COMPLIANCE WITH MAMMOGRAPHY SCREENING IN ISRAELI WOMEN - THE IMPACT OF A PRE-SCHEDULED APPOINTMENT AND OF THE LETTER-STYLE

The objectives of this study were to determine the impact of different personal invitations on screening mammography attendance and to clari fy the influence of personal characteristics and health-related attitu des and behaviors on compliance. One thousand and five hundred women, aged 50-74 years, were randomly selected in the city of Haifa. Four le tters of invitation were used. Actual mammography performance was vali dated by a national computerized database. All other data was collecte d via a telephone interview following the mammography. The overall com pliance rate amounted to 45%. The major predictors of compliance were having had a clinical breast examination within the previous year (p = 0.0008), having a health professional recommend routine mammography ( p = 0.01) and perceiving mammography as efficient in early detection o f breast cancer (p = 0.02). Aggressiveness of message details, or a fa mily physician's or higher authority's signature on the letter had no impact on compliance. A letter of invitation for a routine mammogram a t a specific time resulted in an overall rate of compliance 3-fold hig her than the baseline. Based on the results of this study, Kupat Holim Clalit decided to implement use of personal invitations for screening mammography to Israeli women on a regular basis.