'If I feel something wrong, then I will get a mammogram': understanding barriers and facilitators for mammography screening among Chilean women.
BACKGROUND
Breast cancer is the leading cause of cancer among women in Chile and in many Latin American countries. Breast cancer screening is an effective strategy to reduce mortality, but it has a very low compliance among Chilean women.


OBJECTIVE
To understand barriers and facilitators for breast cancer screening in a group of Chilean women aged 50-70.


METHODS
Following the Predisposing, Enabling and Reinforcing (PRECEDE) framework, seven focus groups (N = 48 women) were conducted with women that have had diverse experiences with breast cancer and screening practices. Information was collected using field notes and audio and video recording. Following the grounded theory model, a sequential process of open, axial and selective coding was used for the information analysis. Atlas ti 5.5 software was used for coding and segmenting the data obtained from the interviews.


RESULTS
The presence of symptoms and/or the finding of lumps through breast self-examination (BSE) were the main predisposing factors for getting a mammogram. Secrecy, embarrassment and fatalism about breast cancer were significant cultural factors that influenced the decision to seek mammogram screening. Confidence in medical staff and dignity in the treatment at the clinic were important enabling factors. The main reinforcing factors for getting the test were a sense of fulfilment by doing something good for themselves and getting timely information about the results.


CONCLUSIONS
Primary health care providers should use culturally appropriate strategies to better inform women about the importance of mammography screening and the limitations of BSE for preventing advanced breast cancer.
Püschel
Klaus
K
Department of Family and Community Medicine, Chile School of Medicine, P. Universidad Católica de Chile, Lira 44 no. 1, Piso, Santiago, Chile. kpuschel@med.puc.cl
Thompson
Beti
B
Coronado
Gloria
G
Gonzalez
Karla
K
Rain
Carolina
C
Rivera
Soledad
S
D000368:Aged; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D016504:Breast Self-Examination; D002677:Chile; D005260:Female; D017144:Focus Groups; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011795:Surveys and Questionnaires