title: [Reasons for non-participation in mammography screening--a survey in Schleswig-Holstein, Germany].
abstract: BACKGROUND
  In 2007, an organized population-based mammography screening program in Schleswig-Holstein has been implemented. According the European guideline a participation rate of 70% should be reached as a measurement of quality. In Schleswig-Holstein participation rate reached only 45% and is one of the lowest rates in Germany. The reasons are unknown.
  
  
  METHODS
  To 20,000 women, aged 50-69, who did not participate in mammography screening after an invitation letter, a questionnaire was sent to assess reasons of non-participation and knowledge about the program. We calculated the proportion of women answering to given aspects in the questionnaire.
  
  
  RESULTS
  The response rate was 14.8% (n = 2591). Women reported multiple reasons for non-participation. Medical reasons and personal attitude were the most frequent ones. Organizational reasons were of minor importance. 75% of women get primarily informed about the program by the invitation letter. 25% of women talked with their practitioner about the program.
  
  
  CONCLUSIONS
  The low participation rate of mammography screening in Schleswig-Holstein is not based on worse organization but on medical reasons or personal attitudes of the women. It seems, that information about the program and benefits and harms of mammography screening has not reached the general population. So general practitioner or gynecologists should advice women more intensively. Leaflets and pamphlets should be more disseminated.
authors.affiliation: Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck.
authors.forename: M
authors.initials: M
authors.lastname: Schnoor
authors.forename: A
authors.initials: A
authors.lastname: Hallof
authors.forename: D
authors.initials: D
authors.lastname: Hergert-Lüder
authors.forename: A
authors.initials: A
authors.lastname: Katalinic
authors.forename: A
authors.initials: A
authors.lastname: Waldmann
mesh_terms: D000368:Aged; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000517:prevention & control*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys; D057220:Health Literacy / Q000706:statistics & numerical data*; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D010358:Patient Participation / Q000706:statistics & numerical data*; D015995:Prevalence; D016387:Women's Health / Q000706:statistics & numerical data