7. Inviting women to screening programmes
For inviting asymptomatic women aged 50 to 69 with an average risk of breast cancer (in whom screening is strongly recommended) to attend organised population-based screening programmes, the ECIBC's Guidelines Development Group (GDG) suggests:
- using a letter followed by an SMS notification (conditional recommendation, high certainty of the evidence)
- using a letter followed by an automated phone call (conditional recommendation, very low certainty of the evidence)
If these strategies are not available, the GDG suggests either:
- an e-mail (conditional recommendation, low certainty of the evidence)
- or an automated phone call alone (conditional recommendation, moderate certainty of the evidence).
Finally, the GDG suggests not using a letter followed by a personalised phone call (conditional recommendation, very low certainty of the evidence).
Inviting women to screening: letter followed by SMS notification vs. letter
Issued on: May 2019
Healthcare question
Should a letter followed by a SMS notification vs. a letter alone be used for inviting asymptomatic women to organised population-based breast cancer screening programmes?
Recommendation
The ECIBC's Guidelines Development Group (GDG) suggests using a letter followed by a SMS notification over a letter alone for inviting asymptomatic women between the ages of 50-69 (in whom screening is strongly recommended) to attend organised population-based breast cancer screening programmes.
Recommendation strength
| Conditional recommendation |
| High certainty of the evidence |
Justification
The GDG made a conditional recommendation for the intervention, based on the moderate costs, the probably increased equity and the judgement that the intervention was probably acceptable to key stakeholders and feasible to implement.
Subgroup considerations
Participation rate was not considered an appropriate outcome for the other age ranges. For women in the age groups, 45-49 and 70-74, outcomes such as confidence and satisfaction of the woman in making an informed decision are crucial and the GDG advises interpretation of this intervention in the context of the recommendations on screening age ranges.
Considerations for implementation and policy making
Access to phone numbers may differ by jurisdiction and that may have impact on feasibility. For instance, in some countries storing of phone numbers is permitted (e.g. through primary care), in others not.
Research priorities
Satisfaction and informed decision making outcomes need to be addressed.
Supporting material
- Organised vs. non-organised screening
- Double vs. single reading in mammograpy screening
- Communication skills training
- Communication with care providers
- Optimal number of mammography readings
- Specialised training
- Risk stratification
- Women aged 40-44: screening vs. no screening
- Women aged 45-49: screening vs. no screening
- Women aged 45-49: annual vs. biennial screening
- Women aged 45-49: annual vs. triennial screening
- Women aged 45-49: triennial vs. biennial screening
- Women aged 50-69: screening vs. no screening
- Women aged 50-69: annual vs. biennial screening
- Women aged 50-69: annual vs. triennial screening
- Women aged 50-69: triennial vs. biennial screening
- Women aged 70-74: screening vs. no screening
- Women aged 70-74: annual vs. biennial screening
- Women aged 70-74: annual vs. triennial screening
- Women aged 70-74: triennial vs. biennial screening
- Single reading with AI support
- Double reading with AI support
- Screening with tomosynthesis vs. mammography
- Screening with tomosynthesis plus mammography vs. mammography alone
- Tailored screening with tomosynthesis
- Screening with tomosynthesis vs. mammography
- Tailored screening with MRI
- Tailored screening with ABUS
- Tailored screening with HHUS
- Informing about benefits and harms: use of decision aids
- Informing about benefits and harms: Numbers in addition to plain language
- Informing about benefits and harms: Infographics in addition to plain language
- Informing about benefits and harms: Story telling in addition to plain language
- Inviting women to screening: letter vs. no invitation
- Inviting socially disadvantaged women to screening: Targeted vs. general communication strategy
- Inviting women with an intellectual disability to screening
- Inviting non-native speakers to screening
- Inviting socially disadvantaged women to screening: Tailored vs. targeted communication strategy
- Inviting socially disadvantaged women to screening: Tailored vs. general communication strategy
- Inviting women to subsequent screening rounds: letter vs. no invitation
- Inviting women to screening: letter with fixed appointment vs. letter
- Inviting women to subsequent screening rounds: letter with fixed appointment vs. lett
- Inviting women to screening: letter with GP signature vs. letter
- Inviting women to subsequent screening rounds: letter with GP signature vs. letter
- Inviting women to screening: letter followed by phone call vs. letter
- Inviting women to subsequent screening rounds: letter followed by phone call vs. letter
- Inviting women to screening: letter followed by phone call vs. no invitation
- Inviting women to screening: letter followed by written reminder vs. letter
- Inviting women to subsequent screening rounds: letter followed by written reminder vs. letter
- Inviting women to screening: letter followed by face to face intervention vs. letter
- Inviting women to subsequent screening rounds: letter followed by face to face intervention vs. letter
- Inviting women to screening: e-mail vs. letter
- Inviting women to screening: automated telephone call vs. letter
- Inviting women to screening: letter followed by automated telephone call vs. letter
- Inviting women to screening: letter followed by SMS notification vs. letter
- Inviting women to screening: letter followed by personalised phone call vs. automated phone call
- Negative result: letter vs. nothing
- Further assessment: letter followed by a phone call
- Further assessment: timing of results
- Negative result: phone call vs. letter
- Negative result: face to face interview vs. letter
- Negative result: timing of results
- Tomosynthesis vs. assessment mammography
- Obtaining a sample from a suspicious breast lesion
- Type of guidance for needle core biopsy
- Stage 1: conventional exams
- Stage 1: PET-CT exams
- Stage 2: conventional exams
- Stage 2: PET-CT exams
- Stage 3: conventional exams
- Stage 3: PET-CT exams
- Stage 3: conventional exams plus PET-CT
- Use of clip-marking
- Additional magnetic resonance imaging
- Contrast-enhanced mammography
- Threshold of oestrogen for endocrine therapy
- Threshold of progesterone for endocrine therapy
- Multigene testing: 70 gene signature at low clinical risk
- Multigene testing: 70 gene signature at high clinical risk
- Multigene testing: 21 gene recurrence score
- Organising screening programmes
- Risk stratification
- Women 40-44
- Women 45-49
- Women 50-69
- Women 70-74
- Women with high breast density
- General Population
- Vulnerable Population
- Informing women about their results
- Women recalled due to suspicious lesions
- Obtaining a sample from a suspicious lesion
- Type of guidance for needle core biopsy
- Stage 1
- Stage 2
- Stage 3
- Planning surgical treatment
- Hormone receptor to guide use of endocrine therapy
- Multigene testing to guide use of chemotherapy