Influence of a Free Coupon and an Educational Booklet on Breast Cancer Screening in Mie Prefecture, Japan

Abstract

In 2009, the Japanese government launched a new intensive project to encourage women to undergo breast cancer screening. All women aged 40, 45, 50, 55 and 60yr received a cancer screening information booklet and a free screening coupon from the municipality. In Mie prefecture (29 municipalities), 66,507 women were targeted by the project, of whom 18,276 (27.5%) underwent breast cancer screening test in fiscal 2009. Among those who received the free coupon, this represented a 4.4-fold increase in the number of women who were screened in comparison with women of the same age in the previous year, whereas the increase was only 1.1-fold for those who did not receive the coupon. Despite the low percentage of coupon usage, the significant increase in the number of women screened suggested that this project was effective for encouraging women to undertake breast cancer screening.
This project was aimed at assessing three main aspects: “notification of individuals”, “use of education-oriented media” and “ reduction of personal expenditure”. It will be necessary to evaluate the degree to which each aspect contributes to the increase in women attending for screening.
In order to increase the participation rate further, efforts must be made to reduce structural barriers, such as inconvenient locations or times, or complex administrative procedures according to community-specific needs. It will also be important to encourage women to undergo screening regularly (not just once). Therefore, in health education, women need to be motivated to undergo breast cancer screening not because it is free but because it is essential for long-term health.