tated by the adoption of comprehensive office system changes (e.g., through the use of office chart reminders, patient health maintenance cards, on-site training and start-up assistance visits, continuing education seminars, and quality assurance feedback). Such programs have proved effective in increasing the rates of performance of FOBT (Manfredi et al., 1998). In one randomized trial, the intervention consisted of an 11-minute video about colon cancer screening, the selection of a color-coded educational brochure reflecting degree of interest in screening, and a marker of the same color attached to the chart. The numbers of requisitions for FOBT and flexible sigmoidoscopy and the rates of completion of these tests increased signifi cantly under this program (Pignone et al., 2000).

SOURCE: PhotoDisc, Inc.

In contrast to colorectal cancer screening, a relatively large proportion of women have availed themselves of screening mammography. Approxi