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Biennial screening mammography: How many women ask for more? Estimate of the interval mammogram rate in an organised population-based screening programme. LA RADIOLOGIA MEDICA 2020; 126:200-205. [PMID: 32577906 DOI: 10.1007/s11547-020-01238-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 06/07/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To estimate the interval mammogram rate, i.e. the undertaking of an additional mammography between scheduled screening rounds, and identify factors influencing this phenomenon. METHODS Data from our screening programme for the year 2014, excluding prevalent rounds, were analysed. Information about the number of women who underwent interval mammograms was obtained reviewing the questionnaires and searching the department database. Data on age, breast density, family history of breast cancer, number of screening rounds, previous recalls, general practitioner, and city of residence (used as a proxy of local socio-economic differences) were evaluated using chi-square test. RESULTS Of 2780 screened women (incident rounds), 2566 had complete data (92%). The interval mammogram rate was 384/2566 (15%, 95% confidence interval 14-17%). Women classified with American College of Radiology c or d breast density categories showed a higher interval mammography probability than those with a and b density (p < 0.001); women in their second round showed a higher probability of interval mammogram compared to women in their fifth, sixth, or seventh round (p ≤ 0.004). No significant differences were found between women with and without an interval mammogram when considering previous recalls for a negative work-up (p = 0.241), positive breast cancer family history (p = 0.538), and city of residence (p = 0.177). CONCLUSIONS The interval mammogram rate was relatively low (15%). Higher breast density and first of years of adherence to the programme were associated with higher interval mammogram rate.
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Labrie NHM, Ludolph RA, Schulz PJ. Mammography perceptions and practices among women aged 30-49: The role of screening programme availability and cultural affiliation. PATIENT EDUCATION AND COUNSELING 2020; 103:369-375. [PMID: 31506173 DOI: 10.1016/j.pec.2019.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 07/26/2019] [Accepted: 09/01/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To explore the role of systematic screening programme availability and cultural affiliation as drivers of mammography perceptions/practices among women aged 30-49, who are not eligible for screening. METHODS Cross-sectional survey about mammography perceptions/practices among N = 918 Swiss women (30-49), across three cultural-linguistic regions (Swiss-German, Swiss-French, Swiss-Italian) and 26 cantons. RESULTS In cantons offering systematic screening programmes, women appeared more likely to ask for a mammogram, felt more susceptible to breast cancer, and perceived more benefits to screening. Swiss-German women engaged less in screening and felt less susceptible to breast cancer than women in other cultural-linguistic regions. Within the Swiss-German region, women living in cantons with programmes were more likely to ask for a mammogram than in cantons without. CONCLUSIONS Programme availability and cultural affiliation both appear related to young women's screening perceptions/practices. While the interaction between these factors should be further explored, this study provides some preliminary evidence that cultural affiliation is the more important driver. PRACTICE IMPLICATIONS Health communication efforts should consider the impact of these drivers on women's intentions to have a mammogram, prior to the recommended age. Tailored communication - public and interpersonal - should be directed towards facilitating informed decision-making and avoidance of mammography overuse.
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Affiliation(s)
- Nanon H M Labrie
- Athena Institute, Faculty of Beta Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands.
| | - Ramona A Ludolph
- Institute of Communication & Health, Faculty of Communication Sciences, Università della Svizzera italiana, Via Giuseppe Buffi 6, 6900 Lugano, Switzerland.
| | - Peter J Schulz
- Institute of Communication & Health, Faculty of Communication Sciences, Università della Svizzera italiana, Via Giuseppe Buffi 6, 6900 Lugano, Switzerland.
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Molina Y, Beresford SAA, Thompson B. Psychological Outcomes After a False Positive Mammogram: Preliminary Evidence for Ethnic Differences Across Time. J Racial Ethn Health Disparities 2017; 4:123-133. [PMID: 26896036 PMCID: PMC4991952 DOI: 10.1007/s40615-016-0209-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 12/29/2015] [Accepted: 01/18/2016] [Indexed: 12/29/2022]
Abstract
Adverse psychological consequences of screening mammography are well-documented for women who receive a false positive result. However, little is known about ethnic differences. To address this gap, we examine distress associated with an abnormal mammogram (results-related distress) and perceived lifetime risk of breast cancer (perceived risk) among Latinas and non-Latina White (NLW) women 3 months after receipt of a false positive result. A sample of 28 Latina and 27 NLW women who received an initial abnormal mammogram result and later, a definitive non-cancer diagnosis were recruited for this descriptive, longitudinal study. Women were interviewed twice: within 30 days and 3 months after a false positive result. Questionnaires included standard sociodemographic questions, the Impact of Events Scale-Revised, and two perceived breast cancer risk items. All participants experienced decreased distress 3 months after the initial results. Latinas experienced higher levels of distress, F(1,45) = 4.58, p = 0.04, and had a significant increase in perceived breast cancer risk over time, F(1,45) = 3.99, p = 0.05. Larger population-based studies are necessary to confirm ethnic differences in mental health consequences of false positive results. Given cultural emphases concerning respect for authority figures, healthcare professionals may be particularly helpful in working with Latinas to mitigate distress and clarify accurate perceptions of breast cancer risk through evidence-based practice.
