title: The effect of mammography pain on repeat participation in breast cancer screening: a systematic review.
abstract: Uptake is crucial to reducing breast cancer mortality through screening. This review synthesised all available evidence on mammography pain as a deterrent to subsequent breast screening. Ten databases were searched. Studies containing empirical data relating mammography pain to breast screening re-attendance were included (n = 20). In the most robust studies asking women why they had not re-attended, 25%-46% cited pain, equivalent to approximately 47,000-87,000 women per year in England. The most robust evidence for an association between pain experienced at a previous mammogram and subsequent rates of re-attendance suggests that women who previously experienced pain are more likely than those who did not to fail to re-attend: RR 1.34 (95% CI: 0.94-1.91). The complexity of the pain phenomenon and of screening behaviours must be recognised. However, there is sufficient evidence to conclude that painful mammography contributes to non-re-attendance. Given the importance of cumulative participation, effective pain-reducing interventions in mammography are needed.
authors.affiliation: Division of Cancer Research, Medical Research Institute, University of Dundee, Mailbox 4, Ninewells Hospital & Medical School, Dundee DD1 9SY, UK. p.j.whelehan@dundee.ac.uk
authors.forename: Patsy
authors.initials: P
authors.lastname: Whelehan
authors.forename: Andy
authors.initials: A
authors.lastname: Evans
authors.forename: Mary
authors.initials: M
authors.lastname: Wells
authors.forename: Steve
authors.initials: S
authors.lastname: Macgillivray
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008327:Mammography / Q000009:adverse effects*; D010146:Pain / Q000209:etiology*; D010349:Patient Compliance / Q000706:statistics & numerical data*