Breast cancer screening attendance in two Swiss regions dominated by opportunistic or organized screening

Abstract

BackgroundIn Switzerland, the French-speaking region has an organized breast cancer (BC) screening program; in the German-speaking region, only opportunistic screening until recently had been offered. We evaluated factors associated with attendance to breast cancer screening in these two regions.MethodsWe analyzed the data of 50–69 year-old women (n = 2769) from the Swiss Health Survey 2012. Factors of interest included education level, place of residence, nationality, marital status, smoking history, alcohol consumption, physical activity, diet, self-perceived health, history of chronic diseases and mental distress, visits to medical doctors and cervical and colorectal cancer screening. Outcome measures were dichotomized into ≤2 years since most recent mammography versus >2 years or never.ResultsIn the German- and French-speaking regions, mammography attendance within the last two years was 34.9 % and 77.8 %, respectively. In the French region, moderate alcohol consumption (adjusted OR 2.01, 95 % CI 1.28–3.15) increased screening attendance. Compared to those with no visit to a physician during the recent year, women in both regions with such visits attended statistically significantly more often BC screening (1–5 times vs. no visit: German (adjusted OR 3.96, 95 % CI 2.58–6.09); French: OR 7.25, 95 % CI 4.04–13.01). Non-attendance to cervical screening had a negative effect in both the German (adjusted OR 0.44, 95 % CI 0.25–0.79) and the French region (adjusted OR 0.57, 95 % CI 0.35–0.91). The same was true for colorectal cancer screening (German (adjusted OR 0.66, 95 % CI 0.52–0.84); French: OR 0.52, 95 % CI 0.33–0.83). No other factor was associated with BC screening and none of the tests of interaction comparing the two regions revealed statistically significant results.ConclusionThe effect of socio-demographic characteristics, lifestyle, health factors and screening behavior other than mammography on non-attendance to BC screening did not differ between the two regions with mainly opportunistic and organized screening, respectively, and did not explain the large differences in attendance between regions. Other potential explanations such as public promotion of attendance for BC screening, physicians’ recommendations regarding mammography participation or women’s beliefs should be further investigated.

The relative risk of second primary cancers in Switzerland: a population-based retrospective cohort study

“…Language region of residence was added to the models due to known regional differences in lifestyle-associated risk factors (i.e. alcohol and tobacco consumption [27]), screening behaviour [28,29] and treatment regimens [30].…”

Association between serious psychological distress and nonparticipation in cancer screening and the modifying effect of socioeconomic status: Analysis of anonymized data from a national cross‐sectional survey in Japan

“…Several studies have reported that individuals experiencing psychological distress (PD), such as depression or anxiety, are less likely to participate in cancer screening. According to our in‐house, preliminary, systematic review, most population‐based studies examining the associations between PD and screening for colorectal, breast, or cervical cancers have been conducted in North America or Europe. One meta‐analysis reported a significant reduction in mammography screening rates among women with mood disorders .…”

“…One meta‐analysis reported a significant reduction in mammography screening rates among women with mood disorders . However, subsequently published studies reported a nonsignificant association between PD and participation in mammography screening . Findings for colorectal and cervical cancer screening have been controversial.…”

“…Low socioeconomic status (SES) reportedly is associated with both high PD and nonparticipation in cancer screening . However, only a few studies have considered the modifying effect of SES on the relation between PD and participation in cancer screening . The objectives of the current study were: 1) to investigate the association between serious PD (SPD) and participation in cancer screening in the general population, and 2) to explore the modifying effect of SES on the association between SPD and participation in cancer screening.…”

“…25 However, subsequently published studies reported a nonsignificant association between PD and participation in mammography screening. 10,14,[18][19][20][21] Findings for colorectal and cervical cancer screening have been controversial. Moreover, because the majority of previous studies were conducted in countries with relatively high cancer screening rates, their findings may not be applicable to countries with lower cancer screening rates, such as Japan.…”