Dartmouth Medical School
For Release: April 17, 2006
Contact: MedNews Office
"Can You Hear Me Now?"
Telephone Proves Valuable Tool in Increasing Cancer Screening Rates
HANOVER, NH - 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.
"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 Dartmouth Medical School's Dr. Allen Dietrich, a family physician and associate director for population sciences at Norris Cotton Cancer Center. "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 was funded by the National Cancer Institute (NCI) and enrolled 1413 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. These 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% for mammograms, 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 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," said study co-author Dr. Jonathan N. Tobin, an epidemiologist and President/CEO of Clinical Directors Network (CDN), a clinical research network in New York City. "We have identified an important strategy methodology that is both highly effective and low cost and will enable patients to remain up-to-date for their cancer 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 to the 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 professor of community and family medicine at Dartmouth Medical School.
Dietrich and his research team at Dartmouth Medical School and CDN will begin a larger NCI funded study to be conducted in partnership with through Medicaid managed care organizations in May 2006. "We hope the next study will demonstrate that this model can be sustained over time using existing medical infrastructure, without outgoing support from research grants," said Dietrich.
This study's findings could have several implications in the medical community, according to the authors. The authors add that in addition to potentially saving lives through earlier detection of cancer and reducing 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.