title: Distance to screening site and non-participation in screening for breast cancer: a population-based study.
abstract: BACKGROUND
  In population-based breast cancer screening programmes, the geographical distance to the screening site may influence a woman's propensity to participate. The aim of this study was to analyse the effect driving distance to the screening unit had on women's participation in a breast cancer screening programme.
  
  
  METHODS
  All women invited to the first round of breast cancer screening in the Central Denmark Region were eligible for inclusion (n = 149,234). Information on participation was collected from a regional administrative database. The shortest road distance between each woman's residence and her affiliated screening site was assessed using Network Analyst, ArcGIS.
  
  
  RESULTS
  The unadjusted association between distance and non-participation formed a J-shape curve. Adjustment for socio-demographic characteristics caused the J-shape to disappear, and the probability of non-attendance rose with longer distance to the screening site but flattened after ~45 km. Women without access to a vehicle had a higher risk of non-participation than women with access to a vehicle.
  
  
  CONCLUSIONS
  A long road distance to the screening site was associated with an increased risk of non-participation. Women without access to a vehicle were at higher risk of non-participation than women who had access to a vehicle.
authors.affiliation: The Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark Section for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark The Research Centre for Cancer Diagnosis in Primary Care (CaP), Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark Department for Public Health Programs, Regional Hospital of Randers, Skovlyvej 1, 8930 Randers, Denmark.
authors.forename: L F
authors.initials: LF
authors.lastname: Jensen
authors.affiliation: The Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark The Research Centre for Cancer Diagnosis in Primary Care (CaP), Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark.
authors.forename: A F
authors.initials: AF
authors.lastname: Pedersen
authors.affiliation: Department for Public Health Programs, Regional Hospital of Randers, Skovlyvej 1, 8930 Randers, Denmark Health Promotion and Health Science Research, Department of Public Health, Aarhus University, Bartholins Allé 2 DK, 8000 Aarhus C, Denmark.
authors.forename: B
authors.initials: B
authors.lastname: Andersen
authors.affiliation: The Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Fenger-Grøn
authors.affiliation: The Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark The Research Centre for Cancer Diagnosis in Primary Care (CaP), Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark.
authors.forename: P
authors.initials: P
authors.lastname: Vedsted
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D003718:Denmark; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D010358:Patient Participation; D012307:Risk Factors; D012959:Socioeconomic Factors; D014195:Travel