Two different interventions did not significantly increase regular mammography screening, according to a large randomized study published in the Journal of the National Cancer Institute.

Behavioral interventions, such as personalized mailings, have been reported to increase one-time cancer screening. However, few studies have examined the impact of behavioral interventions on regular or on-going participation in screening exams.

Sally Vernon, Ph.D., of the University of Texas School of Public Health in Houston and colleagues assigned 5,500 female veterans to one of three interventions designed to encourage annual mammograms: a baseline survey plus a targeted mailing; a baseline survey plus a targeted mailing that was tailored to individual participants; or the baseline survey alone. The investigators then looked to see how many women in each group had completed two mammograms as recommended during the three-year follow-up period.

Neither the targeted mailing nor the targeted and tailored mailing was associated with a statistically significant increase in the percentage of women who had regular mammograms compared to the survey-only group.

Noting that two other trials have recently reported similar findings, the authors write, “Collectively, these findings and ours provide little support for an additional benefit of using tailored interventions, either mailed or by telephone, to increase regular mammography screening.”

In an accompanying paper by Deborah del Junco, Ph.D., of the University of Texas Health Science Center in Houston and colleagues, the researchers report that the results of the intervention trial are likely to be internally valid and applicable to the larger population. They assessed the validity of the trial by including two additional control groups in the study design and by comparing the characteristics of study participants with those of nonparticipants. The investigators found that the baseline survey by itself did not influence subsequent mammography screening rates. In addition, they found that mammography rates actually decreased in the final study year in the veteran population.

“Similar rates of mammography coverage and compliance in the US female population and the decline reported for the US female population between 2000 and 2005 lend additional support to the generalizability of our results,” the authors write.

SOURCE:
Journal of the National Cancer Institute, February 26, 2008