The impact of reminder letters on attendance for breast cancer screening.

Objective: The aims of this investigation was to analyse the response to second and third postal invitations from a group of patients previously invited for mammographic screening and to identify any demographic differences between responders and non-responders.

Subjects: The subjects were females aged 50-64 yr resident in 6 adjacent District Electoral Divisions (DEDs) in North Dublin where screening had not been carried out prior to the study.

Method: Non-responders to an invitation for screening were re-invited by computer-generated letter to attend for screening 6 weeks after issue of the first invitation and a final invitation was issued at 12 weeks. Data sources used for the project register were the Eastern Health Board General Medical Services data base (GMS), Voluntary Health Insurance Board (VHI) data and self-registration.

Results: There were 1,310 females in the target age group who were eligible for screening. The response rate to the first invitation was 60.7 per cent. Issue of second invitation increased the response rate by 17.9 per cent. A third invitation increased the response rate by a further 7.6 per cent. Those with private medical insurance were more likely to respond to the first and third invitations. The was no difference in response rate to the second invitation for those with and without private insurance. Women aged 55-64 were more likely to respond to first, second or third invitations than those aged less than 55 yr.

Conclusions: Issue of second mailed invitations to women in the target age for mammography screening is cost-effective and should be incorporated into routine policy. Response to third invitations is not cost-effective.