Cost-effectiveness of a tailored intervention designed to increase breast cancer screening among a non-adherent population: a randomized controlled trial

BMC Public Health

Yosikazu Nakamura⁴  Daisuke Shibuya⁶  Aiko Seki⁵  Kazuhiro Harada¹  Akio Yonekura⁷  Jun Fukuyoshi⁷  Hiroshi Saito³  Kei Hirai²  Yoshiki Ishikawa⁴ 

[1]Faculty of Sport Sciences, Waseda University, Tokyo, Japan

[2]Center of the Study for Communication Design & Support Office for Large-scale Education and Research Projects, Osaka University, Osaka, Japan

[3]Screening Assessment & Management Division, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

[4]Department of Public Health, Jichi Medical University, Shimotsuke, Tochigi, Japan

[5]Faculty of Human Sciences, Osaka University, Osaka, Japan

[6]Cancer Detection Center, Miyagi Cancer Society, Miyagi, Japan

[7]Cancer Scan, Tokyo, Japan

关键词: Non-adherent population;    Cost-effectiveness;    Cancer worry;    Tailored intervention;    Mammography;   

Others  :  1163131
DOI  :  10.1186/1471-2458-12-760

 received in 2012-04-26, accepted in 2012-08-29,  发布年份 2012

【 摘 要 】

Background

Although the percentage of women who initiate breast cancer screening is rising, the rate of continued adherence is poor. The purpose of this study was to examine the effectiveness and cost-effectiveness of a tailored print intervention compared with a non-tailored print intervention for increasing the breast cancer screening rate among a non-adherent population.

Methods

In total, 1859 participants aged 51–59 years (except those aged 55 years) were recruited from a Japanese urban community setting. Participants were randomly assigned to receive either a tailored print reminder (tailored intervention group) or non-tailored print reminder (non-tailored intervention group). The primary outcome was improvement in the breast cancer screening rate. The screening rates and cost-effectiveness were examined for each treatment group (tailored vs. non-tailored) and each intervention subgroup during a follow-up period of five months. All analyses followed the intention-to-treat principle.

Results

The number of women who underwent a screening mammogram following the reminder was 277 (19.9%) in the tailored reminder group and 27 (5.8%) in the non-tailored reminder group. A logistic regression model revealed that the odds of a woman who received a tailored print reminder undergoing mammography was 4.02 times those of a women who had received a non-tailored print reminder (95% confidence interval, 2.67–6.06). The cost of one mammography screening increase was 2,544 JPY or 30 USD in the tailored intervention group and 4,366 JPY or 52 USD in the non-tailored intervention group.

Conclusions

Providing a tailored print reminder was an effective and cost-effective strategy for improving breast cancer screening rates among non-adherent women.

【 授权许可】

   
2012 Ishikawa et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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