Abstract
The effectiveness of a genetics-based public health screening programs depend on the successful recruitment of subjects who qualify for intensified screening by virtue of a positive genetic test. Herein we compare the effectiveness of a mailed invitation and follow-up phone call for non-responding subjects and an initial invitation by telephone addressed to male BRCA1 mutation carriers for prostate screening.The final participation rate was 75% (42 of 56) for men who were initially contacted by mail (and follow-up phone call) and 81% (30 of 37) for men who were initially contacted by telephone. Among the men who were initially contacted by mail, it was necessary to telephone 54% of these patients (30 of 56).After a calculation of the cost-effectiveness related to these results, we conclude that if the costs of the phone call were to exceed the costs of the letter by 2.5 times or more, then savings would be arranged by initiating contact with a mailed invitation.
Highlights
Mutations in BRCA1 and BRCA2 confer high risks of breast and ovarian cancer in women [1,2,3,4]
Men who carry a mutation in these genes are at increased risk of prostate cancer [5,6,7] Extensive population screenings for prostate cancer are of limited cost-effectiveness, if they are addressed to high risk groups of patients only, the cost-effectiveness seem to be satisfactory, and BRCA1 and BRCA2 carriers may benefit from cancer surveillance using PSA and rectal examination
The success of a genetic-based public health screening program depends on the efficient recruitment of subjects who qualify for intensified screening by virtue of a positive genetic test
Summary
Mutations in BRCA1 and BRCA2 confer high risks of breast and ovarian cancer in women [1,2,3,4]. Men who carry a mutation in these genes are at increased risk of prostate cancer [5,6,7] Extensive population screenings for prostate cancer are of limited cost-effectiveness, if they are addressed to high risk groups of patients only, the cost-effectiveness seem to be satisfactory, and BRCA1 and BRCA2 carriers may benefit from cancer surveillance using PSA and rectal examination. There are several methods by which healthcare professionals might encourage patients to participate in enhanced screening programs. The passive approach depends on public awareness the potential participant is made aware of (that screening is available) and approaches the screening center on their own volition or upon the recommendation of their physician; in this case, recruitment is enhanced by media coverage, as well. There are no studies which evaluate the effectiveness of various recruitment methods for prostate screening among male BRCA1 mutation carriers. We compare the effectiveness of two approaches: 1) a mailed invitation and follow-up telephone call for patients who did not respond and 2) an initial invitation by telephone
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