title: Understanding barriers to organized breast cancer screening in France: women's perceptions, attitudes, and knowledge.
abstract: BACKGROUND
  The participation rate in organized breast cancer screening in France is lower than recommended. Non-participants either use opportunistic screening or do not use either screening modality.
  
  
  OBJECTIVE
  To assess any differences in perceptions, attitudes and knowledge related to breast cancer screening between users of opportunistic screening and non-users of any screening mammograms and to identify potential barriers to participation in organized screening.
  
  
  METHODS
  Six focus groups were conducted in May 2010 with 34 French non-participants in organized screening, 15 who used opportunistic screening (OpS group) and 19 who used no screening (NoS group). The guide used for both groups explored perceptions and attitudes related to health, cancer and screening; perceptions of femininity; and knowledge about breast cancer screening. Thematic content analysis was performed.
  
  
  RESULTS
  Perceptions, attitudes and knowledge differed between the two groups. Women in the OpS group perceived a high susceptibility to breast cancer, visited their gynaecologist regularly, were unfamiliar with organized screening modalities and had doubts about its quality. NoS women had very high- or low-perceived susceptibility to breast cancer, knew about screening modalities, had doubts about its usefulness and expressed negative opinions of mammograms.
  
  
  CONCLUSIONS
  Differences in perceptions and attitudes related to breast cancer screening partially explain why some women choose opportunistic screening or no screening. General practitioners and gynaecologists are in a unique position to provide individually tailored preventative messages to improve participation in organized screening.
authors.affiliation: Universite Paris-Est (UPEC), Faculté de médecine, Département de Médecine Générale, 8 rue du Général Sarrail, Créteil, F-94010, France. emilie.ferrat@u-pec.fr
authors.forename: Emilie
authors.initials: E
authors.lastname: Ferrat
authors.forename: Julien
authors.initials: J
authors.lastname: Le Breton
authors.forename: Memtolom
authors.initials: M
authors.lastname: Djassibel
authors.forename: Kalaivani
authors.initials: K
authors.lastname: Veerabudun
authors.forename: Zahida
authors.initials: Z
authors.lastname: Brixi
authors.forename: Claude
authors.initials: C
authors.lastname: Attali
authors.forename: Vincent
authors.initials: V
authors.lastname: Renard
mesh_terms: D000368:Aged; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology; D055088:Early Detection of Cancer / Q000379:methods / Q000523:psychology; D005260:Female; D017144:Focus Groups; D005602:France; D057220:Health Literacy / Q000379:methods / Q000592:standards; D006301:Health Services Needs and Demand; D006801:Humans; D008327:Mammography / Q000523:psychology; D008403:Mass Screening / Q000379:methods / Q000458:organization & administration / Q000523:psychology; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology*; D011320:Primary Health Care / Q000379:methods / Q000592:standards; D036301:Qualitative Research; D012938:Social Perception
keywords: Attitude to health; breast cancer; mammography; primary health care; qualitative research; screening.