Compliance with mammography screening in Israeli women: the impact of a pre-scheduled appointment and of the letter-style

Isr J Med Sci. 1997 Feb;33(2):103-11.


The objectives of this study were to determine the impact of different personal invitations on screening mammography attendance and to clarify the influence of personal characteristics and health-related attitudes and behaviors on compliance. One thousand and five hundred women, aged 50-74 years, were randomly selected in the city of Haifa. Four letters of invitation were used. Actual mammography performance was validated by a national computerized database. All other data was collected via a telephone interview following the mammography. The overall compliance rate amounted to 45%. The major predictors of compliance were having had a clinical breast examination within the previous year (p = 0.0008), having a health professional recommend routine mammography (p = 0.01) and perceiving mammography as efficient in early detection of breast cancer (p = 0.02). Aggressiveness of message details, or a family physician's or higher authority's signature on the letter had no impact on compliance. A letter of invitation for a routine mammogram at a specific time resulted in an overall rate of compliance 3-fold higher than the baseline. Based on the results of this study. Kupat Holim Clalit decided to implement use of personal invitations for screening mammography to israeli women on a regular basis.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Aged
  • Appointments and Schedules*
  • Correspondence as Topic*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Israel
  • Logistic Models
  • Mammography / psychology*
  • Mass Screening / psychology*
  • Middle Aged
  • Patient Compliance / psychology*
  • Reminder Systems / standards*
  • Surveys and Questionnaires
  • Time Factors