Preventative Cancer Screening Direct Mail Program Response and Diagnosis Rates


Preventative cancer screenings are used to diagnose cancer in age- and gender-appropriate populations. Direct mail campaigns conducted by hospitals, health departments, and other health institutions are one way to encourage receipt of these screenings. The purpose of this study was to examine the effectiveness of two preventative cancer screening mailer campaigns used by a large mid-western health system to encourage utilization of these screenings and to diagnose cancer cases.


Mammogram and colonoscopy direct mail pieces were sent to age- and gender-appropriate individuals, based on national guidelines. In 2013, 91,000 mammogram mailers and 40,000 colonoscopy mailers were mailed to individuals living within the hospital service area. Individuals who received the mailer were instructed to call a phone number to schedule their screening. A customer relationship management system (CRM) was used to track who received mailers, screenings, and who was subsequently diagnosed with cancer. Differences in response and diagnosis rates are reported using counts and percents.


Mammogram mailers were associated with 1909 mammograms (2.1% response rate), of which 16 resulted in a breast cancer diagnosis (0.84% of all who received a mammogram). Fifty-four colonoscopies were associated with the direct mail program (0.1% response rate) of which two resulted in diagnosed cases of colorectal cancer (3.7% of all who received a colonoscopy). The ratio of mailers to diagnosed breast and colorectal cancer cases were 5,688:1 and 20,000:1, respectively. The cost per mailer was $0.33 and $0.36 per mailer for breast and colorectal cancer, respectively.


The health system spent $1877 and $7200 in direct mail, respectively for the breast and colorectal mailers, to generate one diagnosed case of breast or colorectal cancer at the health system. Given the total lifetime cost of cancer treatment, the direct mail method of encouraging utilization of these preventative services appears to be cost-effective.

Value in Health Journal
Birmingham, L; Musarra, L; Oglesby, W
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