Abstract
BACKGROUND: Participation in organised breast cancer screening (OBCS) in France has declined over the past decade. This study evaluated the contribution of mobile mammography units (MMUs) to increasing screening participation through a prospective cluster-randomised controlled trial conducted in France. METHODS: This interventional study was conducted among the general population in four departments of the Normandy region. Areas located >15 min from a radiology centre were grouped into clusters and randomly assigned (1:1) to either an intervention or control arm. In total, 320 areas inhabited by 87,449 women aged 50-74 years were included. In the intervention arm, women whose last mammogram was performed at least 22 months earlier received, besides to the usual invitation, an appointment at the MMU sent by the regional screening management structure. The primary outcome was the BCS participation rate. A cluster-adjusted proportion test was used to compare participation between arms. RESULTS: In the intervention arm, 22,964 women were screened out of the 38,382 invited, yielding a participation rate of 59.8 % vs 51.1 % in the control areas (25,099/49,067). The MMU intervention was associated with a statistically significant increase in participation of 8.7 % (p < 0.0001) compared with the control arm. In the intervention arm, women screened in the MMU tended to be younger and more deprived than those who opted for a radiology centre. CONCLUSIONS: The addition of an MMU to the OBCS programme in France significantly increased participation among women living furthest from radiology centres and can reduce social and geographic inequities.