title: Psychosocial factors and attendance at a population-based mammography screening program in a cohort of Swedish women.
abstract: BACKGROUND
  A better understanding of the factors that influence mammography screening attendance is needed to improve the effectiveness of these screening programs. The objective of the study was to examine whether psychosocial factors predicted attendance at a population-based invitational mammography screening program.
  
  
  METHODS
  Data on cohabitation, social network/support, sense of control, and stress were obtained from the Malmö Diet and Cancer Cohort Study and linked to the Malmö mammography register in Sweden. We analyzed 11,409 women (age 44 to 72) who were free of breast cancer at study entry (1992 to 1996). Mammography attendance was followed from cohort entry to December 31, 2009. Generalized Estimating Equations were used to account for repeated measures within subjects. Adjusted odds ratios (OR) and 95% confidence intervals (CI) are reported.
  
  
  RESULTS
  Among 69,746 screening opportunities there were 5,552 (8%) cases of non-attendance. Higher odds of non-attendance were found among women who lived alone (OR = 1.47 (1.33-1.63)) or with children only (OR = 1.52 (1.29-1.81)), had one childbirth (OR = 1.12 (1.01-1.24)) or three or more childbirths (OR = 1.34 (1.21-1.48)), had low social participation (OR= 1.21 (1.10-1.31)), low sense of control (OR = 1.12 (1.02-1.23)), and experienced greater stress (OR = 1.24 (1.13-1.36)).
  
  
  CONCLUSIONS
  Public health campaigns designed to optimize mammography screening attendance may benefit from giving more consideration of how to engage with women who are less socially involved.
authors.affiliation: Department of Clinical Sciences in Malmö, Diagnostic Radiology, Lund University, Skåne University Hospital Malmö, Inga Marie Nilssons gata 49, SE 20502 Malmö, Sweden. mlagerlu@gmail.com.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Lagerlund
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Sontrop
authors.forename: Sophia
authors.initials: S
authors.lastname: Zackrisson
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000523:psychology; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008132:Loneliness / Q000523:psychology; D008327:Mammography / Q000523:psychology*; D008875:Middle Aged; D010298:Parity; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D015406:Single Parent / Q000523:psychology; D058992:Social Participation / Q000523:psychology; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology; D013548:Sweden