Pain and discomfort during mammography

Aro, Arja R.; Absetz-Ylöstalo, P.; Eerola, Tuomas; Pamilo, M.; Lönnqvist, Jouko

doi:10.1016/0959-8049(96)00140-2

Cited by 57 publications

(30 citation statements)

References 25 publications

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“…7 Expecting mammography to be painful and uncomfortable decreased the likelihood of attending screening. We know that over 60% of attenders do rate mammography as painful, 35 and pain seems to deter women from regular uptake of screening. 23 Screening organisers should inform women about the possible, short lived pain and discomfort and make eVorts to minimise it.…”

Section: Discussionmentioning

confidence: 99%

Psychosocial predictors of first attendance for organised mammography screening

Aro¹,

Koning

Absetz³

et al. 1999

J Med Screen

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Objective-To study psychosocial predictors of attendance at an organised breast cancer screening programme. Setting-Finnish screening programme based on personal first round invitations in 1992-94, and with 90% attendance rate. Methods-Attenders (n=946) belonged to a 10% random sample (n=1680 women, age 50, response rate 64%) of the target population (n=16 886), non-attenders (n=641, 38%) came from the whole target population. Predictors were measured one month before the screening invitation. Measures included items for social and behavioural factors, Breast Cancer Susceptibility Scale, Illness Attitude Scale, Health Locus of Control Scale, Anxiety Inventory, and Depression Inventory. Univariate and multivariate logistic regression analyses were used to predict attendance. Results-Those most likely to attend were working, middle income, and averagely educated women, who had not had a mass mammogram recently, but who regularly visited gynaecologists, attended for Pap smear screening, practised breast self examination, and who did not smoke. Low confidence in their own capabilities in breast cancer prevention, overoptimism about the sensitivity of mammography, and perception of breast cancer risk as moderate were also predictive of attendance. Expectation of pain at mammography was predictive of non-attendance. Conclusion-Mammography screening organised as a public health service was well accepted. A recent mammogram, high reliance on self control of breast cancer, and an expectation of pain at mammography deterred attendance at screening. Further information about these factors and health information on screening are needed. (J Med Screen 1999;6:82-88) Keywords: mammography; attendance; psychosocial factors High quality mammographic screening of women aged 50-74 may significantly reduce breast cancer mortality.1 In Finland screening has been carried out since 1987 as a public health policy, with personal invitations sent to women aged between 50 and 59 every two years. Uptake is around 90%, 2 close to the Swedish figures 3 and higher than in many other countries with similar services.Several reports have looked at the diVerences between attenders and non-attenders. 4 Only a few studies, however, have used a prospective design in which background characteristics were monitored before the invitation to the first screening round, and participation was verified at the screening registry afterwards. Married, healthy women, interested in their health, especially health check-ups, who perceived their risk of breast cancer to be high and believed in the benefit of screening, were more likely to attend.5-7 Sociodemographic factors-for example, level of education or social class, were not predictive. 5-7Nonattendance may be partly explained by recent mammography elsewhere. It has been suggested that emotional factors, such as anxiety and depression, may aVect attendance, 9 but no study has included standardised, prospective measures.This study aimed at determining the influence of psychosocial factors, cognitiv...

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Section: Discussionmentioning

confidence: 99%

Psychosocial predictors of first attendance for organised mammography screening

Aro¹,

Koning

Absetz³

et al. 1999

J Med Screen

Self Cite

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“…These findings are consistent with various other studies which show generally high levels of satisfaction with screening (including respect for privacy and treatment by staV) but in which pain or discomfort is often mentioned. [34][35][36][37][38] Various authors have suggested that screening might cause false reassurance. [6][7][8] The results of our study provide no indications of false reassurance among women who received a negative screening result.…”

Section: Discussionmentioning

confidence: 99%

Does mammographic screening and a negative result affect attitudes towards future breast screening?

