Simple prompts may improve cancer screening compliance among high-risk groups

People getting recommended screening tests for one cancer can be reminded about other relevant screenings. It's a simple way to increase compliance for potentially life-saving tests.

In a new study, Thomas Jefferson University researchers investigated the potential for this kind of intervention for patients enrolled in a lung cancer screening program, directed by Julie Barta, MD,  an associate professor at Sidney Kimmel Medical College.

The study participants were women age 50-75 who are smokers or have a significant smoking history, says Meghan Maceyko, MD, a fourth-year general surgery resident. The recommendation is that they get an annual chest CT (computed tomography) to check for diseases of the lung, including cancer. 

As smokers, these older women are also at heightened risk for breast cancer. "Smoking is a risk factor in all cancers," Dr. Maceyko says.

The study looked retrospectively at the patients' electronic health records to see whether the women had gotten a mammogram in the two years before their lung cancer screen. The researchers delved into patient characteristics and found that women with a greater smoking history and those with previous cancer diagnoses were more likely to be overdue for breast cancer screening.

Thus, the highest risk patients seemed to have the lowest adherence to recommended screenings, which points to a "critical gap in preventive care," the researchers observe.

That gap in care could be addressed by adding a question about breast cancer screening to patients' intake interviews - a simple intervention that targets those at high risk. "It should be relatively easy to integrate an additional prompt for women," Dr. Maceyko says. For medical centers that have lung cancer screening programs, like Jefferson Health, the infrastructure is already in place. The next step is to choose an easy and effective prompt, such as a pop-up reminder on a questionnaire or an added question by the intake nurse.

In addition, more research in this area may open further avenues to improve screening adherence, such as prompting questions about other cancer screenings or creating paths for electronic health records to flag overdue tests.