Psychological predictors of attendance at annual breast screening examinations

Abstract

Summary This retrospective analysis of psychological predictors of attendance studied the women from the annual screening arm of the United Kingdom Coordinating Committee on Cancer Research (UKCCCR) trial of annual screening mammography for the early detection of breast cancer. Some women attended screening at the first invitation in year 1 (attenders), others did not attend for screening at any time (non-attenders), whereas a third group delayed attending until year 2 (ambivalent attenders). A total of 147 women were recruited to the study: 80 attenders, 28 non-attenders and 39 ambivalent attenders. It proved extremely difficult to contact non-attenders to take part in the study. Non-attenders were significantly more depressed on the Hospital Anxiety and Depression Scale; had experienced more miscarriages, stillbirths or terminations of pregnancy; were less knowledgeable about mammography; and were displeased to have received an invitation to screening. Whereas non-attenders are unlikely ever to attend breast screening because of their long-standing attitudes and preferred coping styles, ambivalent attenders may become more amenable to screening with the passage of time. In this study such women were persuaded to attend in year 2 with a simple, cost-effective intervention: an additional invitation letter after a year.Keywords: attendance; breast screening; depression; perinatal losses; psychology Low take-up rates for breast screening examinations pose a serious challenge for health promotion. Attenders and non-attenders for mammography have now been compared in a variety of UK, European and US settings, and the studies of Fallowfield, Rimer, Vernon, Frazier, Sutton and Polednak are useful exemplars.

Relationship between anxiety level and radiological investigation. Comparison among different diagnostic imaging exams in a prospective single-center study

“…Hence, as already demonstrated by previous studies [12,13] our results demonstrate that radiological diagnostic examinations are responsible for strong emotional reactions and, among these, appear to be the main emotional response that often results in physical symptoms because of hyperactivity of the autonomic nervous system [14]. These symptoms can make the patient less cooperative during this examination [15].…”

Do reproductive and hormonal risk factors for breast cancer associate with attendance at mammography screening?

“…The literature shows a similar mixed picture, with many studies finding no effect of nulliparity on screening [10,11,14,25,26], a positive effect of parity [9,12,27], but less screening among women with more children [28][29][30][31]. Even though we controlled for sociodemographic factors, it is likely that a residual or unmeasured effect from sociodemographic or behavioral factors explains this association.…”

Relocation of a static breast screening unit: a study of factors affecting attendance

“…2 Commonly cited factors influencing attendance are the woman's attitude towards her own health, her perceived risk of breast cancer, and her knowledge of the disease. [3][4][5][6] One early study from Edinburgh cited distance from home to the screening unit as having the greatest eVect upon attendance, 7 whereas others have shown the perceived travelling time to be more important than the distance itself. 8 Socioeconomic status is linked to attendance in some studies, 6 7 but not in others.…”