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Affiliation(s)
- Yamile Molina
- School of Public Health, University of Illinois-Chicago, 1603 W Taylor St, 649 SPHPI MC923, Chicago, IL, 60612, USA.
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
| | - Shirley A A Beresford
- School of Public Health, University of Washington, Seattle, WA, USA
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Beti Thompson
- School of Public Health, University of Washington, Seattle, WA, USA
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Ouédraogo S, Dabakuyo-Yonli TS, Amiel P, Dancourt V, Dumas A, Arveux P. Breast cancer screening programmes: challenging the coexistence with opportunistic mammography. PATIENT EDUCATION AND COUNSELING 2014; 97:410-7. [PMID: 25282326 DOI: 10.1016/j.pec.2014.08.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 08/10/2014] [Accepted: 08/26/2014] [Indexed: 05/06/2023]
Abstract
OBJECTIVE This study investigated predictive factors of women's participation in organized mammography screening (OrgMS) and/or opportunistic mammography screening (OppMS) when the two screening modes coexist. METHODS Questionnaires were sent to 6,000 women aged 51-74 years old invited to attend an OrgMS session between 2010 and 2011 in France. Data collected concerned the women's healthcare behaviour and their socioeconomic characteristics. Women without a personal or family history of breast cancer that could explain their participation in OppMS were retained in the generalized logits analysis. RESULTS The data of 1,202 women were analysed. Of these, 555 (46.2%) had attended OrgMS only, 105 (8.7%) OppMS only and 542 (45.1%) had performed both OrgMS and OppMS. Multivariable analyses showed that women who had regular gynaecological check-ups were more likely to perform OppMS only or both OrgMS and OppMS, OR 95% CI were 2.1 [1.1-3.9], 1.9 [1.4-2.6], respectively. Being employed also increased participation in OppMS only [OR: 2.1 (1.2-3.7)] or both OrgMS and OppMS [OR: 1.5 (1.1-2.05)]. CONCLUSION AND PRACTICE IMPLICATIONS In countries where OrgMS and OppMS coexist, strategies involving gynaecologists, referring doctors or company doctors and the organization of healthcare services to promote adequate screening round may help to reduce the overuse of mammography.
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Affiliation(s)
- Samiratou Ouédraogo
- Breast and Gynaecologic Cancer Registry of Cote d'Or, Georges-François Leclerc Comprehensive Cancer Care Centre, Dijon, France; EA 4184, Medical School, University of Burgundy, Dijon, France.
