Evaluation of a Service Intervention to Improve Uptake of Breast Cancer Screening in a London Borough with Many Hard to Reach Communities

Vincent Icheku,Nike Arowobusoye

doi:10.13189/ujph.2015.030207

Abstract

Uptake of breast cancer screening is lowest in areas of London with many hard to reach communities. This report evaluates two interventions to improve uptake of breast cancer screening in the Royal London Borough of Greenwich with many hard to reach communities. The interventions involved splitting 2,004 women eligible for screening into two groups. Group 1 who were sent letter only invites has a target group (n=1,452) and eligible women screened were (n=878). Whilst, group 2 who were sent letter invites combined with Short Message service (SMS) reminder has a target group (n=552) and eligible women screened were (n=376). The result shows a significant difference in attendance rates between the two invitation methods. The screening uptake by the women who received invitation letter only had an attendance rate of 60 percent (table1). The screening uptake by the women who received invitation letter and SMS reminder was 68 percent (table 2). This amounts to 8 percent differential rate, which translates to an additional 44 women who were screened, as a direct result of receiving an SMS reminder. Applying the achieved result to the Letter Only group indicates that an additional 12 women would theoretically have been screened if the 'Letter only' invites were also sent with SMS reminder. An overall 2.54 percentage point increase in screening outcome was achieved when compared the uptake in the months of the project (July to Dec 2011) with the uptake in similar months in 2010. Finally, the results prove that intervention by letter invite combined with SMS reminder is the most effective method of improving uptake of breast cancer screening in the borough with many hard to reach communities.

Highlights

Breast cancer is a significant cause of mortality and morbidity amongst women and a major public health problem in the United Kingdom (UK)
[6] This view corroborates a report that London population is characterised by higher rates of mobility, ethnic diversity, young people and an increased rate of social deprivation, which has had a negative impact on breast cancer screening uptake. [7]
[22] Table1 shows the individual practice’s breast cancer screening target who were sent letter only invitation. It shows the number of women who presented themselves for screening on the basis of the invitation letter and percentage screening uptake

Summary

Introduction

Breast cancer is a significant cause of mortality and morbidity amongst women and a major public health problem in the United Kingdom (UK). The survival rate for breast cancer was around 50 per cent 40 years ago. This means that more women than ever are surviving breast cancer mainly due to early detection through screening. [4] The National Health Service (NHS) Breast Screening Programme (NHSBSP) was established in March 1987 and began inviting women in 1988. [4] London generally is characterised by low uptake of breast cancer screening. [6] This view corroborates a report that London population is characterised by higher rates of mobility, ethnic diversity, young people and an increased rate of social deprivation, which has had a negative impact on breast cancer screening uptake. The low uptake in London is thought to be related to both socio-economic deprivation and ethnicity. [6] This view corroborates a report that London population is characterised by higher rates of mobility, ethnic diversity, young people and an increased rate of social deprivation, which has had a negative impact on breast cancer screening uptake. [7]

Methods

Results

Discussion

Conclusion