Predicting reattendance to the second round of the Maltese national breast screening programme: an analytical descriptive study

Abstract

Background A range of barriers influence women’s uptake to a first breast screening invitation. Few studies however, have examined factors associated with second screening uptake. This study follows Maltese women to explore predictors and behaviours to re-attendance, and to determine if uptake of first invitation to the Maltese Breast Screening Programme (MBSP) is a significant predictor of second screening uptake. Methods A prospective study was conducted to determine factors associated with re-attendance for 100 women invited to the second MBSP round. Records of women’s second attendance to the MBSP were extracted in January 2016 from the MBSP database. Data were analyzed using chi-square tests, Independent Samples t-test, Mann Whitney test, Shapiro Wilk test and logistic regression. Results There were no significant associations for sociodemographic or health status variables with second screening uptake ( p > 0.05), except breast condition (Fisher’s exact test, p = 0.046). Non-attendees at second screening were most unsure of screening frequency recommendations (χ2 = 9.580, p = 0.048). Attendees were more likely to perceive their susceptibility to breast cancer ( p = 0.041), believed breast cancer to be life changing ( p = 0.011) and considered cues to action to aid attendance ( p = 0.028). Non-attendees were in stronger agreement on mammography pain ( p = 0.008) and were less likely to consider cues to action (15.4% non-attendees vs 1.4% attendees) ( p = 0.017 respectively). ‘Perceived barriers’, ‘breast cancer identity’, ‘causes’ and ‘consequences’ were found to be significant predictors of second screening uptake, with ‘perceived barriers’ being the strongest. The inclusion of illness perception items improved the regression model’s accuracy in predicting non-attendance to the second screening round (84.6% vs 30.8%). First screening uptake was found to be a significant predictor of subsequent uptake (OR = 0.102; 95% CI = 0.037, 0.283; p = 0.000). Conclusions Interventions to increase uptake should target first invitees since attending for the first time is a strong predictor of uptake to the second cycle. Further research is required given the small sample. Particular attention should be paid to women who did not respond to their first invite or are unsure or reluctant participants initially.

How do women comply with cancer screenings? A study in four regions of France

“…Some women commented that they had missed the first appointment because of a recent mammogram before the age of 50, or that they had attended the OS when their gynaecologist had retired. Entry into the OS system is key, as several studies have shown that first attenders have a high probability of re attending [ 21 – 23 ]. On the other hand, many non-participants declared that they had had opportunistic mammograms.…”

Influential factors in Black and White breast cancer survivors' beliefs about breast cancer

“…A deeper analysis of BC survivors' beliefs about their cancer is critically important to better understand survivors screening behaviors and inform effective planning of navigation strategies during survivorship care, such as breast surveillance guidelines 24,25 . While, there is a widespread of BC‐related research on women's perceived severity and susceptibility from the general population, 26‐31 very few studies have observed susceptibility to a BC recurrence and disease severity among BC survivors 15,23,32,33 . More recently we investigated Black BC survivor's adjuvant treatment attitudes, and found women reporting higher susceptibility to a BC recurrence had more positive adjuvant endocrine therapy attitudes, and women with higher disease severity and susceptibility to a BC recurrence had more positive chemotherapy attitudes 15 .…”