Background: The NHS Cancer Screening Programmes in the U.K is committed to ensuring women receive sufficient and accurate information to make informed choices on screening.Information about the programme and the screening procedure has been translated into many minority ethnic languages.There is, however, little understanding of how risks of breast cancer and screening are perceived by the public.Specifically, no study has ever been done on how these risks might be effectively communicated to Migrant and Minority Ethnic (MME) groups.The Informed Choice for All Project (2006-8) investigated this problem, using a participatory action research approach.An Interactive Risk Communication (IRC) tool was developed as part of the project.This paper presents the results of the evaluation of this tool among five ethnic/language groups: African-Caribbean, Bangladeshi, Chinese, Pakistani, and White.Methods:The effectiveness of the tool was tested against a leaflet The Facts produced by the NHS Breast Screening Programmes.A total of 228 participants took part in the trial.They were randomly allocated to be exposed to the IRC tool and the leaflet in two different orders, tool first (n=1 11), and leaflet first (n=1 17).The evaluation took place in a city in the North of England.Findings: The results show that the IRC tool is a more effective means than a leaflet for conveying both knowledge about the major risk factors for breast cancer (W=23095.5, p<0.001, PP) and cancer screening risks (signed-rank Wilcoxon test; W=25569.5, p<0.001, PP).Statistical tests have shown that there was no evidence of any cross-over effect.The leaflet was clearly unhelpful to those MME participants who were non-literate in English.Further analysis shows that the majority of participants benefited from the IRC tool despite their ethnicity and level of literacy in English (n=108 White, n=120 MME; W=8704.5 p<0.001, ITT).Conclusion: The IRC tool is a far a more effective means than the leaflet for communicating both messages about breast cancer risks and the efficacy of screening i.e.the chances of recall, of being diagnosed with breast cancer, and the meanings of "false negative" and "false positive".