title: [Study of non-participation in the breast cancer screening program in the city of Valencia (Spain)].
abstract: OBJECTIVE
  To determine the reasons for non-participation of women in a breast cancer screening program.
  
  
  METHODS
  We performed an observational, cross-sectional study in women who were invited to participate in the breast cancer screening program in the city of Valencia and who failed to attend. The women were interviewed in their homes through a questionnaire consisting of 25 questions grouped as follows: knowledge of the program, reasons for nonparticipation, attitudes or beliefs and characteristics of the interviewees (socioeconomic and educational variables and age). A descriptive analysis was performed. Differences in the characteristics of women were evaluated through bivariate analysis. Multivariate analysis was performed through logistic regression.
  
  
  RESULTS
  A total of 783 addresses were used, 411 questionnaires were completed and 361 were analyzed. The 50 questionnaires used in the pilot study were excluded because, as a consequence of this study, the questionnaire had been modified. Most of the women (93.4%) (CI: 90.3-95.7) remembered having an appointment. The main reason for not attending was being screened in another health service in 48.8% (CI: 43.6-53.9), followed by various personal reasons in 16.1% (CI: 12.3-19.9) and inability to keep the appointment at the specified time in 15.5% (CI: 11.8-19.2). Comparison of women in the middle and upper social classes with those in the lower classes revealed important differences. Middle and upper class women had a higher probability of knowing about the program and of being on hormone replacement therapy (HRT) and the most frequent reason for non-attendance was attendance at another program run by another health service. In lower class women the reasons for non-attendance were fear, not believing the program to be important to health and inability to keep the appointment at the specified time. In the multivariate analysis, the variables that entered the model were HRT, social class and education. Thus, middle or upper class women undergoing HRT and with secondary or higher education had a higher probability of being screened.
  
  
  CONCLUSIONS
  The profile of non-participating women belongs on the one hand to those in the middle or upper social classes, undergoing HRT and being screened by other health services and, on the other, to a group of women of low social class, whose reason for non-participation is fear and timetable difficulties.
authors.affiliation: Centro de Salud Pública de Valencia, Conselleria de Sanitat, Valencia. manuela.alcaraz@sanidad.m400.gva.es
authors.forename: M
authors.initials: M
authors.lastname: Alcaraz
authors.forename: A
authors.initials: A
authors.lastname: Lluch
authors.forename: J
authors.initials: J
authors.lastname: Miranda
authors.forename: I
authors.initials: I
authors.lastname: Pereiro
authors.forename: M D
authors.initials: MD
authors.lastname: Salas
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D008327:Mammography / Q000523:psychology / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000523:psychology / Q000706:statistics & numerical data*; D008875:Middle Aged; D009042:Motivation; D010865:Pilot Projects; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016312:Treatment Refusal / Q000706:statistics & numerical data*
vernacular_title: Estudio de la no participación en el programa de prevención de cáncer de mama en la ciudad de Valencia.