Good Call: Telephone calls
increase cancer screening rates
Newswise — Exploring ways to
increase cancer screening in minority and low-income women in New
York City, researchers found that a telephone could be a powerful
weapon in the fight against cancer. The study, appearing in the
April 18 online edition of Annals of Internal Medicine,
showed that telephone calls delivered by trained personnel helped
women overcome barriers to screening and improved screening rates
for breast, cervical and colorectal cancer.
“This study represents a promising
step toward addressing the clear-cut disparity in cancer screening
rates and death rates for certain low-income and minority groups,”
said lead author Dr. Allen Dietrich, a family physician and
professor of community and family medicine at Dartmouth Medical
School. “Our team found that telephone support can increase the
historically low cancer screening rates for minority women. We are
hopeful that this model can be transferred to other populations who
could benefit from this type of outreach.”
This randomized, controlled trial
enrolled 1413 women ages 50 to 69 who were patients of 11 community
health centers in New York City, and whose records indicated they
were overdue for cancer screening. These women were randomly
assigned to receive either telephone calls from prevention care
managers or to simply continue with the centers’ usual care.
Eighteen months later, the researchers found that screening rates
increased 12% for mammographies, 7% for Papanicolaou tests and 13%
for colorectal screenings when they compared the rates for women who
received the phone calls to those that had not.
“What makes this study so exciting
is that we reached a population that has always had access problems
and we showed that with the right care, attention and support, we
were able to substantially reduce their barriers to cancer
screening,” said study co-author Dr. Jonathan Tobin, head of the
Clinical Directors Network in New York City. “We’ve identified a
methodology that we believe is both low cost and highly effective
and we believe it will enable patients to remain up-to-date in their
early detection services.”
Women who were assigned to the
intervention group received an average of four telephone support
calls from a bilingual prevention care manager. These managers were
trained to provide information on screenings and to respond to a
number of common barriers that each patient could face that could
delay their screenings. Barriers mentioned in the study include a
lack of information on how to ask for a screening or schedule it,
and many patients said they had trouble communicating with their
physician. Care managers scheduled appointments, sent information
cards to each patient to help communications efforts with their
physician on their next visit, and provided directions to screening
facilities.
“Since sixty percent of the
patients were Spanish speaking and several are recent immigrants the
to U.S., the ability for them to speak with someone who could
communicate across cultural boundaries and help navigate the system
was especially important,” noted Dietrich, who is also associate
director for population sciences at Norris Cotton Cancer Center at
Dartmouth-Hitchcock Medical Center in Lebanon, NH.
Dietrich and his research team
will begin a larger study through Medicare managed care
organizations in May 2006. “We hope the next study proves that this
model can be sustained over time using existing medical
infrastructure without support from research grants,” said Dietrich.
These findings could have several
implications in the medical community, according to the authors. In
addition to potentially saving lives through earlier detection and
addressing health care disparities in the US, other preventive
services such as smoking cessation could be incorporated into
telephone support to increase the value of this outreach, they
write.