A randomized, double-blinded study conducted in British Columbia, Canada, where there is a publicly funded, organized screening program and screening mammography is recommended at 24-month intervals. Eligible women aged 51-73 years old and overdue for their screening mammogram by 6-24 months are identified in the database of the Screening Mammography Program of BC (SMPBC). Family physicians are recruited by mail and asked to sign letters to the overdue women in their practices. The overdue women are randomized and mailed either the signed reminder letter and the standard reminder postcard, or the standard reminder postcard alone. The primary endpoint is the proportion of overdue women attending a screening mammogram appointment 6 months after the mailing.

Inclusion Criteria:

Active family physicians (family physicians, general practitioners or primary care physicians) who have overdue women in their practice that meet the following criteria:

• Previously been enrolled in the SMPBC and had a previous normal screening mammogram.
• Have agreed to being contacted for research on the SMPBC questionnaire
• Are 6-24 months overdue from their last screening mammogram
• Live in BC
• Have listed an active family physician as the contact to receive their mammography results

Exclusion Criteria:

• Family physicians who do not work in primary care
• Family physicians who do not have overdue women in their practice

Total includes patients who were screened before randomization

6 months