Socioeconomic status &amp; returning for a second screen in the Ontario breast screening program

Tatla, R K; Paszat, Lawrence; Bondy, Susan J.; Chen, Z; Chiarelli, Anna M.; Mai, Verna

doi:10.1016/s0960-9776(03)00100-0

Cited by 34 publications

(34 citation statements)

References 26 publications

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“…The first is socioeconomic level, measured by education level and income, and also represented by the proxies oral contraceptive use and number of children, depicting family planning, which is in turn directly influenced by the socioeconomic level of an individual. Although it was already known that a lower socioeconomic level was a predictor of worse adherence in the general population (9,10,30), our results show that, even in a population composed majorly of underserved women, economic contrasts are still observed and also influence screening compliance.…”

Section: Discussioncontrasting

confidence: 58%

Adherence to a Breast Cancer Screening Program and Its Predictors in Underserved Women in Southern Brazil

Caleffi

Ribeiro

Bedin

et al. 2010

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Adherence to breast cancer screening is a key element to ensure effectiveness of programs aiming at downstaging of breast cancer. In this study, we evaluated adherence to a screening program and its predictors in underserved women in southern Brazil.Methods: Attendance to the program, which is based on yearly mammogram and clinical examination, was evaluated prospectively. Mean time frames between visits were calculated. Possible predictors of adherence (defined as mean intervals ≤18 mo), such as socioeconomic indicators and health/lifestyle behaviors, were investigated.Results: A total of 3,749 women (age 51 ± 8 y, illiteracy rate of 6.8%, 57.4% with parity ≥3) were analyzed. Median time between screening rounds was 16.5 months (interquartile range, 13.1-25.7), and median number of rounds attended was 3 (interquartile range, 2-4); 57.6% had mean intervals ≤18, and 71% ≤24 months. The most important independent predictors of adherence were high genetic risk [relative risk (RR), 1.25; 95% confidence interval (95% CI), 1.11-1.40], illiteracy (RR, 0.77; 95% CI, 0.67-0.90), parity ≥5 (RR, 0.89; 95% CI, 0.83-0.96), and smoking (RR, 0.82; 95% CI, 0.77-0.88).Conclusions: Although the proposed screening interval was 1 year, compliance to biannual screening (accepted in several international programs) was high, especially when considering the low socioeconomic level of the sample.Impact: This project aims to test a breast cancer screening model for underserved populations in limitedresource countries where adherence is an issue. The identification of worst adherence predictors can point to interventions to improve outcomes of similar public health screening strategies. Cancer Epidemiol Biomarkers

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Section: Discussioncontrasting

confidence: 58%

Adherence to a Breast Cancer Screening Program and Its Predictors in Underserved Women in Southern Brazil

Caleffi

Ribeiro

Bedin

et al. 2010

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…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).…”

Section: Methodsmentioning

confidence: 99%

“…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).…”

Section: Introductionmentioning

confidence: 99%

“…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).…”

Section: Introductionmentioning

confidence: 99%

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

Edwards

Chiarelli

Stewart

et al. 2009

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Previous research suggests that predisposing factors such as previous screening experience, participation in preventive health behaviors, and knowledge/beliefs about breast cancer and screening influence a woman's decision to make a timely return for a second screen. Methods: A stratified random sample of compliers and noncompliers to biennial screening were selected from a cohort of 51,242 women ages 50 to 65 years who had their initial screen at the Ontario Breast Screening Program. In total, 1,901 women were telephone-interviewed. The associations between predisposing factors and compliance were estimated separately for centers with and without nurses using logistic regression analyses adjusted for demographics and smoking status. Results: Women screened at nurse centers were less likely to comply if they thought women should stop

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“…For example, intervals used to define two consecutive mammograms during a given time window have ranged from 12 months to three years. [Bobo, 2004;Engelman, 2004;Rimer, 2002;Tatla, 2003;Partin, 2005] Several studies defined success as receiving a second screen within two years, but they varied by whether they allowed an additional time window (e.g., three months) to account for scheduling difficulties. [Andersen, 2000;Crane, 1998;Jepson, 1997;Song, 1998;Ulcickas, 1999] When repeat and regular screening was defined by number of mammograms received during a given time period, definitions varied by number of mammograms required and length of observation period.…”

Section: Introductionmentioning

confidence: 99%

Concordance of population-based estimates of mammography screening

Boudreau

Luce

Ludman

et al. 2007

Preventive Medicine

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Objective-Estimates of adherence to mammography screening guidelines vary, in part, due to lack of consensus on defining adherence. This study estimated adherence to repeat (two successive on-time screenings) and regular screening (three or more successive screenings) and evaluated the impact of varying operational definitions and evaluation periods.Methods-The study included women aged 50-80 without a history of breast cancer who: were on a biennial screening cycle and due for a screening mammogram between 1995 and 1996; underwent screening (index date) in response to a reminder letter; and belonged to Group Health, an integrated health care delivery system in Washington State, for six or more years after the index date. Automated records provided information on enrollment, health care utilization, and procedures.Results-Among 1336 women, 67-82% experienced a repeat screen. Adherence to regular screening over the six year evaluation period was 42-84%-and higher with longer allowable intervals between screenings, when definitions did not require on-schedule screenings, when intervals were reset after a diagnostic mammogram, and for shorter evaluation periods.Conclusion-Estimates of adherence to screening guidelines varied by the operational definition of "success" and time period of evaluation. Consensus in definitions and terminology is needed to compare evaluations.

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Socioeconomic status & returning for a second screen in the Ontario breast screening program

Cited by 34 publications

References 26 publications

Adherence to a Breast Cancer Screening Program and Its Predictors in Underserved Women in Southern Brazil

Adherence to a Breast Cancer Screening Program and Its Predictors in Underserved Women in Southern Brazil

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

Concordance of population-based estimates of mammography screening

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