Psychosocial predictors of first attendance for organised mammography screening

Abstract

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...

Willingness to Take Travel-Related Health Risks—A Study among Finnish Tourists in Asia during the Avian Influenza Outbreak

“…The instrument was largely based on the international SARS Psychosocial Research Consortium survey [15], with additional questions on risk perceptions: perceived personal and comparative risk of avian influenza, SARS, and infectious diseases in general; perceived risk of flu, other diseases, accidents, and other travel-related hazards; personal and comparative risk taking tendency; issues important in risk taking; perceived efficacy to prevent avian flu, SARS, and infectious diseases in general; and precautionary behaviors while on trip (for the items and the response categories, please see Table 1). Psychological scales included seven subscales of the Illness Attitudes Scales [13,16]: fear of illness (general reliability 0.91) [17], worry about illness (0.92), effects of symptoms (0.93), concern about pain (0.87), fear of disease (0.92), fear of death (0.89), and health habits (0.79); Short-form Anxiety Inventory (0.84) [18]; Life Orientation Test (0.78) [19].…”

Organised mammography screening reduces breast cancer mortality: A cohort study from Finland

“…The nonparticipants, however, may be persons with breast cancers at the time invitations are generated, or persons with unhealthy behaviour. 21 We therefore adjusted the effect estimates of the participants for self-selection. The corrected estimates were well below one referring that selection did not explain the current result.…”

Reattendance in the Swiss mammography screening pilot programme

“…2 The effect of cognitive (knowledge, behaviour, attitude, perception of personal risk) and emotional factors (anxiety, fear, pain, beliefs) on screening attendance has consistently been observed, 2,6,7 despite the dif culty in measuring psychosocial variables.…”