Background: Understanding women's life conditions regarding their non-participation in different healthpromoting and disease-preventing activities is important as it may draw attention to potential areas for improvement in the healthcare sector. Mammographic screening, a disease-preventing service, facilitates early detection of any potential malignancies and consequently prompts initiation of treatment. The reasons for nonparticipation in mammographic screening can be understood from different perspectives, such as socioeconomic and lifestyle-related determinants of health. This study aims to gain a deeper understanding of women's experiences and perceptions about non-participation in mammographic screening in a Swedish region with a single mammographic facility. Methods: Data from individual semi-structured interviews, conducted in 2018 with eleven women between the ages of 48 and 73, were analysed by a qualitative content analysis. Results: The findings reveal three main categories: 1) doubts regarding mammographic screening and its organisation, 2) sense and sensibility in the decision to refrain from mammographic screening, and 3) dependency and options. These three categories indicate aspects, such as the individual's life situation, accessibility to the offered service, and the flexibility of the healthcare system, that need to be considered to improve the organisation of mammographic screening. Conclusion: Listening to the women's voices regarding their experiences and perceptions about mammographic screening is important as individual characteristics and social circumstances interact with healthcare and affect the degree of participation.

Purpose: An organized population-based mammographic screening programme aims for an early detection of potential breast abnormalities so that treatment can commence. Continuous participation and a high attendance rate are vital for an effective programme. It is important to understand the underlying reasons for participation in mammographic screening, should there be factors that are amendable within reason and could be adjusted. Therefore, the invited women are valuable sources of information. This study aimed at describing the experiences and perceptions about mammographic screening of women from three municipalities in a Swedish county. Method: Six semi-structured focus-group discussions, each with four to five participants, were held. Content analysis was then conducted. Results: The screening procedure, such as staff professionalism, was covered. Other people’s opinions and the woman’s own understanding affected the women’s decisions on whether or not to undergo the procedure. Structural conditions, such as travel time and financial issues, were sources of concern. However, the offer to perform mammographic screening was perceived with gratitude. Conclusions: Structural conditions, risk and time perceptions, the screening procedure, attitudes towards undergoing it and appreciation of its benefit may influence the women’s continuous willingness to be screened, which in turn may affect public and individual health.

Background Breast cancer is the most common cancer type among women globally. To facilitate early detection, all 40–74-year-old female residents of Sweden are invited to participate in a population-based mammographic screening programme. Approximately 20% of all invited women decline the offer, and if this is due to systematic differences that can be adjusted, it can indicate inequity in healthcare. Assessment of and being updated about the health and healthcare of the residents are largely the responsibilities of the self-governed regions in Sweden. The understanding of the residents’ health serves as a basis for decision making and priority setting. This study aims to describe how politicians representing a region in Sweden perceive women’s participation in mammographic screening and the politicians’ own possibility to promote such participation. Methods Qualitative thematic analysis was conducted on the data obtained from individual semi-structured interviews held in 2019. The interviewees comprised ten politicians (six women and four men, 38–71 years old) representing a sub-committee focusing on public health and healthcare issues. Results Two main themes have been identified: 1) expected actions and 2) expected conditions for acting, including a total of four sub-themes. According to the politicians, the expected actions, such as obtaining information and being updated about matters regarding mammographic screening, concern both the women invited to the screening and the politicians themselves. Additionally, for both the individual and the healthcare organisation, here represented by the politicians, expected actions entail a shared commitment to maintain health. The expected conditions for acting refer to the politician’s awareness of the factors influencing the women’s decision to undergo or refuse the screening and having the resources to enable taking actions to facilitate participation. Conclusions Expected actions and expected conditions for acting are tightly connected and entail some form of prioritisation by the politicians. Setting the priorities can be based on information about the purpose of the screening and an understanding of social determinants’ impacts on women’s decision to refrain from mammographic screening, as well as available resources.