Improving Breast and Cervical Cancer Screening Compliance through Direct Physician Contact in a Military Treatment Facility: A Non-randomized Pilot Study

Abstract

Introduction: Screening for breast cancer (BC) and cervical cancer (CC) decreases morbidity and mortality. Most interventions to improve screening rely on automated modalities or nonphysician patient contact. There is limited data on direct patient contact by a physician to encourage BC and CC screening. This non-randomized pilot study sought to evaluate the potential of direct physician contact to improve BC and CC screening rates. Materials and Methods: A Family Medicine physician telephoned patients on his panel who were due or overdue for BC and CC screening. If the patient did not answer her phone, a voicemail was left; if unable to leave a voicemail, a letter was mailed. The completion rate of recommended screening tests was measured 3 months after contact and compared to a retrospectively identified control population. The change in compliance of the patient panel over 3 months was also calculated. Results: Direct physician conversation by telephone yielded higher completion rates for BC and CC screening versus control patients, but only the CC completion rate increase was statistically significant. Direct conversation BC screening completion rate: 41.2% versus 22.7% (P =. 22, n = 48). Direct conversation CC screening completion rate: 45% versus 13.9% (P =. 01, n = 44). The intervention patient panel compliance with screening recommendations increased 20.5% for BC and 10.5% for CC. Conclusion: Direct physician contact may be beneficial to increase compliance for more invasive screening tests.