Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2009, vol. 18, nr 6, November-December, p. 609–614

Publication type: original article

Language: English

Recruitment Methods for First−Round Mammographic Screening for Breast Cancer in Lower Silesia

Metodyka rekrutacji na mammografię podczas pierwszej rundy badań przesiewowych raka piersi na Dolnym Śląsku

Bartłomiej Szynglarewicz1,, Rafał Matkowski1,2,, Piotr Kasprzak3,, Małgorzata Strychalska3,, Urszula Staszek1,2,, Krzysztof Szewczyk1,2,, Józef Forgacz1,, Marek Pudełko1,, Jan Kornafel2,

1 2nd Department of Surgical Oncology, Lower Silesian Oncology Center, Wroclaw, Poland

2 Department of Oncology and Gynacecological Oncology Clinic, Wroclaw Medical University, Wroclaw, Poland

3 Breast Imaging and Minimal Invasive Biopsy Department, Lower Silesian Oncology Center, Wroclaw, Poland

Abstract

Background. A population−based mammographic screening program can significantly reduce breast cancer mortality. One of the most important factors of well−organized screening is an effective invitation system resulting in a high attendance rate.
Objectives. The aim of this study was to assess the effectiveness of invitation methods during the first round of a breast cancer screening program and to compare it in the years 2007 and 2008.
Material and Methods. Questionnaire data of 153,807 women 50–69 years of age who were screened during 2007–2008 in the region of Lower Silesia were analyzed. Before mammography they were asked about the invitation method which induced them to participate in the screening examination. The answers were prospectively collected in a computer data base.
Results. For 54% of the women their decision was mostly influenced by the invitational letter (2007 vs. 2008: 59% vs. 47.6%), 11% by mass−media (10% vs. 12%), 11.5% by health professionals (9.8% vs. 14%), 2.5% by texting via mobile phone (2.2% vs. 2.7), and 21% by other ways (19% vs. 23.7%), i.e. leaflet, advertising, telephone hotline, or web−site. The women invited by letter or leaflet were most often screened in high−volume specialized breast care centers. Those invited by media rather chose small services near their homes. In multi−disciplinary institutions, the women were most effectively invited by medical professionals.
Conclusion. Communication using invitational letters should be intensified and improved because of the significant reduction in the amount of participants responding to this method. Leaflets, advertising, and media remain effective especially in specialized high−volume breast care centers. The activity of health professionals increases, being the most helpful in multi−disciplinary institutions with mammography units. Texting invitations seems to be insufficient.

Streszczenie

Wprowadzenie. Badania przesiewowe raka piersi mogą istotnie zmniejszyć umieralność na ten nowotwór pod warunkiem, że programem jest objęty duży odsetek kobiet z docelowej populacji. Skuteczny system rekrutacji jest zatem podstawowym warunkiem prowadzenia badań przesiewowych.
Cel pracy. Analiza różnych metod rekrutacji podczas pierwszej rundy badania przesiewowego oraz porównanie ich skuteczności między pierwszym i drugim rokiem prowadzenia programu.
Materiał i metody. Analizą objęto 153 807 kobiet w wieku 50–69 lat, które wykonały przesiewową mammografię na Dolnym Śląsku podczas pierwszej rundy programu (lata 2007–2008). Przed badaniem pacjentki podawały źródło informacji, które skłoniło je do wzięcia udziału w badaniach przesiewowych. Odpowiedzi w sposób prospektywny gromadzono w komputerowej bazie danych.
Wyniki. Dla 54% kobiet najważniejszym źródłem informacji, na podstawie których podjęły decyzję o poddaniu się przesiewowej mammografii był list zapraszający (2007 vs 2008: 59% vs 47,6%), dla 11% media (10% vs 12%), dla 11.5% personel ochrony zdrowia (9,8% vs 14%), dla 2.5% sms (2,2% vs 2,7), a dla 21% inne metody (19% vs 23,7%): ulotka informacyjna, promocja bezpośrednia, informacyjna linia telefoniczna lub strona internetowa. Kobiety zapraszane za pomocą listów i ulotek najczęściej wykonywały badanie w dużych i wyspecjalizowanych ośrodkach, kobiety zapraszane przez media najchętniej wybierały małe ośrodki blisko miejsca swojego zamieszkania. W wieloprofilowych placówkach dysponujących także pracownią mammografii najskuteczniejsze zaproszenia pochodziły od pracowników ochrony zdrowia.
Wnioski. Należy znacznie zintensyfikować kolportowanie i być może zmodyfikować treść listów wysyłanych przez NFZ ze względu na znaczące zmniejszenie liczby kobiet, które odpowiedziały na zaproszenie. Ulotki, promocja bezpośrednia i media pozostają skutecznym sposobem rekrutacji na badanie przesiewowe raka piersi, szczególnie prowadzone w wyspecjalizowanych ośrodkach o dużej liczbie wykonywanych badań mammograficznych. Zwiększa się rola pracowników ochrony zdrowia, szczególnie w mniej wyspecjalizowanych wieloprofilowych placówkach medycznych. Wydaje się, że wysyłanie zaproszeń przez sms jest wątpliwe.

Key words

breast cancer, mammography, screening, invitation methods

Słowa kluczowe

rak piersi, mammografia, badania przesiewowe, metody rekrutacji

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