| | - Tienhan S Dabakuyo-Yonli
- EA 4184, Medical School, University of Burgundy, Dijon, France; Biostatistics and Quality of Life Unit, Georges-François Leclerc Comprehensive Cancer Care Centre, Dijon, France
| | - Philippe Amiel
- Social and Human Sciences Research Unit, Gustave-Roussy Cancer Institute, Villejuif, France
| | - Vincent Dancourt
- Inserm U866, Medical School, University of Burgundy, Dijon, France; Association pour le Dépistage des Cancers en Côte d'Or et dans la Nièvre (ADECA 21-58), Dijon, France
| | - Agnès Dumas
- Social and Human Sciences Research Unit, Gustave-Roussy Cancer Institute, Villejuif, France
| | - Patrick Arveux
- Breast and Gynaecologic Cancer Registry of Cote d'Or, Georges-François Leclerc Comprehensive Cancer Care Centre, Dijon, France; EA 4184, Medical School, University of Burgundy, Dijon, France
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Haikel RL, Mauad EC, Silva TB, Mattos JSDC, Chala LF, Longatto-Filho A, de Barros N. Mammography-based screening program: preliminary results from a first 2-year round in a Brazilian region using mobile and fixed units. BMC WOMENS HEALTH 2012; 12:32. [PMID: 23031787 PMCID: PMC3532077 DOI: 10.1186/1472-6874-12-32] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 09/26/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer deaths among women worldwide. The use of mobile mammography units to offer screening to women living in remote areas is a rational strategy to increase the number of women examined. This study aimed to evaluate results from the first 2 years of a government-organized mammography screening program implemented with a mobile unit (MU) and a fixed unit (FU) in a rural county in Brazil. The program offered breast cancer screening to women living in Barretos and the surrounding area. METHODS Based on epidemiologic data, 54 238 women, aged 40 to 69 years, were eligible for breast cancer screening. The study included women examined from April 1, 2003 to March 31, 2005. The chi-square test and Bonferroni correction analyses were used to evaluate the frequencies of tumors and the importance of clinical parameters and tumor characteristics. Significance was set at p < 0.05. RESULTS Overall, 17 964 women underwent mammography. This represented 33.1% of eligible women in the area. A mean of 18.6 and 26.3 women per day were examined in the FU and MU, respectively. Seventy six patients were diagnosed with breast cancer (41 (54%) in the MU). This represented 4.2 cases of breast cancer per 1000 examinations. The number of cancers detected was significantly higher in women aged 60 to 69 years than in those aged 50 to 59 years (p < 0.001) or 40 to 49 years (p < 0.001). No difference was observed between women aged 40 to 49 years and those aged 50 to 59 years (p = 0.164). The proportion of tumors in the early (EC 0 and EC I) and advanced (CS III and CS IV) stages of development were 43.4% and 15.8%, respectively. CONCLUSIONS Preliminary results indicate that this mammography screening program is feasible for implementation in a rural Brazilian territory and favor program continuation.
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Affiliation(s)
- Raphael Luiz Haikel
- Department of Cancer Prevention, Barretos Cancer Hospital, Rua Antenor Duarte Villella, 1331 -, Barretos, São Paulo, SP 14784-400, Brazil.
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Brotons C, Bulc M, Sammut MR, Sheehan M, Manuel da Silva Martins C, Björkelund C, Drenthen AJM, Duhot D, Görpelioglui S, Jurgova E, Keinanen-Kiukkanniemi S, Kotányi P, Markou V, Moral I, Mortsiefer A, Pas L, Pichler I, Sghedoni D, Tataradze R, Thireos E, Valius L, Vuchak J, Collins C, Cornelis E, Ciurana R, Kloppe P, Mierzecki A, Nadaraia K, Godycki-Cwirko M. Attitudes toward preventive services and lifestyle: the views of primary care patients in Europe. the EUROPREVIEW patient study. Fam Pract 2012; 29 Suppl 1:i168-i176. [PMID: 22399549 DOI: 10.1093/fampra/cmr102] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND For preventive interventions in general practice to succeed, patients' points of view must be taken into account in addition to those of GPs. OBJECTIVE To explore patients' views and beliefs about the importance of lifestyle and preventive interventions, to assess their readiness to make changes to their lifestyle and their willingness to receive support from GPs. METHODS Cross-sectional survey conducted by EUROPREV in primary care practices in 22 European countries. Patients were consecutively selected and interviewed from September 2008 to September 2009. RESULTS Seven thousand nine hundred and forty-seven participants, 52.2% females. Only 30.5% of risky drinkers think they need to change, as opposed to 64% of smokers, 73.5% of patients with unhealthy eating habits and 73% with lack of physical activity. Risky drinkers reported that GPs initiated a discussion on alcohol consumption less often (42%) than on smoking (63%), eating habits (59%) or physical activity (55%). Seventy-five per cent, 66% and 63% of patients without hypertension, diabetes or hypercholesterolaemia, respectively, think blood pressure, blood sugar and serum cholesterol should be checked yearly. Women (80%) think they should be screened with the cervical smear test and 72.8% of women aged 30-49 years with mammography, yearly or every 2 years. CONCLUSIONS A high proportion of patients attending primary care with unhealthy lifestyles (especially risky drinkers) do not perceive the need to change their habits, and about half the patients reported not having had any discussion on healthy lifestyles with their GPs. Patients overestimate their need to be screened for cardiovascular risk factors and for cancer.
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Affiliation(s)
- Carlos Brotons
- Sardenya Primary Health Care Center, Sardenya, Barcelona, Spain.
