The overall goal of the Fogarty International Research Collaboration (FIRCA) project is to increase the capacity of the Catholic University of Chile to conduct rigorous research in breast cancer screening. Breast cancer is the most common cancer among women in the United States (US) and the second leading cause of cancer deaths.  Mortality from breast cancer has been

Catholic University of Chile campus

declining in the past decade.  Much of this decline is thought to be due to improved detection of cancerous tumors at early, more treatable stages.  Use of mammography among women aged 40 and older has been shown to reduce breast cancer mortality by 20-30%.  Further, health promotion efforts have successfully raised awareness about the risk of breast cancer and the need for routine screening.

In Chile, breast cancer is also the most common cancer among women and is the second leading cause of cancer death.  Unlike in the US, the incidence of breast cancer has risen in the past decade.  The rise is coupled with low rates of mammogram screening participation. Use of mammograms for non-diagnostic screening is a relatively new phenomenon in Chile.  For many years, national recommendations called for a clinical breast exam every three years among women aged 50 and older, and diagnostic mammography only among women with positive findings.  Chile’s health care system has undergone changes in its recommendations for cancer screening modalities, and routine mammogram is now a standard part of clinic practice.  However, the rates of screening remain exceedingly low.

The specific aims of this study are:

1. To develop culturally-relevant interventions to improve use of mammograms among Chilean women; and
2. To assess the effectiveness of two levels of intervention—a low-intensity and a high-intensity—in increasing the number of women receiving mammograms over those in usual care.

The primary outcome will be the proportion of women receiving mammograms in each arm of the intervention.  Receipt of mammograms will be ascertained by a review of the computerized data base in the Juan Pablo II Clinic in La Pintana, Chile.  Secondary outcomes include changes in knowledge, attitudes, and beliefs about mammography screening.