Sociodemographic predictors of non-attendance at invitational mammography screening--a population-based register study (Sweden).
OBJECTIVE
To investigate the role of sociodemographic factors in predicting mammography uptake in an outreach screening program.


METHODS
Linkage of data from a regional population-based mammography program with four Swedish nationwide registers: the Population and Housing Census of 1990, the Fertility Register, the Cancer Register, and the Cause of Death Register. We computed odds ratios (OR) and 95% confidence intervals (CI) for non-attendance by sociodemographic factors. Non-attendance was defined as failure to attend in response to the two most recent invitations.


RESULTS
Multivariate analyses among 4198 non-attenders and 38,972 attenders revealed that both childless and high-parity women were more likely to be non-attenders (OR = 1.8, 95% CI: 1.6-2.0 and OR = 2.2, 95% CI: 1.8-2.7, respectively). Women living without a partner were less likely to attend (OR = 1.7, 95% CI: 1.5-1.9), as were non-employed women (OR = 2.1, 95% CI: 1.9-2.3). Those renting an apartment were more likely to be non-attenders compared with home-owners (OR = 1.8, 95% CI: 1.6-2.0), and immigrants from non-Nordic countries were more than twice as likely to be non-attenders compared with Swedish-born women (OR = 2.4, 95% CI: 2.0-2.8).


CONCLUSIONS
There are identifiable subgroups in which mammography utilization can be increased. Special attention should be paid to women who have never attended, childless women, and non-Nordic immigrants.
Lagerlund
Magdalena
M
Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden. Magdalena.Lagerlund@mep.ki.se
Maxwell
Annette E
AE
Bastani
Roshan
R
Thurfjell
Erik
E
Ekbom
Anders
A
Lambe
Mats
M
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D003159:Community-Institutional Relations; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000458:organization & administration / Q000706:statistics & numerical data*; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data*; D011159:Population Surveillance; D011237:Predictive Value of Tests; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D013548:Sweden / Q000453:epidemiology