Barriers to screening mammography

Abstract

Breast cancer (BRCA) is the second most commonly diagnosed cancer among women in the USA, and mammography is an effective means for the early detection of BRCA. Identifying the barriers to screening mammography can inform research, policy and practice aiming to increase mammography adherence. A literature review was conducted to determine common barriers to screening mammography adherence. PsycINFO and PubMed databases were searched to identify studies published between 2000 and 2012 that examined barriers associated with reduced mammography adherence. Three thematic groups of barriers, based on social ecology, were identified from the literature: healthcare system-level, social and individual-level barriers. Researchers must consider screening behaviour in context and, therefore, should simultaneously consider each level of barriers when attempting to understand screening behaviour and create interventions to increase mammography adherence.

Barriers to Breast Cancer Screening among Diverse Cultural Groups in Melbourne, Australia

“…A broad list of statements was assembled from a review of publications describing barriers to breast screening [16,37,38]. From these, a summary list of statements considered to reflect barriers for women from CALD backgrounds was selected (see Table 2).…”

“…Emotional barriers include anxiety driven by personal beliefs [13,14] and negative expectations, such as concerns related to perceived disrespect from screening providers and feelings of embarrassment [16]. Physical discomfort during previous mammograms has also been associated with under-screening [17].…”

“…Knowledge barriers include a lack of breast cancer risk awareness, not understanding the importance of screening regardless of current symptoms, and believing misinformation, such as ‘screening is harmful’ or that ‘there is no cure for breast cancer’ [18,19]. Structural barriers refer to practical challenges associated with making appointments, accessing screening services, and managing priorities, such as family commitments [16]. Financial barriers include direct costs of screening, and non-medical out of pocket costs associated with screening participation.…”

Promoting mammography screening among Chinese American women using a message-framing intervention

“…To our knowledge, this is the first study examining the effect of message framing and moderated message framing in a sample of CAW. Previous studies that have included minority women have typically not included Asian American women, who may differ from other minority women in terms of their specific beliefs about mammography and breast cancer, such as cultural beliefs about modesty and low perceived risk of breast cancer due to race and ethnicity [17,18] and therefore likely benefit from information that is culturally targeted. In addition, Asian American women are not a homogenous group, and differences exist among different subpopulations, including CAW [20], further suggesting the need for more specific culturally targeted interventions.…”

“…Factors influencing CAW's rates include those relevant to other racial and ethnic groups, such as physician recommendation and English proficiency [14][15][16][17][18]. In addition, some factors are perceived as more important for screening by CAW, relative to other racial and ethnic groups, such as trouble making appointments and taking time off work, while some factors are unique barriers for CAW, such as a preference for a Chinese-speaking physician [19,20].…”