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

Abstract

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...

Who participates in the gastric cancer screening and on‐time rescreening in the National Cancer Screening Program? A population‐based study in Korea

“…Geography was an important factor considered in other studies of regular screening behavior. (24,27) However, a previous study conducted in Korea reported that geography was not significantly associated with the GC screening rate. (38) Despite these limitations, the results provide important information on promoting GC screening.…”

“…This is lower than the rate for breast cancer among population-based samples in Western countries. (24)(25)(26)(27) In 1997, on-schedule mammography rescreening rates for breast cancer were 72.4-81.5% in the US National Breast and Cervical Cancer Early Detection Program (NBC-CEDP). (24) The NBCCEDP offers free screening to low-income women, which might explain the high rescreening rate.…”

Predisposing Factors Associated with Compliance to Biennial Breast Screening among Centers with and without Nurses

“…Demographic questions included date of birth from which their age at interview was calculated (50-59; 60-69 years), highest level of education achieved, current marital status (married; other, which included single, widowed, divorced, or separated), country of birth (North America; Europe; Asia; other), and height and weight that were used to calculate body mass index [kg/m 2 ; below average (<20); average (20)(21)(22)(23)(24)(25); overweight (26)(27)(28)(29)(30); obese (>30)]. Additional questions on risk factors and health practices included family history of breast cancer (one or more first-degree relatives with breast cancer; no first-degree relatives with breast cancer), their use of hormone therapy (ever; never), time since last Pap test (<2; z2 years), and smoking status (never; former; current).…”

“…Demographic factors such as younger age, higher education, higher income, and being married have been shown to be associated with returning for a second screen (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Whether women live in a rural or urban setting has also been shown to have an influence on screening (20)(21)(22). Although living in an urban area has been found to be positively associated with rescreening in mammography facilities in the United States, living in a rural area has been found to be positively associated with rescreening in the Ontario Breast Screening Program (OBSP) as well as in the BreastScreen Victoria Programme in Australia (20)(21)(22).…”

“…Whether women live in a rural or urban setting has also been shown to have an influence on screening (20)(21)(22). Although living in an urban area has been found to be positively associated with rescreening in mammography facilities in the United States, living in a rural area has been found to be positively associated with rescreening in the Ontario Breast Screening Program (OBSP) as well as in the BreastScreen Victoria Programme in Australia (20)(21)(22). Studies from both the United States and Switzerland have shown that foreign birth is associated with not returning for a second screen (5,23).…”