Effectiveness of Telephone Counseling for Mammography: Results from Five Randomized Trials

Background. Women over age 50 continue to be underscreened for breast cancer. The purpose of this report is to compare the effectiveness of a barrier-specific telephone counseling intervention across the five study sites of the Breast Cancer Screening Consortium (BCSC). Methods. Each of the BCSC projects was a randomized study of the effectiveness of telephone counseling (TC) in comparison to a control condition. Eligible underusers were identified and surveyed by telephone before and after the implementation of the interventions. Data from a total of 3,461 underusers were analyzed. We tested whether significantly more women randomized to TC than to control were regular mammography users at the follow-up survey. Data were analyzed separately by site. Results. Overall, TC was not significantly more effective than control in encouraging regular mammography. The pooled consortium-wide odds ratio was 1.08 (95% confidence interval: 0.91 to 1.27). Conclusions. TC has the potential to support maintenance of mammogram use. Modifications are needed to maximize this potential and additional methods should be used in conjunction with TC to reach women who are underusers of mammography.