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21 March 2013 
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Invitation reminder study
ISRCTN ISRCTN02240458
DOI 10.1186/ISRCTN02240458
ClinicalTrials.gov identifier
EudraCT number
Public title Invitation reminder study
Scientific title A randomised controlled trial of the effect of a breast screening appointment reminder letter on population uptake
Acronym N/A
Serial number at source 1
Study hypothesis The aim of this study is to investigate whether sending an appointment reminder letter to women invited for routine breast screening improve appointment attendance.
Lay summary Background and study aims
Breast screening saves lives by detecting cancer earlier, which can make treatment more effective. This reduction in cancer deaths depends partially on women regularly attending their three-yearly routine screening appointments. Even though many women who do not attend will have made an informed decision, others will be in favour of screening but may have simply forgotten about the appointment. Women’s attendance at breast screening should be based on decisions about the likely benefits and risks of screening rather than on whether they remember their appointment. We are therefore carrying out a study to investigate whether a reminder letter sent by post to arrive close to a woman’s screening appointment increases attendance and whether this approach is cost-effective.

Who can participate?
Women living in Bolton, Bury and Rochdale, South Lancashire, and Liverpool will be entered into the study when they are invited to their routine three-yearly screening appointment.

What does the study involve?
One half of the women invited to their routine screening receive a reminder letter around two days before the screening appointment in addition to the normal invitation letter. The other group with only receive the standard invitation letter without any reminders.

What are the possible benefits and risks of participating?
This reminder letter was produced following consultation, including with lay people, to ensure that it contains only accurate information, and is non-coercive in tone. Women in the reminder group of the study who are in favour of screening but may have simply forgotten about the appointment will be reminded to either attend the appointment or call in and re-book. We do not anticipate any risks that may adversely affect the participants as a result of taking part in the trial.

Where is the study run from?
Centre for Cancer Prevention (CCP) at Barts and The London, Queen Mary University of London, UK

When is study starting and how long is it expected to run for?
The study started in November 2012 and is due to end by December 2013.

Who is funding the study?
National Health Service (NHS) - Cancer Screening Services.

Who is the main contact?
Prof Stephen Duffy
s.w.duffy@qmul.ac.uk
Ethics approval Not provided at time of registration
Study design Multicentre randomised controlled trial
Countries of recruitment United Kingdom
Disease/condition/study domain Breast cancer screening
Participants - inclusion criteria All women scheduled for invitation to their next breast screening appointment in Liverpool, South
Lancashire, and Bolton, Bury and Rochdale.
Participants - exclusion criteria 1. Self referrals
2. Early re-calls
3. Women who are invited because of a higher risk of breast cancer
4. Women who have cancelled their appointment before the letter extract is generated and who do not re-book at a later stage are excluded as they will never appear in any of the letter extracts.
Anticipated start date 01/11/2012
Anticipated end date 31/12/2013
Status of trial Ongoing
Patient information material Not available in web format, please use the contact details below to request a patient information sheet
Target number of participants 20,000 (10,000 in each arm)
Interventions There are no trial drugs or treatments associated with this trial.

Women in the intervention arm will be sent a reminder letter by post approximately seven days before
their screening appointment.
Primary outcome measure(s) An increase in attendance within 30 days of the first offered appointment
Secondary outcome measure(s) Attendance within 90 days of the first offered appointment, secondly, within 180 days of the date the episode was opened, and thirdly, at the date and time of the first offered appointment.

Subgroup analyses will be performed and the cost per additional attendance will be calculated.
Sources of funding NHS Cancer Screening Programmes (UK)
Trial website
Publications
Contact name Prof  Stephen  Duffy
  Address Centre for Cancer Prevention
Wolfson Institute of Preventive Medicine
Queen Mary University of London
Charterhouse Square
  City/town London
  Zip/Postcode EC1M 6BQ
  Country United Kingdom
  Tel +44 (0)20 7882 3535
  Fax +44 (0)20 7882 3890
  Email s.w.duffy@qmul.ac.uk
Sponsor Queen Mary University of London (UK)
  Address Joint R&D Office
5 Walden Street
  City/town London
  Zip/Postcode E1 2EF
  Country United Kingdom
  Tel +44 (0)20 7882 7260
  Email sponsorsrep@bartshealth.nhs.uk
  Sponsor website: http://www.bartsandthelondon.nhs.uk/our-services/research-and-development/
Date applied 22/10/2012
Last edited 11/01/2013
Date ISRCTN assigned 30/11/2012
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