Impact of follow up letters on non-attenders for breast screening: a general practice based study

To determine the effectiveness of follow up letters to non-attenders for screening on the breast screening uptake in practices with a low preliminary uptake of screening.

Observational study of two groups of general practices. In 40 of these practices, the preliminary uptake of screening was less than 60%. These 40 practices were offered help from a clerical officer to check names and addresses of non-attenders, and to send non-attenders a reminder letter.

93 general practices in South West London in 1995-96.

Preliminary and final uptake of breast screening.

Breast screening uptake increased by an average of 4.6% in the 40 intervention practices compared with 1.6% in the 53 control practices (difference 3.0%, P < 0.0001). However, the absolute increase in the uptake of screening in the intervention group was small (from 53.8% to 58.5%). The marginal cost for each additional women screened was Pounds 7 (compared with an average cost for each women screened of Pounds 27).

Reminder letters can help increase the uptake of screening in practices with a low preliminary uptake of breast screening. However, they have a limited role in improving the uptake of breast screening in inner city areas, and other methods of increasing uptake therefore need to be developed and evaluated.