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Cancer Screening: Reducing Client Out-of-Pocket Costs – Breast Cancer


What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a Community Guide systematic review published in 2008 (Baron et al., 8 studies, search period 1966-2004) combined with more recent evidence (0 studies, search period 2004-2008). The systematic review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to cancer prevention and control. This finding updates and replaces the 2008 CPSTF finding on Cancer Screening: Reducing Client Out-of-Pocket Costs – Breast Cancer pdf icon [PDF - 784 KB].

Summary of Results

Eight studies qualified for the original systematic review; no new studies were identified for the update.

  • Mammography screening: median increase of 11.5 percentage points (interquartile interval: 6.0 to 28.5 percentage points; 8 studies).

Summary of Economic Evidence

An economic review of this intervention did not find any relevant studies.


Findings should be applicable to various populations and settings in which people would accept screening but have limited financial resources.

Evidence Gaps

The CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

The following outlines evidence gaps for reducing client out-of-pocket costs to increase breast, cervical, or colorectal cancer screening.

  • Are interventions effective for promoting colorectal cancer screening with methods other than FOBT?
  • Are interventions to promote colorectal cancer screening equally effective when addressing colorectal cancer screening more generally, as when specific to one type of test?
  • What are the incremental effects of adding intervention components to other interventions?
  • What influence do newer methods of communication (e.g., the Internet, e-mail, social media, automated interactive voice response, texting) have on intervention effectiveness?
  • What is the influence of health system factors on intervention effectiveness?

Study Characteristics

No qualifying studies were identified during the updated search period.