Text-message reminders increase uptake of routine breast screening appointments: a randomised controlled trial in a hard-to-reach population

Br J Cancer. 2015 Mar 17;112(6):1005-10. doi: 10.1038/bjc.2015.36.


Background: There is a need for interventions to promote uptake of breast screening throughout Europe.

Methods: We performed a single-blind randomised controlled trial to test whether text-message reminders were effective. Two thousand two hundred and forty women receiving their first breast screening invitation were included in the study and randomly assigned in a 1 : 1 ratio to receive either a normal invitation only (n=1118) or a normal invitation plus a text-message reminder 48 h before their appointment (n=1122).

Findings: In the intention-to-treat analysis, uptake of breast screening was 59.1% among women in the normal invitation group and 64.4% in the text-message reminder group (χ(2)=6.47, odds ratio (OR): 1.26, 95% confidence intervals (CI): 1.05-1.48, P=0.01). Of the 1122 women assigned to the text-message reminder group, only 456 (41%) had a mobile number recorded by their GP and were thereby sent a text. In the per-protocol analysis, uptake by those in the control group who had a mobile number recorded on the GP system was 59.77% and by those in the intervention group who were sent a reminder 71.7% (χ(2)=14.12, OR=1.71, 95% CI=1.29-2.26, P<0.01).

Interpretation: Sending women a text-message reminder before their first routine breast screening appointment significantly increased attendance. This information can be used to allocate resources efficiently to improve uptake without exacerbating social inequalities.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Appointments and Schedules*
  • Breast / pathology*
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / pathology
  • Cell Phone
  • Early Detection of Cancer / methods
  • Europe
  • Female
  • Humans
  • Intention to Treat Analysis / methods
  • Middle Aged
  • Reminder Systems*
  • Single-Blind Method
  • Social Class
  • Text Messaging*