Trial to Evaluate the Impact of Various Behavioural Interventions to Increase Mammography Uptake Among Singaporean Women

NCT07283107 | Enrolling By Invitation

• 1 other identifier: 2025-0880
• Study Type: interventional
• Target: 8,910
• Locations: 1 country
• Sites: 1

Brief Summary

Breast cancer is the leading cancer among women in Singapore, yet mammography screening rates remain critically low at 34.7%, despite the availability of a national program since 2002. This shortfall significantly limits the potential of screening to reduce mortality at a population level. While various behavioral interventions have been tested internationally to increase uptake, their applicability in the local context remains uncertain. Existing studies in Singapore are either outdated, small in scale, or not sufficiently targeted. In particular, two subgroups of women warrant closer examination due to the scarcity of data: (1) never-screeners: those who have never undergone a mammogram and (3) recent screeners: those who had a mammogram more than two years ago but have not scheduled their next one. These cohorts exhibit distinct behavioral and psychological barriers that prevent adherence to regular, guideline-recommended screening. E.g., key barriers for never- screeners include low perceived susceptibility to breast cancer, lack of awareness about the benefits of early detection, fear or anxiety about pain or receiving a cancer diagnosis, cultural or personal modesty concerns or lack of a physician's recommendation. In contrast, the repeat recent screeners often have a misconception that a single normal result is sufficient, negative experiences during prior screenings (e.g., false positives, pain), absence of reminder systems and competing life priorities and lack of time. Among these, engaging never-screeners is particularly challenging, as they may not perceive screening as personally relevant or necessary, and many have successfully avoided the healthcare system for years. Yet, failure to engage these groups; poses a significant public health concern, as it undermines the effectiveness of population-level cancer control strategies. The PROMPT study is designed to fill this critical gap by systematically evaluating multiple low-cost, scalable outreach strategies in two parallel randomized trials. Its findings will provide robust, local evidence to inform policy and improve engagement of these hard-to-reach populations.

Conditions

This Study Evaluates Interventions to Increase Surveillance Mammography Uptake for Early Breast Cancer Detection Among Singaporean Women

Keywords

Mammography; Breast Cancer; Cancer Screening; Early Cancer Detection

Outcome Measures

Primary Outcomes (1)

• Comparison of Mammogram Uptake Between Interventional Arms (2-5) and Control Arm (Arm 1)

  Comparison of the proportion of women who undergo surveillance mammography among participants in Arms 2-5 versus Arm 1 (control arm).

  4 months from the time participants receive the reminders

Secondary Outcomes (3)

• Impact of social and demographic factors on mammogram completion.

  4 months from the time participants receive the reminder

• Post-trial telephone survey

  1-2 months post-trial

• Mammogram uptake at 6 and 12 months post-trial

  6 and 12 months from the time participants received the first mailed reminder

Study Arms (5)

Control Arm (Arm 1)

NO INTERVENTION

Does not receive any reminder to go for mammogram.

Arm 2: : One mailed reminder

EXPERIMENTAL

Receives a single mail reminder

Behavioral: Arm 2: One mailed reminder

Arm 3: Two mailed reminders

EXPERIMENTAL

Receives two mail reminders, 1 month apart

Behavioral: Arm 3: Two mailed reminders

Arm 4: Mailed Reminder with Prescheduled Appointment

EXPERIMENTAL

Recieves a mailed reminder with prescheduled appointment

Behavioral: Arm 4: Mailed reminder with prescheduled appointment

Arm 5: Mailed reminder with enhanced messaging

EXPERIMENTAL

Receives mailed reminder with enhanced messaging

Behavioral: Arm 5: Mailed reminder with enhanced messaging

Interventions

Arm 2: One mailed reminder BEHAVIORAL

Receives a mailed reminder with basic information about breast cancer and instructions on scheduling a mammogram

Arm 2: : One mailed reminder

Arm 3: Two mailed reminders BEHAVIORAL

Receives a mailed reminder + follow-up mailed reminder, 1 month after the first reminder

Arm 3: Two mailed reminders

Arm 4: Mailed reminder with prescheduled appointment BEHAVIORAL

Receives one mailed reminder with a pre-scheduled appointment, with instructions to change appointment

Arm 4: Mailed Reminder with Prescheduled Appointment

Arm 5: Mailed reminder with enhanced messaging BEHAVIORAL

Receives one mailed reminder with enhanced messaging motivating recipient to undergo screening

Arm 5: Mailed reminder with enhanced messaging

Eligibility Criteria

• Age: 50 Years - 69 Years
• Gender Eligibility Details: Females only
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Singaporean citizen
• Age 50-69
• Registered as a patient at the National University Hospital
• Registered and active user of NUHS App
• Signed up with Healthier SG with a primary care provider within the NUHS Primary Care Network
• For "never-screener" cohort: Must have never undergone mammogram screening
• For "repeat-screener" cohort : Must have completed screening in the last 18-24 months but have not booked their next appointment yet

You may not qualify if:

• Diagnosis of breast cancer in EPIC
• Mammogram done in the past 24 months in EPIC

Sponsors & Collaborators

• National University Hospital, Singapore: lead

Study Sites (1)

National University Hospital Singapore

Singapore, Singapore

Location

MeSH Terms

Conditions

Breast Neoplasms

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Skin and Connective Tissue Diseases

Study Officials

• Soo-Chin Lee, MBBS, MRCP

  National University Hospital Singapore, Singapore

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SCREENING
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 2, 2025
• First Posted: December 15, 2025
• Study Start: November 17, 2025
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): December 31, 2027
• Last Updated: December 29, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

SG (1)