Recruitment for breast screening in a rural practice. Trial of a physician's letter of invitation.

OBJECTIVE: To evaluate a systematic effort to recruit women for breast screening. DESIGN AND
SETTING: Individually addressed letters, signed by the woman's physician (followed by reminder letters and telephone calls as necessary) were sent to women in a rural family practice, prompting them to make an appointment for breast screening at the Ontario Breast Screening Program-the Kingston Centre. PARTICIPANTS: Women were eligible to receive a letter if they were aged 50 to 69, had not had a mammogram for at least 12 months, and did not have a previous diagnosis of breast cancer or current acute symptoms of breast disease. MAIN OUTCOME MEASURES: Response rates were measured to the initial letter, the reminder letter, and the telephone call. Women who came to the breast screening centre as a result of this recruitment effort were surveyed on their reaction to the letter.
RESULTS: The response rate, as measured 9 months after the initial letters were sent, was 57.5%; 38% of respondents to the initial letter and 49% of respondents to the reminder letter said they would not have come to the centre without the letter. Both the breast screening program managers and the family physicians involved considered the project a success.
CONCLUSION: Integrating with an organized breast screening program is one way for busy family physicians systematically to involve their patients in an early detection program without unduly burdening physicians or disrupting normal patient care.