Relationship of attitudes toward uncertainty and preventive health behaviors with breast cancer screening participation

Abstract

Backgroundcxs Early detection of breast cancer is effective for prolonging survival, but the participation rate in breast cancer screening among target Japanese women remains low. This study examined the relationships between tendencies in decision-making under conditions of uncertainty, health behaviors, demographics, and breast cancer screening participation in Japanese women. Methods Secondary analysis was performed using data from the 2017 Keio Household Panel Survey (KHPS). The study population consisted of 2945 households. Data were obtained from the KHPS for women aged 40 years or older. Breast cancer screening participation in the past year, risk aversion, time preference, health behaviors (e.g., smoking, alcohol consumption, and medical treatment received in the past year), and demographic variables were analyzed. Results Data from 708 women were analyzed. Among the respondents, 28.8% had attended breast cancer screening in the past year. Factors found to significantly contribute to breast cancer screening participation included higher risk aversion (odds ratio [OR], 2.34; 95% confidence interval [CI] = 1.03–5.32; p = 0.043), medical treatment received in the past year (OR, 1.56; 95% CI = 1.06–2.30; p = 0.026), higher self-rated health (OR, 1.47; 95% CI = 1.18–1.83; p = 0.001), living above the poverty line (OR, 2.31; 95% CI = 1.13–4.72; p = 0.022), and having children (OR, 1.57; 95% CI = 1.02–2.42; p = 0.042). Factors significantly associated with non-participation in breast cancer screening were smoking (OR, 0.20; 95% CI = 0.10–0.42; p < 0.000), alcohol consumption (OR, 0.56; 95% CI = 0.37–0.86; p = 0.007), being self-employed (OR, 0.22; 95% CI = 0.10–0.46; p < 0.000), and being unemployed (OR, 0.48; 95% CI = 0.26–0.90; p = 0.022). No significant relationship was observed between time preference and screening participation. Conclusions The results indicate that women who recognize the actual risk of developing breast cancer or have high awareness of breast cancer prevention tend to participate in breast cancer screening. Barriers to screening participation are not working for an organization that encourages screening and low income.

Breast Cancer in Asia: Incidence, Mortality, Early Detection, Mammography Programmes, and Risk-based Screening Initiatives

“…The participation rate in Korea was the highest among the countries with organized mammography screening at 59.7% in 2015 [95]. In 2016, only 44.9% of the target women in Japan had undergone mammography screening within the past 2 years [31]. In Taiwan, the biennial participation rate was slightly below 40% in 2014 [96].…”

“…In addition, they are more capable of affording mammograms, which detect many malignancies that would otherwise remain undetected till a later stage [19]. High-income countries are more likely to offer population-based mammography screening programs [20][21][22][23][24][25][26][27][28][29][30][31][32][33] (Figure 3) and have more resources in terms of qualified physicians and mammogram units per capita (Figure 1), which contributes to higher breast cancer incidence through the increased screening. However, high-income countries such as Kuwait, Bahrain, Qatar, Oman, and Saudi Arabia have much lower incidence rates as compared to low-and lowmiddle-income countries (LMICs) such as Jordan, Syrian Arab Republic, Lebanon, Iraq, and Gaza Strip and West Bank.…”

Breast Cancer in Asia: Incidence, Mortality, Early Detection, Mammography Programs, and Risk-Based Screening Initiatives

“…In addition, they are more capable of affording mammograms, which detect many malignancies that would otherwise remain undetected till a later stage [ 19 ]. High-income countries are more likely to offer population-based mammography screening programs [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ] and have more resources in terms of qualified physicians and mammogram units per capita ( Figure 1 ), which contributes to higher breast cancer incidence through increased screening. However, high-income countries such as Kuwait, Bahrain, Qatar, Oman, and Saudi Arabia have much lower incidence rates, as compared to low- and low-middle-income countries (LMICs) such as Jordan, Syrian Arab Republic, Lebanon, Iraq, and the Gaza Strip and West Bank.…”

Mammography screening is associated with more favourable breast cancer tumour characteristics and better overall survival: case-only analysis of 3739 Asian breast cancer patients

“…9 Lee Kong Chian School of Medicine, Nanyang Technology University, Singapore 308232, Singapore. 10 Division of Breast Surgery, Changi General Hospital, Singapore 529889, Singapore. 11 Breast Department, KK Women's and Children's Hospital, Singapore 229899, Singapore.…”

“…The participation rate in Korea was the highest among the three countries with organized mammography screening at 59.7% in 2015 [ 9 ]. In 2016, only 44.9% of the target women in Japan had undergone mammography screening within the past 2 years [ 10 ]. In Taiwan, the biennial participation rate was slightly below 40% in 2014 [ 11 ].…”