Telephone proves valuable tool for cancer screening
Exploring ways to increase cancer screening for minority and low-income
women in New York City, researchers found that the 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.
Allen Dietrich
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"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," says lead author Allen Dietrich, associate director for
population sciences at Norris Cotton
Cancer Center at Dartmouth-Hitchcock Medical
Center, professor of community and family medicine at Dartmouth Medical School (DMS), and a
family physician. "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."
The randomized, controlled trial was funded by the National Cancer Institute (NCI) and enrolled
1,413 women ages 50 to 69 who were patients of 11 Community Health Centers in
New York City, and whose medical records indicated they were overdue for cancer
screening tests. The women were randomly assigned to receive either telephone
calls from prevention care managers or to simply continue with their doctors'
usual care. Eighteen months later, the researchers found that screening rates
increased 12 percent for mammograms, 7 percent for Pap tests, and 13 percent
for colorectal screenings when they compared the rates for women who received
the phone calls to those who had not.
"What makes this study so exciting is that we reached women with
difficulties accessing needed care and we showed that with the right attention
and support, we were able to substantially reduce their barriers to cancer
screening," says study coauthor Jonathan N. Tobin, an epidemiologist and
president/CEO of Clinical
Directors Network (CDN), a clinical research network in New York City.
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 her
screenings.
Dietrich and his research team at DMS, along with CDN, will begin a larger
NCI-funded study to be conducted in partnership with Medicaid managed care
organizations this month.
The study's findings could have several implications in the medical
community, according to the authors. In addition to potentially saving lives
through earlier detection of cancer and reducing health care disparities, they
note that other preventive services such as smoking cessation could be
incorporated into telephone support to increase the value of the outreach.
By ANDY NORDHOFF
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