Recruitment Methods for First-Round Mammographic Screening for Breast Cancer in Lower Silesia

Background. A population-based mammographic screening program can significantly reduce breast cancer mortality. One of the most important factors of well-organized screening is an effective invitation system resulting in a high attendance rate. Objectives. The aim of this study was to assess the effectiveness of invitation methods during the first round of a breast cancer screening program and to compare it in the years 2007 and 2008. Material and Methods. Questionnaire data of 153,807 women 50-69 years of age who were screened during 2007-2008 in the region of Lower Silesia were analyzed. Before mammography they were asked about the invitation method which induced them to participate in the screening examination. The answers were prospectively collected in a computer data base. Results. For 54% of the women their decision was mostly influenced by the invitational letter (2007 vs. 2008: 59% vs. 47.6%), 11% by mass-media (10% vs. 12%), 11.5% by health professionals (9.8% vs. 14%), 2.5% by texting via mobile phone (2.2% vs. 2.7), and 21% by other ways (19% vs. 23.7%), i.e. leaflet, advertising, telephone hot-line, or web-site. The women invited by letter or leaflet were most often screened in high-volume specialized breast care centers. Those invited by media rather chose small services near their homes. In multi-disciplinary institutions, the women were most effectively invited by medical professionals. Conclusions. Communication using invitational letters should be intensified and improved because of the significant reduction in the amount of participants responding to this method. Leaflets, advertising, and media remain effective especially in specialized high-volume breast care centers. The activity of health professionals increases, being the most helpful in multi-disciplinary institutions with mammography units. Texting invitations seems to be insufficient (Adv Clin Exp Med 2009, 18, 6, 609-614).