title: [Factors associated with non-utilization of mammographic screening services in middle-aged and elderly women in Taiwan].
abstract: BACKGROUND
  Breast cancer is currently the type of cancer with the highest annual incidence among women in Taiwan, resulting in a median age of death of 57 years. Nevertheless, the proportion of Taiwanese women with a history of mammographic screening is relatively low. The international literature associates participation in mammographic screening with factors such as age, education level, ethnicity, and previous cancer history. Few such studies in Taiwan have addressed a cross-section sample that is representative of the overall population.
  
  
  OBJECTIVE
  The present study investigated factors associated with non-utilization of mammographic screening in women aged between 50 to 69 years in Taiwan.
  
  
  METHODS
  This study used secondary data analysis to investigate data obtained from the 2005 National Health Interview Survey in Taiwan. Researchers used logistic regression analysis to evaluate factors associated with mammographic screening in Taiwanese women based on the Andersen behavioral model of health services use.
  
  
  RESULTS
  Only 24.3% of the survey population had received mammographic screening. Results of multiple logistic regression analysis indicated non-utilization of mammographic screening is associated with a relatively low education level, being currently employed, a relatively low average monthly salary, having no additional insurance coverage outside the National Health Insurance, having no physical examination history, and having no history of menopausal hormone replacement therapy use.
  
  
  CONCLUSIONS
  Hospitals and health units may use findings from the present study to plan mammographic screening programs. Mammography promotional material should consider the needs of women with lower education levels; screening schedules should be coordinated with employers and made convenient for working women; and promotional materials should target women who have never previously received a physical examination. Enhancing the willingness of women to obtain mammography may reduce the threat of breast cancer to the lives of Taiwanese women.
authors.affiliation: Office of Superintendant, Dalin Tzu Chi General Hospital, Taiwan, ROC.
authors.forename: Chin-Ying
authors.initials: CY
authors.lastname: Lai
authors.forename: Chin-Mei
authors.initials: CM
authors.lastname: Lai
authors.forename: Chiu-Yuan
authors.initials: CY
authors.lastname: Chen
authors.forename: Malcolm
authors.initials: M
authors.lastname: Koo
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000523:psychology / Q000706:statistics & numerical data*; D008875:Middle Aged; D013624:Taiwan