A cross sectional study on the motivators for Asian women to attend opportunistic mammography screening in a private hospital in Malaysia: the MyMammo study.

Norhashimah Hassan,Shivaani Mariapun,Soo Hwang Teo,Weang Kee Ho

doi:10.1186/s12889-015-1892-1

Abstract

BackgroundTo date, because of limited budgets and lower incidence of breast cancer, the majority of Asian countries do not have population-based screening programmes, but instead offer opportunistic screening. However, there have been few studies which have assessed the motivators for women attending such programmes and the appropriateness of the programmes in terms of targeting women at risk.MethodsWe conducted a prospective cross-sectional study of 1,619 women aged 40 to 74 years attending a subsidized opportunistic screening mammogram from October 2011 to October 2013 at a private hospital in Malaysia. Breast cancer risk was estimated using the Gail Model and two-step cluster analysis was used to examine the motivators of attending screening.ResultsAlthough Malaysia comprises 54.5 % Malay, 24.5 % Chinese and 7.3 % Indian, the majority of women in the MyMammo Study were Chinese (70.1 %) and 99.2 % had a <2 % ten-year risk of breast cancer. The most commonly cited barriers were the perception of not being at risk and fear of painful mammography. We found that highly educated women, cited doctors, family and friends as their main motivators. Of those with only secondary school education, their main motivators were doctors.ConclusionsTaken together, our results suggest the women attending opportunistic mammography screening in Asia are at low risk of breast cancer and this poses challenges to cost-effective and equitable strategies for cancer control. We propose that to improve uptake of screening mammography, awareness programmes should target both doctors and members of the public.

Highlights

To date, because of limited budgets and lower incidence of breast cancer, the majority of Asian countries do not have population-based screening programmes, but instead offer opportunistic screening
Study cohort The MyMammo study is an opportunistic mammography screening programme established at a private hospital in the suburban area of Subang Jaya in Malaysia
We show that the majority of women attending opportunistic screening have an estimated

Summary

Introduction

Because of limited budgets and lower incidence of breast cancer, the majority of Asian countries do not have population-based screening programmes, but instead offer opportunistic screening. Breast cancer is the most common cancer in women and accounts for ~12.7 % of all cancer deaths in Asian women [1]. Breast cancer incidence is lower in Asia compared to that in Western countries, it is rising rapidly in Asian countries because of longer life expectancy and dramatic changes in parity and lifestyle [1,2,3,4]. In high-income Asian countries with higher breast cancer incidence, such as Singapore, Korea and Japan, organized national mammographic screening is available, but uptake varies from 20 to 57 % [8,9,10,11,12]. A number of reasons for poor uptake have been described in Singapore, Thailand, Malaysia and Iran, and Hassan et al BMC Public Health (2015) 15:548 these include cost of screening, lack of time, distance to screening facilities and fear of cancer [14, 18,19,20]

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Discussion

Conclusion