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Prev Med Rep. 2018 Dec 29;13:189-195. doi: 10.1016/j.pmedr.2018.12.016. eCollection 2019 Mar.

Communication of cancer screening results by letter, telephone or in person: A mixed methods systematic review of the effect on attendee anxiety, understanding and preferences.

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University of Warwick, United Kingdom of Great Britain and Northern Ireland.
Warwick Medical School, United Kingdom of Great Britain and Northern Ireland.
Senior Lecturer in Public Health Coventry University, United Kingdom of Great Britain and Northern Ireland.
Public Health England, United Kingdom of Great Britain and Northern Ireland.
Royal Wolverhampton NHS Trust, United Kingdom of Great Britain and Northern Ireland.


Attending and receiving a result from screening can be an anxious process. Using an appropriate method to deliver screening results could improve communication and reduce negative outcomes for screening attendees. Screening programmes are increasingly communicating results by letter or telephone rather than in-person. We investigated the impact of communication methods on attendees. We systematically reviewed the literature on the communication methods used to deliver results in cancer screening programmes for women, focusing on screening attendee anxiety, understanding of results and preferences for results communication. We included qualitative and quantitative research. We searched MEDLINE, PsycINFO, CINAHL, Cochrane Library and Embase. Results were analysed using framework synthesis. 10,558 papers were identified with seven studies meeting the inclusion criteria. Several key ideas emerged from the synthesis including speed, accuracy of results, visual support, ability to ask questions, privacy of results location and managing expectations. Verbal communication methods (telephone and in-person) were preferred and facilitated greater understanding than written methods, although there was considerable variability in attendee preferences. Findings for anxiety were mixed, with no clear consensus on which method of communication might minimise attendee anxiety. The low number of identified studies and generally low quality evidence suggest we do not know the most appropriate communication methods in the delivery of cancer screening results. More research is needed to directly compare methods of results communication, focusing on what impact each method may have on screening attendees.


Communication; Mass screening; Mixed methods; NHSBSP, National Health Service Breast Screening Programme; Psychology; Review

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