Most active recruitment strategies for breast cancer screening programs examined in this review were more effective than no intervention. Combinations of effective interventions can have an important effect. Some costly strategies, as a home visit and a letter of invitation to multiple screening examinations plus educational material, were not effective. Further reviews comparing the effective interventions and studies that include cost-effectiveness, women's satisfaction and equity issues are needed.
Does telephone contact with a physician's office staff improve mammogram screening rates?
Mammography is an important screening tool for the early detection of breast cancer. However, mammogram screening rates are low, despite interventions to improve them. We investigated two methods to improve mammogram screening and compared mammogram rates among women who received these interventions to mammogram screening rates in a control group. We also investigated the costs involved in these interventions.
                We studied mammogram screening rates of three randomized groups of women ages 50 and older from the Deighton Family Practice Center in Southfield, Mich. All women had had a mammogram 1 year previously and were due for another mammogram. Our control group (n = 110) received no intervention. The second group of women (n = 102) received a reminder letter from the radiology department. The third group (n = 86) received a reminder letter followed by a phone call from the physician's office staff if no mammogram had been obtained within 8 weeks after the due date for the mammogram. All three groups were monitored for 14 weeks after the due date to determine mammogram screening rates in each group.
                A mammogram was obtained by 33% of women in group 1, 37% of women in group 2, and 57% of women in group 3. The mammogram screening rate of the third group was significantly greater than in the first two groups. In the third group, the additional cost added by the phone call intervention was $9 per mammogram obtained.
                Mammogram screening rates are increased when patients are contacted by both a reminder letter and a phone call.