Exploration of factors affecting mammography behaviors

Rutledge, Dana N.; Hartmann, William H.; Kinman, Patricia Oney; Winfield, Alan C.

doi:10.1016/0091-7435(88)90040-0

Cited by 126 publications

(31 citation statements)

References 21 publications

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“…Many studies have focused on factors associated with initial participation in breast screening. [5][6][7][8][9][10][11][12][13] The purpose of this paper is to identify predictors of non-attendance for second round screening in Victorian women who attended for first round screening.Adherence to mammography screening schedules has been observed to fall with successive screening rounds.14 It is particularly concerning that women who do not attend after their first round screen largely never participate in the screening programme again. In Nijmegen, 80% of women who attended first round screening attended the second round 15 .…”

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Predictors of non-attendance for second round mammography in an Australian mammographic screening programme

et al. 2000

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Objective-To determine the socioeconomic, cultural, and clinical predictors of non-attendance for second round mammography. Design/participants-Retrospective cohort study of 121 889 women aged 50-69 years who attended for first mammography screening in the BreastScreen Victoria programme in 1995/1996 and who were recommended to be invited for routine biennial mammography. Women were considered to be non-attenders if they had not attended for rescreening within 27 months of their initial screening. Relative risk (RR) was used to compare categories for non-attendance for second screening, and a multivariate model was fitted to adjust for possible confounding. Setting-BreastScreen Victoria, a population based mammographic screening programme, which oVers free biennial mammography to all women 40 years and older. The programme specifically targets women aged 50-69 years. Results-In the multivariate analysis, women from non-English speaking backgrounds were more likely not to attend for second round screening (RR ranged from 1.18 to 1.77). Indigenous women (RR 2.02, 95% confidence interval (CI) 1.61 to 2.54) and women who reported either significant symptoms (RR 1.90, 95% CI 1.76 to 2.05) or other breast symptoms (RR 2.25, 95% CI 2.15 to 2.36) at the time of first round screening were also more likely not to attend for second round screening. Conclusions-Women from non-English speaking backgrounds, indigenous women, and women who report symptoms at the time of first screening are more likely to not attend for second round screening. It is important to investigate why these women do not attend for second round screening so that services can be more appropriately tailored to their needs. (J Med Screen 2000;7:190-194) Keywords: breast; cancer; mammography; attendance In Australia, breast cancer is the most common cancer in women (excluding non-melanocytic skin cancer) and accounted for 29% (9846 cases) of new cancers in women and 17% (2623 cases) of female cancer related deaths in 1996.1 Randomised controlled trials of mammographic screening have shown a 30% reduction in mortality in women aged between 50 and 69 years who are screened.2 Achieving this mortality reduction depends on achieving a screening rate of about 70% of the target population.3 In Victoria, Australia, in 1996 and 1997, 54.9% of women aged 50-69 years attended for screening. For women of non-English speaking background, this rate was 44.8%. 4 Not only should the programme aim to maximise participation in first round screening but, if a mortality reduction is to be achieved, women must also continue to participate in the programme. This requires recruiting women who are eligible for baseline screening and retaining them within the screening programme. Many studies have focused on factors associated with initial participation in breast screening. [5][6][7][8][9][10][11][12][13] The purpose of this paper is to identify predictors of non-attendance for second round screening in Victorian women who attended for first round screening.Adherence to...

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Predictors of non-attendance for second round mammography in an Australian mammographic screening programme

et al. 2000

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“…[2][3][4][5] Inaccurate risk perceptions and elevated levels of distress may serve as barriers to mammography use in this population.6'7 Thus, interventions designed to improve risk comprehension, decrease distress, and enhance mammography use are needed.8…”

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A randomized trial of breast cancer risk counseling: the impact on self-reported mammography use.

