Mammography use and factors associated with its use after the introduction of breast cancer screening programmes in Spain

Abstract

The aim of this study was to measure the use of mammography and the factors associated with testing among Spanish women, after the introduction of screening programmes in Spain. We conducted a cross-sectional population survey of a representative sample of women aged 40-70 (2409 women). Data collection took place in October 2000, using a questionnaire addressing the dependent variable (mammography use) and the independent variables (socio-demographic and socio-health factors, and women's knowledge and attitudes). Mammography use was defined as having received at least one screening test in the previous 2 years. Data analysis consisted of univariate and multivariate analyses. 48.1% (95% confidence interval (CI) 46.0-50.2) of women had received screening mammography. The main factors associated with testing were: mammography invitation from the screening programme (odds ratio (OR) 4.81; 95% CI 3.85-6.01); gynaecologist visit (OR 4.32; 95% CI 3.45-5.41); and intention to have a mammogram (OR 2.94; 95% CI 2.00-4.32). Other test-related factors were: not rejecting test for discomfort or fear of cancer; mammography perceived as necessary; age 56-65; upper/upper-middle socio-economic status. In conclusion, after the introduction of screening programmes, almost half of Spanish women aged 40-70 had received mammography. Invitation to screening, gynaecologist visit and women's attitudes are the main reasons for undergoing testing. Women over 65 years of age and/or those in a lower socio-economic level warrant special attention.

Breast cancer screening programmes: Challenging the coexistence with opportunistic mammography

“…The results of this study showed that when OrgMS and OppMS coexisted, women with a regular gynaecological check-up and those who were employed (compared with unemployed or retired women) were more likely to participate in OppMS or to perform both OrgMS and OppMS. Our results are consistent with previous studies which reported that regular medical follow-up is associated with participation in mammography screening [32][33][34][35][36][37]. Women with a regular gynaecological check-up and those who are employed have more positive attitudes toward cancer screening.…”

Breast and cervical cancer screening in Spain and predictors of adherence

“…Although both educational and economic levels showed associations with cervical cancer screening, only higher educational level was associated with a greater participation in breast cancer screening. As for health care-related variables, consistent with previous studies, having supplementary private health insurance and visiting a general practitioner or gynecologist were positively associated with mammography (Luengo-Matos et al, 2006;Cabeza et al, 2007;Coughlin et al, 2008;Esteva et al, 2008) and Pap smear (Luengo-Matos and Muñoz van den Eynde, 2004;Cabeza et al, 2007;Coughlin et al, 2008;Puig-Tintore et al, 2008) attendance in the current analysis. It would be useful to investigate Multivariate ORs of predictors of participation in mammography screening.…”

“…Therefore, it would be useful to investigate adherence to screening recommendations and to identify factors that influence women to take screening tests. Previous Spanish studies (Alcaraz et al, 2002;Bare et al, 2003;Luengo-Matos and Muñoz van den Eynde, 2004;Asua, 2005;Luengo-Matos et al, 2006;Cabeza et al, 2007;Esteva et al, 2008;Gobierno et al, 2008;Puig-Tintore et al, 2008;Barroso et al, 2009) report adherence rates of 48-72% for mammography and between 49.5 and 75% for Pap smear. In other developed countries the results are different (Coughlin et al, 2004;Coughlin et al, 2008;Von Euler-Chelpin et al, 2008).…”

“…Several studies analyze the factors that make women participate or not in screening programmes. Sociodemographic factors such as age, marital status, educational level and economic status have often been found to be associated with participation (Alcaraz et al, 2002;Bare et al, 2003;Luengo-Matos and Muñoz van den Eynde, 2004;Luengo-Matos et al, 2006;Cabeza et al, 2007;Esteva et al, 2008;Puig-Tintore et al, 2008). In Spain, data on the relationship between chronic conditions and lifestyle and adherence to screening programmes are scarce (Galan et al, 2006).…”

Population-based study of breast cancer screening in Côte d'Or (France)

“…Currently, efforts are made to focus on early detection and treatment to reduce breast cancer mortality. Some studies reported that screening for breast cancer with mammography could reduce breast cancer mortality by approximately 20-35% in women aged 50-69 years (Elmore et al, 2005;Luengo-Matos et al, 2006).…”