7. Inviting women to screening programmes
To improve participation in screening programmes of socially disadvantaged women between the ages of 50 and 69, the ECIBC's Guidelines Development Group suggests:
- using a targeted communication strategy (conditional recommendation, low certainty of the evidence)
- not using a tailored communication strategy (conditional recommendation, moderate certainty of the evidence)
- using tailored or targeted communication strategies (conditional recommendation, very low certainty of the evidence).
Inviting socially disadvantaged women to screening: Tailored vs. general communication strategy
Issued on: May 2017
Healthcare question
Should a tailored communication strategy vs. a general communication strategy be used for socially disadvantaged women?
Recommendation
The ECIBC's Guidelines Development Group (GDG) suggests not using a tailored communication strategy to improve participation in organised population-based breast cancer screening programmes of socially disadvantaged women between the ages of 50 and 69.
Recommendation strength
| Conditional recommendation |
| Moderate certainty of the evidence |
Justification
On the basis of the specific tailored communication strategy providing individualised cancer risk considered, the GDG suggests against tailoring interventions for socially disadvantaged women, as some tailored interventions appear to do more harm than good. However, the impact of other types of tailored interventions is unknown.
Monitoring and evaluation
Monitoring and evaluation of tailored communication strategies that differ from that considered in the randomised controlled trial reviewed for this recommendation is suggested to assess the impact of alternative tailored communication interventions.
Research priorities
- Due to the scarcity of evidence in the different approaches to tailoring communication, the GDG suggests research exploring other tailored interventions for this population. There is the need to have a narrower definition of what tailored interventions are.
- The GDG noted that there is incongruity with the research evidence that was found for tailored interventions for communication strategies for socially disadvantaged women. On the basis of the specific tailored communication strategy in the randomised controlled trial reviewed, the GDG suggests against tailoring interventions for socially disadvantaged women, however, the impact of other types of tailored interventions is unknown. Further research examining all interventions targeting or tailoring socially disadvantaged women is suggested.
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