Drossaert

Boer²,

Seydel³

2001

J Med Screen

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Objectives-To investigate the impact of an experience of a benign mammographic result on intention to seek medical help immediately in the case of breast abnormalities, and on intentions and thoughts about future participation in screening. Setting-The Dutch Breast Cancer Screening Programme for women aged 50-69. Methods-Subjects were women who were invited for an initial breast examination: 223 women filled out a questionnaire about 10 days before and about 6 weeks after their initial breast examination. To be able to control for possible test eVects, another group of 293 women filled out a questionnaire only after mammography. Changes in thoughts and intentions were examined. Results-Most women were very satisfied with the course of their initial breast examination, although pain or discomfort was often mentioned. No clues to suggest false reassurance were found: more than 99% of the women would consider the possibility of breast cancer if they felt a lump in one of their breasts. In such a situation, most women intended to seek medical help within a week. These variables were not influenced by the experience of mammography with a benign result. In general, women were very positive about (repeat) participation, both before and after screening. After screening, the average woman perceived fewer costs in participating, and perceived her own ability to engage in future screening as higher. However, the experience of pain and anxiety during the initial screening did lead to reverse eVects. Women who were less satisfied about their treatment by the staV were more likely to change their intentions to reparticipate in a negative way. Conclusions-As, in general, women became more positive about regular participation after they had attended breast cancer screening, eVorts to improve first round attendance must be continued. At the same time, the screening organisations must continue to prioritise the high level of client friendliness throughout the screening. No evidence for detrimental eVects of screening through false reassurance among participants was found. (J Med Screen 2001;8:204-212)

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“…In the study by Bruijninkx et al, 24 it was found that the percentage of women who recollected that the mammography as painful increased as time passed by. Aro et al 14 have argued that fluctuation of reported mammography pain should be studied over time, because there is evidence from dental patients that memory is reconstructed over time to become consistent with expectations and anxiety. 25 One of the aims of the present study was to examine whether the perceptions of the previous screen changed in the period between two subsequent screenings.…”

Section: Influence Of Negative Experiences On Repeat Attendancementioning

confidence: 99%

Monitoring women's experiences during three rounds of breast cancer screening: results from a longitudinal study

2002

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Objectives: (a) To monitor experiences of women during three successive rounds of breast screening; (b) to examine the impact of previous experiences (obtained either immediately after the latest mammogram or shortly before the subsequent one) on reattendance; and (c) to examine which factors are associated with the experience of pain and distress during screening. Setting: The Dutch Breast Cancer Screening Programme Methods: 2657 women completed a baseline measurement (response rate 67%) about 8 weeks after they had been invited for an initial mammogram (T 1 ). Actual participation data of these women in the second and third rounds of screening were collected. Follow up questionnaires were sent to subgroups of the sample at different times: shortly before the second screening (T 2 ; response rate 86%), shortly after the second screening (T 3 ; response rate 85%), shortly before the third screening (T 4 ; response rate 80%), and shortly after the third screening (T 5 ; response rate 78%). Results: Most women were satisfied with the first screening round and remained positive about subsequent screens. Although pain and anxiety were not uncommon, only a few (10%-15%) experienced moderate or severe levels of distress or pain. Experiences were relatively stable: women who experienced pain in the first screen were more likely to experience pain in subsequent screens (r values from 0.39 to 0.50). Fear of breast cancer was associated with increased distress related to mammography and, to a lesser extent, with increased pain during the mammography. Evidence was found for a relief effect: women were more positive about their previous screen when asked shortly after this screen, than when asked just before the subsequent one. Previous experiences (obtained either proximally or distally) were only slightly predictive for future attendance. Conclusion: Experiences during mammography are fairly stable. Negative experiences were generally not a reason to drop out of the programme. S tudies in different countries with differently organised breast screening programmes have shown that women who participate in breast cancer screening are in general positive about the course of the breast examination.

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Pain and discomfort during mammography

Cited by 57 publications

References 25 publications

Psychosocial predictors of first attendance for organised mammography screening

Psychosocial predictors of first attendance for organised mammography screening

Does mammographic screening and a negative result affect attitudes towards future breast screening?

Monitoring women's experiences during three rounds of breast cancer screening: results from a longitudinal study

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