[Breast cancer prevention behaviour: a perspective of women from three language regions of Switzerland].
Swiss women show, together with women from the Netherlands, France, Belgium, Sweden, Finland, England and Germany, a very high incidence of breast cancer in Europe. Whilst the evidence for primary cancer prevention is slowly growing, its strategies can not yet be implemented in clinical prevention programmes. Therefore, secondary prevention, early detection of cancer, remains the main focus for reducing breast cancer mortality. This is especially true because of the proven relationship between mortality and size of the primary tumour as well as the status of the axilla. Despite these facts, in contrast to the French part of Switzerland, breast cancer screening has not yet been implemented in the German and Italian part of Switzerland.


METHODS
It was the aim of this study to identify prevention measures used by women living in the German-, Italian- and French-speaking part of Switzerland and to explore their attitude towards breast cancer prevention measures. It was asked what these women knew about breast cancer prevention, what type of secondary prevention they used and who motivated them to do so. The investigation included 1721 women from three language regions of Switzerland. Data were collected with a postal survey questionnaire. Descriptive, uni- and multivariate methods were used for data analysis.


RESULTS
The response rate was 34%. Statistically significant differences in breast self-examination were observed between the three regions (p = < 0.001) and defined age-groups (p = < or = 0.001). In all three regions of the country, 90% of women age 50-59 had mammograms, whereas in comparison to the other regions, fewer women from the German part of Switzerland, aged 60-69, had undergone mammography screening. Significant differences in mammography screening again were observed between language regions (p = < or = 0.001) and age-groups (p = < or = 0.001). Eighty-four percent of women were motivated by the gynaecologist to have a mammography, 11% by the family doctor and 10% of the women decided by themselves. More than half of this female Swiss study population wished to see a health policy providing mammography-screening in Switzerland and about one third wished to be more informed about the intervention. An increased need for information and education about prevention and early detection was observed in individuals who had a relative with cancer.


CONCLUSIONS
The majority of women in this study wished to see a health policy in Switzerland which includes a mammography screening programme. Opportunistic mammography screening, lacking systematic quality control and data collection for epidemiological purposes, was widely used in the Italian and in the German speaking region. Data show that there is a need for public and professional information and education about prevention and early detection of breast cancer to prevent misconceptions regarding the effect of breast self-examination and mammography-screening. Womens' organisations and nurses may be in a good position to take up a leading role in breast cancer prevention.
Glaus
Agnes
A
Zentrum für Tumordiagnostik und Prävention, Gallen.
Fäh
Barbara
B
Hornung
Rainer
R
Senn
Hansjörg
H
Stiefel
Fritz
F
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000517:prevention & control*; D005260:Female; D005602:France; D005843:Geography; D005858:Germany; D006801:Humans; D007802:Language; D008875:Middle Aged; D013557:Switzerland