Determinants of women's decision to undergo early mammography: A survey study

Individual well-being and national determinants of screening mammography among women over fifty

BACKGROUND

Breast cancer is the most prevalent cancer among women worldwide, causing over 400,000 cases of premature death annually. Timely screening mammography (SM) could have prevented most death. Although SM utilization varies across countries, few studies have examined country-level factors, and fewer explored their interaction with individual-level factors. The study aims to analyze individual and country-level variables and their interaction that determines SM utilization and variation between countries.

METHODS

Individual, country, and cross-level models are used to analyze the cross-sectional data from the SHARE database for 26,672 women aged 50 or over, from 27 countries. Key individual variables investigated include quality-of-life (QOL), psychological, and subjective-health status. Country-level variable included government health expenditure (GHE) percentage of GDP, and organized screening programs. Models were adjusted for individual variables such as age and education.

RESULTS

Self-reported SM utilization varied from 5 to 67% in the countries examined. On the individual level, higher QOL, psychological, and subjective health status positively correlated with SM utilization, as did GHE and organized programs on the country-level. Surprisingly, the interaction between individual and country-level variables shows that while SM utilization positively correlates with higher psychological and subjective health status in high-GHE countries, it negatively correlates in low-GHE countries, and only weakly positive correlates in mid-level GHE countries.

CONCLUSIONS

Better individual well-being, both physical and psychological, increased SM utilization, as did higher GHE and countrywide SM programs. The negative correlations in low-GHE countries and positive correlations in high-GHE countries underscores disparities that need to be addressed.

Public cancer screening services and participation: What meanings in users' narratives to promote engagement?

Despite the effectiveness of cancer screening (CS) in providing timely diagnoses and early treatments, the participation of citizens remains very low in particular in Southern Italy. This study aims to investigate the meanings that intervene in the relationship between the individual and their active participation in CSs within public healthcare. A total of 101 ad hoc semi-structured interviews were collected with CS users in public service of Campania Region, Italy. The interviews were analyzed through a qualitative-quantitative methodology by T-Lab software. A cluster analysis and multiple matching analysis were conducted. Findings show five clusters: prevention as a sensory and emotional burden; prevention as a strategy to manage the hereditary risk of death; individual's internal demand for health; the times and places of prevention; and the concreteness of doing prevention; and two factors: from the risk of disease diagnosis to preventive measures and from external healthcare settings to internal self-care settings. Findings shed light on how to construct better well-being promotion strategies and foster a subjective health and prevention demand accounting for the continuous experiences of those participating in CSs to encourage greater citizen engagement.

Temporal Evolution and Associated Factors of Adherence to Mammography Screening among Women in Spain: Results from Two National Health Surveys (2017-2020)

Ensuring equity in cancer screening is recommended by the European Commission. Despite the fact that breast cancer screening is a free population-based program in Spain, there remains considerable variation in the adherence to screening rate among population groups. This study was designed to describe the adherence of breast cancer screening in women in Spain, to evaluate the evolution in the period from 2017 to 2020, and to determine the variables that influence choosing to undergo breast cancer screening. A nationwide cross-sectional study with 7220 females aged 50-69 years from the 2017 Spanish National Health Survey and the 2020 European Health Survey for Spain was performed. We investigated mammography uptake rates, with socio-demographic factors, lifestyle habits, and health-related characteristics as independent variables. Multivariable logistic regression was used to identify the associated factors of mammography adherence. Of the women, 78% had undergone mammography in the previous two years, and there was a significant decrease in the uptake rate for breast cancer screening from 2017 (81.23%) to 2020 (74.68%) (p < 0.001). Educational level, marital status, residential location, nationality, smoking status, alcohol consumption, and leisure-time physical activity were all associated factors of mammography uptake.

Determinants of Protective Healthcare Services Awareness among Female Syrian Refugees in Turkey

War-related migration may deprive people of access to a regular healthcare system and cause new diseases to be battled. Since refugee women are more vulnerable to diseases during this period, protective healthcare services awareness is critical for early disease diagnosis. Following the civil war that triggered the migration of millions of Syrians, an extensive survey was undertaken in coordination with the World Health Organization Country Office in Turkey to explore the health status of Syrian refugees in Turkey. Employing the survey data, we aimed to investigate the determinants of the awareness of protective health services (Pap smear test, mammogram, HIV test) among female Syrian refugees. Logit regression analysis was applied in order to investigate the determinants of the awareness of protective health services among the female refugee population. The results revealed a notably low rate of awareness of protective health services among female Syrian refugees. Furthermore, the association of explanatory variables, including socioeconomic factors, healthcare use, and health literacy with the protective health services awareness, was found to be significant.