Effect size and cost-effectiveness estimates of breast and cervical cancer screening reminders by population size through complete enumeration of Japanese local municipalities

BMC Public Health

Toru Takebayashi³  Hideo Tanaka¹  Tomonori Okamura³  Yuji Nishiwaki²  Shigekazu Komoto³ 

[1] Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi 464-8681, Japan;Department of Environmental and Occupational Health, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan;Department of Preventive Medicine and Public Health, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan

关键词: Cervical cancer;    Breast cancer;    Cost effectiveness;    Reminder systems;    Cancer screening;   

Others  :  1161340
DOI  :  10.1186/1471-2458-14-43

 received in 2013-03-03, accepted in 2014-01-09,  发布年份 2014

【 摘 要 】

Background

Client reminders are known to increase cancer screening attendance rates. However, there are significant costs associated with them, and their effect by population size is unknown.

Methods

In 2007 and 2008, the Japanese Government surveyed breast and cervical cancer screening in every municipality in Japan. From the results, we selected all 1,464 municipalities that carried out both screening types. We examined whether changes in screening attendance rates between 2007 and 2008 were associated with client reminders, number of public health nurses per 100,000 population, financial strength index, and 2007 attendance rates for different population sizes. We then calculated cost-effectiveness estimates of client reminders by population size and screening type.

Results

Client reminders were associated with increased attendance rates in populations <100,000. For populations of 50,000–100,000, there was a 2.76% increase in breast cancer screening (95% CI: 0.41, 5.11), and a 2.25% increase in cervical cancer screening (95% CI: 0.89, 3.61). The incremental cost per additional attendance was higher in populations <50,000 than in populations of 50,000–100,000 (breast, $100 versus $54; cervical, $149 versus $67 respectively).

Conclusions

Client reminders for breast and cervical cancer screening increased attendance rates in smaller municipalities in Japan.

【 授权许可】

   
2014 Komoto et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Task Force on Community Preventive Services: Recommendations for client- and provider-directed interventions to increase breast, cervical, and colorectal cancer screening. Am J Prev Med 2008, 35(1S):S21-S25.
• [2]Cancer Research UK. Available from URL: http://aboutus.cancerresearchuk.org webcite [accessed January 11, 2014]
• [3]The foundation for promotion of cancer research Japan: Cancer statistics in Japan 2010. 2010. Available from http://ganjoho.jp/pro/statistics/en/backnumber/2010_en.html webcite [Accessed January 11, 2014]
• [4]Vogt TM, Glass A, Glasgow RE, La Chance PA, Lichtenstein E: The safety net: a cost-effective approach to improving breast and cervical cancer screening. J Womens Health 2003, 12:789-798.
• [5]Tseng DS, Cox E, Plane MB, Hla KM: Efficacy of patient letter reminders on cervical cancer screening: a meta-analysis. J Gen Intern Med 2001, 16:563-568.
• [6]Wagner T: The effectiveness of mailed client reminders on mammography screenings: a meta-analysis. Am J Prev Med 1998, 14(1):64-70.
• [7]Ministry of Health, Labour and Welfare Japan: Comprehensive Survey of Living Conditions 2010. 2011. Available from http://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa10/index.html webcite (in Japanese). [Accessed January 11, 2014]
• [8]Baron RC, Rimer BK, Coates RJ, et al.: Client-directed interventions to increase community access to breast, cervical, and colorectal cancer screening: a systematic review. Am J Prev Med 2008, 35(1S):S56-S66.
• [9]Hogg W, Bass M, Calonge N, Crouch H: Randomized controlled study of customized preventive medicine reminder letters in a community practice. Can Fam Physician 1998, 44:81-88.
• [10]Saywell RM Jr, Champion VL, Zollinger TW, et al.: The cost effectiveness of 5 interventions to increase mammography adherence in a managed care population. Am J Manag Care 2003, 9:33-44.
• [11]Johnston GM, Boyd CJ, MacIsaac MA, Rhodes JW, Grimshaw RN: Effectiveness of letters to Cape Breton women who have not had a recent Pap smear. Chron Dis Can 2003, 24:49-56.
• [12]Richards SH, Bankhead C, Peters TJ, et al.: Cluster randomised controlled trial comparing the effectiveness and cost-effectiveness of two primary care interventions aimed at improving attendance for breast screening. J Med Screen 2001, 8:91-98.
• [13]West DS, Greene P, Pulley L, et al.: Stepped-care, community clinic interventions to promote mammography use among low-income rural African American women. Health Educ Behav 2004, 31(Suppl 4):29S-44S.
• [14]Lantz P, Stencil D, Lippert M, Beversdorf S, Jaros L, Remington P: Breast and cervical cancer screening in a low-income managed care sample: the efficacy of physician letters and phone calls. Am J Public Health 1995, 85:834-836.
• [15]Okamura T, et al.: Factors relate to participation in medical checkups in a rural community an analysis including social network scores. Nihon Koshu Eisei Zasshi 1999, 46(8):616-623.
• [16]Ministry of Health, Labour and Welfare Japan: Cancer screening implementation survey in prefectures and municipalities 2008. 2009.
• [17]Ministry of Health, Labour and Welfare Japan: Regarding the implementation of cancer screening in municipalities 2009. 2010.
• [18]Ministry of Health, Labour and Welfare Japan: Regional health and geriatric health services project report 2007. 2009. Available from http://www.mhlw.go.jp/toukei/saikin/hw/c-hoken/07/index.html webcite (in Japanese). [Accessed January 11, 2014]
• [19]Ministry of Health, Labour and Welfare Japan: Regional health and health promotion business report 2008. 2010. Available from http://www.mhlw.go.jp/toukei/saikin/hw/c-hoken/08/index.html webcite (in Japanese). [Accessed January 11, 2014]
• [20]Committee on the assessment of the cancer screening project, Ministry of Health, Labour and Welfare Japan: Regarding the nature of cancer screening project assessments in our country in the future 2008. 2008. Available from http://www.mhlw.go.jp/shingi/2008/03/dl/s0301-4c.pdf webcite (in Japanese). [Accessed January 11, 2014].
• [21]Ministry of Internal Affairs and Communications Japan: Financial capability index 2007. 2008. Available from http://www.soumu.go.jp/iken/zaisei/H19_chiho.html webcite (in Japanese). [Accessed January 11, 2014].
• [22]Ministry of Internal Affairs and Communications Japan: Financial capability index 2008. 2009. Available from http://www.soumu.go.jp/iken/zaisei/H20_chiho.html webcite (in Japanese). [Accessed January 11, 2014].