title: Factors associated with non-participation of women in a breast cancer screening programme in a town in northern Italy.
abstract: OBJECTIVE
  The aim was to investigate the reasons for the high percentage of women refusing to attend a breast cancer screening programme in the Health District of Brescia, Italy.
  
  
  METHODS
  This was a survey of a sample of non-attenders to the programme, who were interviewed using a structured questionnaire.
  
  
  METHODS
  Non-attenders all lived in a central area of the town near the screening centre.
  
  
  METHODS
  Of the 612 non-attenders eligible for interview, 183 could not be interviewed: one had died, 86 were away from home at two different visits, 32 were no longer resident at the known address, eight had serious health problems, 17 had undergone mastectomy, and 39 refused the interview. Overall, a total of 429 of the 612 eligible women were interviewed (70.1%).
  
  
  RESULTS
  Attenders and non-attenders were compared with respect to demographic and socioeconomic factors, use of preventive medicine, and prevalence of risk factors for breast cancer. The response was higher among less educated women, married and widowed women, and those born in the province than among more educated, single or divorced, and immigrant women. Most of the women interviewed gave practical reasons for non-participation, but lack of interest/distrust and fear/worry/anxiety also seemed important. The number of non-attenders who had had a Papanicolaou test within the previous three years was three times higher than those who had had mammography, suggesting that non-attenders were more interested in types of preventive medicine other than screening for breast cancer by mammography. Attenders and non-attenders appeared similar as regards distribution of conventional breast cancer risk factors.
  
  
  CONCLUSIONS
  Greater effort in the information campaign might increase the participation rate in screening for breast cancer, although to a lesser extent than expected: if non-attenders potentially recruitable in our screening were added to attenders, overall compliance of the programme was about 75%, lower than that observed in some programmes in northern Europe.
authors.affiliation: Department of Hygiene, University of Brescia, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Donato
authors.forename: A
authors.initials: A
authors.lastname: Bollani
authors.forename: R
authors.initials: R
authors.lastname: Spiazzi
authors.forename: M
authors.initials: M
authors.lastname: Soldo
authors.forename: L
authors.initials: L
authors.lastname: Pasquale
authors.forename: S
authors.initials: S
authors.lastname: Monarca
authors.forename: L
authors.initials: L
authors.lastname: Lucini
authors.forename: G
authors.initials: G
authors.lastname: Nardi
mesh_terms: D001943:Breast Neoplasms / Q000517:prevention & control*; D003710:Demography; D005260:Female; D006801:Humans; D007558:Italy; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires