[Predictors of mammography adherence among Icelandic women.].
OBJECTIVE
In Iceland, breast cancer is a second only to lung cancer as a cause of women s cancer related deaths. Despite the widely-recognized utility of mammography for detecting breast cancer at early stages when it is most curable, many Icelandic women do not adhere to mammography screening recommendations. The aim of the present population-based study was to identify factors that facilitate and hinder women s adherence to mammography screening in Iceland.


METHODS
A randomly selected sample of Icelandic women between the ages of 40-69 years, not previously diagnosed with breast cancer (n=1000), were recruited to the study by mail. Participants (n=619) completed questionnaires assessing: demopgraphic variables, knowledge of screening guidelines, possible facilitators (e.g., physician recommendation) and barriers (e.g. concern about radiation) to adherence, as well as stages of mammography screening adoption (precontemplation, contemplation, action and maintenance).


RESULTS
Women in the precontemplation stage were more afraid of radiation than women on other stages. They as well as women on contemplation stage were more afraid that mammography would be painful, and less satisfied with previous service at the mammography screening center. Doctors recommendations, as well as women s knowledge about mammography screening guidelines, were positively related to mammography adherence.


CONCLUSIONS
These findings suggest that physicians may have an important role in motivating women to follow mammography screening recommendations. Educating women about mammography screening guidelines and addressing their concern about radiation and pain may increase mammography adherence further. Service at the mammography screening center may also improve adherence.
Arnadóttir
G
G
Department of Sociology, University of Iceland, Odda, 101 Reykjavík, Iceland. gudruarn@hi.is.
Jónsson
F H
FH
Sigurðardóttir
V
V
Bovbjerg
D
D
Valdimarsdóttir
H B
HB