The effectiveness of mailed patient reminders on mammography screening: a meta-analysis

Am J Prev Med. 1998 Jan;14(1):64-70. doi: 10.1016/s0749-3797(97)00003-2.


Background: Researchers have tried to increase mammography screening rates by using patient-oriented reminders. This paper compares the effectiveness of mailed patient reminders at increasing mammography screening.

Methods: Sixteen published articles met the inclusion criteria and were included in the meta-analysis. To assess the association between reminders and mammography screening, the Mantel-Haenszel odds ratio (OR) was calculated.

Results: Among U.S. studies in which controls did not receive any type of reminder, women who received reminders were approximately 50% more likely to get a mammogram (OR 1.48; chi(2)MH(1) = 38.27, P < .001). In addition, tailored letters were found to be more effective than generic reminders (OR 1.87; chi(2)MH(1) = 4.70, P < .05). Combining cost and effectiveness data allowed for estimates of cost per woman screened, which ranged from $0.96 to $5.88.

Conclusions: Patient reminders are effective at increasing mammography screening. More research is needed to assess (1) the cost-effectiveness of patient reminders and (2) their effectiveness across race, education, income, and type of insurance.

Publication types

  • Meta-Analysis
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Breast Neoplasms / prevention & control*
  • Costs and Cost Analysis
  • Female
  • Follow-Up Studies
  • Humans
  • Mammography / economics
  • Mammography / statistics & numerical data*
  • Mass Screening / organization & administration*
  • Mass Screening / statistics & numerical data
  • Odds Ratio
  • Patient Compliance
  • Program Development / methods*
  • Randomized Controlled Trials as Topic
  • Reminder Systems / economics
  • Reminder Systems / statistics & numerical data*
  • Sensitivity and Specificity
  • United States