Factors related to non-adherence to mammography in a city of the Brazilian Amazonian area: A population-based study

Abstract

Objective: To assess the prevalence of mammography use and factors related to non-adherence in Boa Vista, capital of Roraima, Brazil. Method: A cross sectional study, quantitative analysis, based on household survey was performed between June and August 2013, using a face-to-face interview with a pre-tested form. Target population was women between 40 and 69 years. The sample size target was 240 participants, and the sampling method was random cluster sampling. The study was approved by the Institutional Review Board of Federal University of Roraima. Results: 241 women were included without refusals. The prevalence of non-use of mammography in the past two years was 55.6% (95CI 49.1-61.9). In univariate analysis, the risk factors for non-adherence to mammography were having low educational level, family income below three minimum wages, receiving government assistance, not having consulted with a doctor and no health insurance. In multivariate analysis, only low educational level and receiving government assistance remained as risk factors. Medical consultation or health worker visiting were protective factors. Conclusion: Adherence to mammography is unsatisfactory in Boa Vista, Roraima, and has a predominantly opportunistic character. Low educational level is confirmed as an independent risk factor, but belonging to a family that receives government assistance can be interpreted as a social marker of families and/or areas lacking of government intervention to increase access to breast cancer control programs.

Socioeconomic determinants of cancer screening utilisation in Latin America: A systematic review

“…Most studies found an association between education levels and participation in mammography in the previous 1–3 years. [19, 23, 31, 34–36, 39] Less clear associations were found in a study in Brazil [23] that only found primary education to be a determinant for participating in mammography; in another study in Costa Rica,[24] education negatively correlated with yearly participation in mammography, although not when the interval was set at three years. This study concluded that better-educated women tend to wait longer between mammography and Pap smear screenings than their less educated counterparts.…”

“…Most studies defined education level as number of years of schooling. [14, 16–20, 24, 26, 27, 30, 35, 36] A few studies defined the level of education as the completion of primary, secondary or tertiary education,[21–23, 33] which makes regional comparisons more difficult.…”

Breast Cancer Risk Perception and Mammography Screening Behavior of Women in Northeast Brazil

“…In recent studies from various countries, high educational level was one of the most important predictors of adherence to MS. [28][29][30][31] In agreement with our results, several Brazilian studies reported a greater chance of adherence to MS among women with higher educational levels. 5,8,27,32,33 In contrast, a recent study also performed in the Northeast region of Brazil, among women who had predominantly a low educational level, high income instead of education was associated with MS participation. 9 The nationwide adherence study by Narayan et al in the United States identified both high income and educational level as important predictors of adherence to MS. 29 Data of the present study also indicated that occupied women performed MS more often compared with those who were not occupied.…”

Contributors of Mammography Screening with Zero-Inflated Count Regression Models by Bayesian Approach

“…In South Africa, 94.7% of the participants never used any breast cancer screening methods (36). In under-developed countries, the participation rate is almost the same as Iran: 75% of women over 40 in Turkey (37), 76.9% in Taiwan (38), 56% in Singapore (39), and 69.1% in Qatar (40) had no experience of mammography, and in Brazil 55.6% have not performed mammography in the past two years (41). On the other hand, the participation rate is higher in the developed countries: 85% of women aged 50-70 in Greece, 59.9% of Japanese women aged 40-70 (2), and 65.9% of African women aged 50-74 residing in Australia have performed mammography every two years and only 19% of them did not undergo mammograms (42).…”