve participation in an organized screening program.