Strategies for increasing mammography screening in primary care in Chile: results of a randomized clinical trial

Cancer Epidemiol Biomarkers Prev. 2010 Sep;19(9):2254-61. doi: 10.1158/1055-9965.EPI-10-0313.

Abstract

Background: Breast cancer is the cancer with the highest incidence among women in Chile and in many Latin American countries. Breast cancer screening has very low compliance among Chilean women.

Methods: We compared the effects on mammography screening rates of standard care, of a low-intensity intervention based on mail contact, and of a high-intensity intervention based on mail plus telephone or personal contact. A random sample of 500 women with the age of 50 to 70 years registered at a community clinic in Santiago who had not had a mammogram in the past 2 years were randomly assigned to one of the three intervention groups. Six months after randomization, participants were re-evaluated for their compliance with mammography screening. The outcome was measured by self-report and by electronic clinical records. An intention to treat model was used to analyze the results.

Results: Between 92% and 93% of participants completed the study. Based on electronic records, mammography screening rates increased significantly from 6% in the control group to 51.8% in the low-intensity group and 70.1% in the high-intensity group. About 14% of participants in each group received opportunistic advice, 100% of participants in the low- and high-intensity groups received the mail contact, and 50% in the high-intensity group received a telephone or personal contact.

Conclusion: A primary care intervention based on mail or brief personal contact could significantly improve mammogram screening rates.

Impact: A relatively simple intervention could have a strong impact in breast cancer prevention in underserved communities.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / prevention & control
  • Chile / epidemiology
  • Early Detection of Cancer / methods*
  • Female
  • Humans
  • Mammography
  • Middle Aged