Abstract
BackgroundA better understanding of the factors that influence mammography screening attendance is needed to improve the effectiveness of these screening programs. The objective of the study was to examine whether psychosocial factors predicted attendance at a population-based invitational mammography screening program.MethodsData on cohabitation, social network/support, sense of control, and stress were obtained from the Malmö Diet and Cancer Cohort Study and linked to the Malmö mammography register in Sweden. We analyzed 11,409 women (age 44 to 72) who were free of breast cancer at study entry (1992 to 1996). Mammography attendance was followed from cohort entry to December 31, 2009. Generalized Estimating Equations were used to account for repeated measures within subjects. Adjusted odds ratios (OR) and 95% confidence intervals (CI) are reported.ResultsAmong 69,746 screening opportunities there were 5,552 (8%) cases of non-attendance. Higher odds of non-attendance were found among women who lived alone (OR = 1.47 (1.33-1.63)) or with children only (OR = 1.52 (1.29-1.81)), had one childbirth (OR = 1.12 (1.01-1.24)) or three or more childbirths (OR = 1.34 (1.21-1.48)), had low social participation (OR= 1.21 (1.10-1.31)), low sense of control (OR = 1.12 (1.02-1.23)), and experienced greater stress (OR = 1.24 (1.13-1.36)).ConclusionsPublic health campaigns designed to optimize mammography screening attendance may benefit from giving more consideration of how to engage with women who are less socially involved.
Highlights
A better understanding of the factors that influence mammography screening attendance is needed to improve the effectiveness of these screening programs
The number of screening opportunities after baseline ranged between one and twelve, and there was a positive association between the number of invitations received and screening attendance
In this cohort of Swedish women who received regular invitations to attend mammography screening, nonattendance was more common among women who were living alone, among single mothers, among women with one child or three or more children, and among those who had low social participation, low control and greater stress
Summary
A better understanding of the factors that influence mammography screening attendance is needed to improve the effectiveness of these screening programs. The objective of the study was to examine whether psychosocial factors predicted attendance at a population-based invitational mammography screening program. The public health impact of population-based screening programs depends to a large extent on optimizing participation rates. A better understanding of the factors influencing attendance at outreach mammography screening programs is important for further improvement of the organization and effectiveness of mammography screening. Following recommendations from the National Board of Health and Welfare, female residents of Malmö, Sweden (the setting of the current study) have been invited to a population-based mammography screening program since 1990, in intervals of 1.5 or 2 years depending on age group and breast density [3]. The comparatively low screening attendance made it interesting to study factors affecting screening attendance in this geographical area
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