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Damiani G, Federico B, Basso D, Ronconi A, Bianchi CBNA, Anzellotti GM, Nasi G, Sassi F, Ricciardi W. Socioeconomic disparities in the uptake of breast and cervical cancer screening in Italy: a cross sectional study. BMC Public Health 2012; 12:99. [PMID: 22305108 PMCID: PMC3314546 DOI: 10.1186/1471-2458-12-99] [Citation(s) in RCA: 116] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 02/03/2012] [Indexed: 02/13/2023] Open
Abstract
BACKGROUND Breast and cervical cancer screening are widely recognized as effective preventive procedures in reducing cancer mortality. The aim of this study was to evaluate the impact of socioeconomic disparities in the uptake of female screening in Italy, with a specific focus on different types of screening programs. METHODS A cross-sectional study was conducted using data from the 2004-2005 national health interview survey. A sample of 15, 486 women aged 50-69 years for mammography and one of 35, 349 women aged 25-64 years for Pap smear were analysed. Logistic regression models were used to estimate the association between socioeconomic factors and female screening utilization. RESULTS Education and occupation were positively associated with attendance to both screening. Women with higher levels of education were more likely to have a mammogram than those with a lower level (OR = 1.28; 95% CI = 1.10-1.49). Women of intermediate and high occupational classes were more likely to use breast cancer screening (OR = 1.77; 95% CI = 1.55-2.03, OR = 1.63; 95% CI = 1.40-1.91) compared to unemployed women. Women in the highest occupational class had a higher likelihood of cervical cancer screening compared to those in the lowest class (OR = 1.81; 95% CI = 1.63-2.01). Among women who attended screening, those with lower levels of education and lower occupational classes were more likely than more advantaged women to attend organized screening programs rather than being screened on the basis of their own initiative. CONCLUSIONS Inequalities in the uptake of female screening widely exist in Italy. Organized screening programs may have an important role in increasing screening attendance and tackling inequalities.
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Affiliation(s)
- Gianfranco Damiani
- Department of Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Bruno Federico
- Department of Health and Sport Sciences, Università di Cassino, Via S. Angelo snc, 03043 Cassino (FR), Italy
| | - Danila Basso
- Department of Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Alessandra Ronconi
- Department of Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | | | - Gian Marco Anzellotti
- Department of Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Gabriella Nasi
- Department of Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Franco Sassi
- Health Division, Directorate for Employment, Labour and Social Affairs, OECD-Organization for economic Cooperation and Development, 2 rue André Pascal, 75775 Paris, Cedex 16, France
| | - Walter Ricciardi
- Department of Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
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Cullati S, Charvet-Bérard AI, Perneger TV. Cancer screening in a middle-aged general population: factors associated with practices and attitudes. BMC Public Health 2009; 9:118. [PMID: 19402895 PMCID: PMC2685378 DOI: 10.1186/1471-2458-9-118] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Accepted: 04/29/2009] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The aim of this study was to identify factors associated with cancer screening practices and with general attitudes toward cancer screening in a general population. METHODS Mailed survey of 30-60 year old residents of Geneva, Switzerland, that included questions about screening for five cancers (breast, cervix uteri, prostate, colon, skin) in the past 3 years, attitudes toward screening, health care use, preventive behaviours and socio-demographic characteristics. Cancer screening practice was dichotomised as having done at least one screening test in the past 3 years versus none. RESULTS The survey response rate was 49.3% (2301/4670). More women than men had had at least one cancer screening test in the past 3 years (83.2% vs 34.5%, p < 0.001). A majority of women had had a cervical smear (76.6%) and a mammography (age 30-49: 35.0%; age 50 and older: 90.3%); and 55.1% of men 50-60 years old had been screened for prostate cancer. Other factors associated with screening included older age, higher income, a doctor visit in the past 6 months, reporting a greater number of preventive behaviours and a positive attitude toward screening. Factors linked with positive attitudes included female gender, higher level of education, gainful employment, higher income, a doctor visit in the past 6 months and a personal history of cancer. CONCLUSION Attitudes play an important role in cancer screening practices among middle-aged adults in the general population, independent of demographic variables (age and sex) that determine in part screening recommendations. Negative attitudes were the most frequent among men and the most socio-economically disadvantaged. The moderate participation rate raises the possibility of selection bias.
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Affiliation(s)
- Stéphane Cullati
- Division of Clinical Epidemiology, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 6, CH – 1211 Geneva 14, Switzerland
| | - Agathe I Charvet-Bérard
- Geneva Foundation for breast cancer screening, Bd de la Cluse 43, CH – 1205 Geneva, Switzerland
| | - Thomas V Perneger
- Division of Clinical Epidemiology, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 6, CH – 1211 Geneva 14, Switzerland
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