title: A randomised trial of the effect of postal reminders on attendance for breast screening.
abstract: BACKGROUND
  Some women make an informed choice not to attend breast screening, whereas others may have forgotten about the appointment. We report on a randomised trial that investigates whether a reminder letter affects attendance.
  
  
  METHODS
  Women scheduled for a breast screening appointment were randomised to either receive a reminder letter a few days before their breast screening appointment in addition to the standard invitation letter (intervention) or not (control). The primary outcome was attendance within 30 days of the first offered appointment. Secondary outcomes were attendance within 90 and 180 days.
  
  
  RESULTS
  In all, 11,383 (49.9%) women were randomised to the intervention and 11,445 (50.1%) to the control. In the intervention arm, 7759 (68.2%) attended within 30 days of the first offered appointment compared with 7349 (64.2%) in the control arm. This difference was significant (P<0.001). The odds ratio (OR) (95% confidence interval) for the primary end point was 1.19 (1.13-1.26). This was not significantly affected by age, socioeconomic status or type of screen (prevalent or incident). Secondary endpoint analyses supported these results. Results did differ, however, between the different centres studied.
  
  
  CONCLUSIONS
  This study found that postal reminders increase breast screening uptake, and could be practicable to implement in the NHS Breast Screening Programme.
authors.affiliation: Centre for Cancer Prevention, Wolfson Institute for Cancer Prevention, Charterhouse Square, London EC1M 6BQ, UK.
authors.forename: Prue C
authors.initials: PC
authors.lastname: Allgood
authors.affiliation: Nightingale Centre and Genesis Prevention Centre, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester, M23 9QZ, UK.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Maxwell
authors.affiliation: Peel and Shriek Consulting, 182 Highbury Hill, London, N5 1AU, UK.
authors.forename: Sue
authors.initials: S
authors.lastname: Hudson
authors.affiliation: Centre for Cancer Prevention, Wolfson Institute for Cancer Prevention, Charterhouse Square, London EC1M 6BQ, UK.
authors.forename: Judith
authors.initials: J
authors.lastname: Offman
authors.affiliation: Bolton Hospital NHS Foundation Trust, Minerva Road, Farnworth, Greater Manchester, BL4 0JR, UK.
authors.forename: Gillian
authors.initials: G
authors.lastname: Hutchison
authors.affiliation: Royal Liverpool University Hospital, Prescot Street, Liverpool, Merseyside, L7 8XP, UK.
authors.forename: Cathryn
authors.initials: C
authors.lastname: Beattie
authors.affiliation: Wrightington, Wigan and Leigh NHS Foundation Trust, Appley Bridge, Wigan, Lancashire, WN6 9EP, UK.
authors.forename: Raquel
authors.initials: R
authors.lastname: Tuano-Donnelly
authors.affiliation: Theorize Ltd, 134 Slade Lane, Levenshulme, Manchester, M19 2AQ, UK.
authors.forename: Anthony
authors.initials: A
authors.lastname: Threlfall
authors.affiliation: Wrightington, Wigan and Leigh NHS Foundation Trust, Appley Bridge, Wigan, Lancashire, WN6 9EP, UK.
authors.forename: Tina
authors.initials: T
authors.lastname: Summersgill
authors.affiliation: Royal Liverpool University Hospital, Prescot Street, Liverpool, Merseyside, L7 8XP, UK.
authors.forename: Lesley
authors.initials: L
authors.lastname: Bellis
authors.affiliation: Bolton Hospital NHS Foundation Trust, Minerva Road, Farnworth, Greater Manchester, BL4 0JR, UK.
authors.forename: Collette
authors.initials: C
authors.lastname: Robinson
authors.affiliation: Bolton Hospital NHS Foundation Trust, Minerva Road, Farnworth, Greater Manchester, BL4 0JR, UK.
authors.forename: Samantha
authors.initials: S
authors.lastname: Heaton
authors.affiliation: Visiting Professor in Cancer Screening, University of Oxford, Cancer Epidemiology Unit, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK.
authors.forename: Julietta
authors.initials: J
authors.lastname: Patnick
authors.affiliation: Centre for Cancer Prevention, Wolfson Institute for Cancer Prevention, Charterhouse Square, London EC1M 6BQ, UK.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Duffy
mesh_terms: D000367:Age Factors; D000368:Aged; D001071:Appointments and Schedules; D001943:Breast Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D017010:Reminder Systems; D013222:State Medicine; D006113:United Kingdom