et al. 1999

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The most important risk factors for breast cancer are age and family history of breast cancer.' Relatives until the intervention session began. One year after the intervention, participants were contacted for a blinded follow-up interview.Eligible participants were women 40 years and older with a family history ofbreast cancer in at least one first-degree relative. Women with a prior cancer diagnosis (except basal or squamous cell skin cancers) were excluded. Sixty-one percent of those interviewed agreed to be randomized and 71% of those randomized actually completed their intervention visit (for an overall acceptance rate of 43%). Characteristics of women who declined to participate were provided in a previous report." Those women who attended the counseling visit (n = 508) constituted the study sample for this trial. Ofthose who completed a counseling visit, 85% (n = 430) completed the 12-month follow-up interview and served as participants in this report. There was no evidence of differential dropout rates between the groups (16% for breast cancer risk counseling [BCRC]

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“…78 -90 Because electronic searches might not identify all relevant studies, 91 reference lists and published reviews of interventions 70,75,76 were reviewed, and a hand search of the journals Preventive Medicine and American Jour- *References 5,6,13,16,17,19,23,24,26,42,43,45,51,[53][54][55]18,22,32,34,36,40,41,45,54,56,57. ‡References 5,6,8,[14][15][16][18][19][20]22,23,40,41,[49][50][51]54,[58][59][60][61][62]…”

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Effectiveness of Interventions to Increase Papanicolaou Smear Use

Yabroff

Mangan²,

Mandelblatt³

2003

The Journal of the American Board of Family Medicine

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Background: Many women fail to adhere to Papanicolaou smear screening guidelines. Although many interventions have been developed to increase screening, the effectiveness of different types of interventions is unclear.Methods: We performed a systematic review of interventions to increase Papanicolaou smear use published between 1980 and April 2001 and included concurrently or randomized controlled studies with defined outcomes. Interventions were classified as targeted to patients, providers, patients and providers, or health care systems and as behavioral, cognitive, sociologic, or a combination based on the expected action of the intervention. Effect sizes and 95% confidence intervals were calculated for each intervention.Results: Forty-six studies with 63 separate interventions were included. Most interventions increased Papanicolaou smear use, although in many cases the increase was not statistically significant. Behavioral interventions targeted to patients (eg, mailed or telephone reminders) increased Papanicolaou smear use by up to 18.8%; cognitive and sociologic interventions were only marginally effective, although a single culturally specific, sociologic intervention using a lay health worker increased use by 18.0% (95% confidence interval [CI]: 7.6, 28.4). Provider-targeted interventions were heterogeneous. Interventions that targeted both patients and providers did not appear to be any more effective than interventions targeted to either patients or providers alone. One of the most effective interventions, which introduced a system change by integrating a nurse-practitioner and offered same-day screening, increased screening by 32.7% (95% CI: 20.5, 44.9). Screening with regular Papanicolaou smears can decrease not only cervical cancer mortality but also the incidence of invasive disease. Conclusions1,2 Despite increases in recent Papanicolaou smear use during the past two decades, 3,4 with national estimates of approximately 80% within the past 3 years, 4 some women still fail to adhere to recommended Papanicolaou smear screening guidelines, are found to have advanced disease, and die of invasive cervical cancer.27-29 Thus, the potential benefits of routine screening are not being fully realized. Increasing the provision of Papanicolaou smear counseling by primary care providers and, ultimately, routine Papanicolaou smear use are important components of current Healthy People 2010 goals for reducing cervical cancer mortality. 30Physician recommendation is one of the strongest predictors of screening use, 13,17,[31][32][33][34][35][36][37] but in many cases, women report that their provider did not recommend Papanicolaou smears. 5,7,18,38 -45 Explanations for this behavior include lack of time, busy schedules and forgetfulness, 46,47 screening efficacy in the absence of symptoms or concern about proficiency, 31,48 or confusion about conflicting professional recommendations. 46 In the absence of a physician recommendation, patients might assume that screening is unnecessary.Women who do not receiv...

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Exploration of factors affecting mammography behaviors

Cited by 126 publications

References 21 publications

Predictors of non-attendance for second round mammography in an Australian mammographic screening programme

Predictors of non-attendance for second round mammography in an Australian mammographic screening programme

A randomized trial of breast cancer risk counseling: the impact on self-reported mammography use.

Effectiveness of Interventions to Increase Papanicolaou Smear Use

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