title: Impact of follow up letters on non-attenders for breast screening: a general practice based study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  93 general practices in South West London in 1995-96.
  
  
  METHODS
  Preliminary and final uptake of breast screening.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of General Practice, St George's Hospital Medical School, London, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Majeed
authors.forename: R
authors.initials: R
authors.lastname: Given-Wilson
authors.forename: E
authors.initials: E
authors.lastname: Smith
mesh_terms: D001943:Breast Neoplasms / Q000517:prevention & control*; D005194:Family Practice / Q000379:methods*; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015397:Program Evaluation