Unit of Epidemiology - CPO Piemonte, Center for Cancer Prevention, Turin, Italy.
Eur J Public Health. 2012 Jun;22(3):413-8. doi: 10.1093/eurpub/ckr090. Epub 2011 Jul 11.
Several factors can influence access to population breast cancer screening. The aim of the study was to evaluate the impact of different information approaches, women's socio-demographic characteristics and organizational factors on mammography screening uptake.
We selected 5744 women aged 40-45 years who were randomly assigned to be given letters with: (i) a pre-fixed appointment plus standard leaflet (Group 1); (ii) a pre-fixed appointment plus a more comprehensive booklet (Group 2); (iii) point (ii) plus the offer of a counselling session (Group 3); and (iv) an invitation to contact the centre to get information and arrange participation (Group 4).
Ninety-five women were excluded before the invitation and 5649 were randomized. After excluding undelivered letters (n = 41) and women reporting an exclusion criterion following our invitation (n = 248), the final eligible population was 5360 women. Participation rates following the first contact were 36.5, 39.9, 35.8 and 16.5% for Groups 1-4, respectively. The rates increased to 40.9, 43.6, 40.1 and 35.1% after the reminder letters. Women receiving more complete information had a higher uptake (Group 2), although not statistically significant. Differences among the four groups were maintained by controlling the effect of socio-demographic and attendance determinants. Regardless of intervention, participation was higher among married, higher educated, white-collared women, those born in northern Italy, living closer to the screening unit and with a female-collaborative doctor.
Invitation letters with a fixed appointment correlate with a higher attendance rate. Providing women with more information on procedures, risks and benefits of mammography screening does not modify their participation.
有几个因素会影响人群乳腺癌筛查的可及性。本研究的目的是评估不同信息方法、女性社会人口统计学特征和组织因素对乳房 X 线照片筛查参与度的影响。
我们选择了 5744 名年龄在 40-45 岁的女性，将她们随机分为四组，分别接受以下信件：（i）预约固定时间并附有标准传单（第 1 组）；（ii）预约固定时间并附有更全面的手册（第 2 组）；（iii）第（ii）点加提供咨询服务（第 3 组）；和（iv）邀请联系中心获取信息并安排参与（第 4 组）。
在邀请之前，有 95 名女性被排除在外，5649 名女性被随机分组。排除未送达的信件（n=41）和在收到我们的邀请后报告排除标准的女性（n=248）后，最终符合条件的女性人数为 5360 人。第一次联系后的参与率分别为第 1-4 组的 36.5%、39.9%、35.8%和 16.5%。在发出提醒信后，这一比例分别增加至 40.9%、43.6%、40.1%和 35.1%。收到更完整信息的女性参与率更高（第 2 组），尽管差异无统计学意义。在控制社会人口统计学和出席决定因素的影响后，四组之间的差异仍然存在。无论干预措施如何，已婚、受教育程度较高、白领女性、出生在意大利北部、居住在离筛查单位较近且有女性合作医生的女性参与率更高。
附有固定预约的邀请信与更高的出席率相关。为女性提供更多关于乳房 X 线照片筛查程序、风险和益处的信息并不能改变她们的参与度。
