Psychosocial predictors of first attendance for organised mammography screening

Abstract

Objective To study psychosocial predictors of attendance at an organised breast cancer screening programme. Setting Finnish screening programme based on personal first round invitations in 1992–94, and with 90% attendance rate. Methods Attenders (n=946) belonged to a 10% random sample (n=1680 women, age 50, response rate 64%) of the target population (n=16 886), non-attenders (n=641, 38%) came from the whole target population. Predictors were measured one month before the screening invitation. Measures included items for social and behavioural factors, Breast Cancer Susceptibility Scale, Illness Attitude Scale, Health Locus of Control Scale, Anxiety Inventory, and Depression Inventory. Univariate and multivariate logistic regression analyses were used to predict attendance. Results Those most likely to attend were working, middle income, and averagely educated women, who had not had a mass mammogram recently, but who regularly visited gynaecologists, attended for Pap smear screening, practised breast self examination, and who did not smoke. Low confidence in their own capabilities in breast cancer prevention, overoptimism about the sensitivity of mammography, and perception of breast cancer risk as moderate were also predictive of attendance. Expectation of pain at mammography was predictive of non-attendance. Conclusion Mammography screening organised as a public health service was well accepted. A recent mammogram, high reliance on self control of breast cancer, and an expectation of pain at mammography deterred attendance at screening. Further information about these factors and health information on screening are needed.