title: Could screening participation bias symptom interpretation? An interview study on women's interpretations of and responses to cancer symptoms between mammography screening rounds.
abstract: OBJECTIVE
  To explore how women with negative mammography screening results, but who were later diagnosed with interval breast cancer, reacted when they observed breast symptoms that could indicate malignancy in-between screening rounds.
  
  
  METHODS
  Semistructured individual interviews with women who have been diagnosed with breast cancer during mammography screening intervals.
  
  
  METHODS
  Two breast diagnostic units covering two counties in Norway.
  
  
  METHODS
  26 women diagnosed with interval breast cancer.
  
  
  RESULTS
  Women with a screening negative result react in two ways when experiencing a possible symptom of breast cancer. Among 24 women with a self-detected palpable lesion, 14 sought medical advice immediately. Their argument was to dispose of potential cancer as soon as possible. Ten women delayed seeking medical advice, explaining their delay as a result of practical difficulties such as holidays, uncertainty about the symptom, and previous experiences of healthcare services' ability to handle diffuse symptoms. Also, a recent negative mammography scan led some women to assume that the palpable lesion was benign and wait for the next screening round.
  
  
  CONCLUSIONS
  Participating in mammography screening may contribute to a postponed reaction to breast cancer symptoms, although most women acted rapidly when detecting a palpable breast lesion. Furthermore, screening participation does not necessarily increase awareness of breast cancer symptoms.
authors.affiliation: Department of Public Health and General Practice,  Norwegian University of Science and Technology, Medical Faculty, Trondheim,  Norway.
authors.forename: Marit
authors.initials: M
authors.lastname: Solbjør
authors.forename: John-Arne
authors.initials: JA
authors.lastname: Skolbekken
authors.forename: Ann Rudinow
authors.initials: AR
authors.lastname: Sætnan
authors.forename: Anne Irene
authors.initials: AI
authors.lastname: Hagen
authors.forename: Siri
authors.initials: S
authors.lastname: Forsmo