title: Factors Associated with Breast Cancer Screening Decision Stage among Women in Tehran, Iran.
abstract: BACKGROUND
  Early detection through screening is the best method to reduce death due to breast cancer. It has been shown, having knowledge and generating positive attitudes, influences the decision of women to participate in the screening programs. The aim of this study was to identify the factors associated with breast cancer screening (BCS) and with an intention to have screening among women in Tehran, Iran.
  
  
  METHODS
  A cross-sectional study was carried out from January to July 2011, among women who had attended to primary health-care centers in West Tehran using multi-stage sampling method. We invited 1,240 women sequentially to complete a self-administered survey questionnaire at the beginning of their visit; and 1,012 (82%) completed the survey. The questionnaire included, items drawn from the Preventive Health Model that assess socio-demographic background and perceptions about BCS. Multiple logistic regression analysis was performed to identify factors associated with screening and intention to do screening in the future.
  
  
  RESULTS
  The mean age of subjects was 38.2 years. Women who perceived more screening efficacy (odd ratio [OR] =1.63; confidence interval [CI] 95%: 1.12-2.37) and fewer performance barriers (OR = 0.82; CI 95%: 0.68-0.97) were more likely to perform clinical breast exam in the future. The women who reported higher clinical breast exam self-efficacy (OR = 1.82; CI 95%: 1.39-2.37), mammography self-efficacy (OR = 1.31; CI 95%: 1.04-1.65), screening efficacy (OR = 1.53; CI 95%: 1.18-1.97), and family influence (OR = 1.27; CI 95%: 1.05-1.54), and those who reported fewer screening performance barriers (OR = 0.56; CI 95%: 0.48-0.67) were more likely to decide for carried out mammography in the future. Most respondents indicated that they intended to do clinical breast exam and mammography in the future (75.8% and 72.1% respectively). About 65% of women reported they would do both.
  
  
  CONCLUSIONS
  We found that women's intention to do BCS was very high and a comprehensive national program is needed to guide their intention. Among different demographic factors, the impact of education level on doing BCS was significant.
authors.affiliation: Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Nojomi
authors.affiliation: Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Nasim
authors.initials: N
authors.lastname: Namiranian
authors.affiliation: Department of Medical Oncology Thomas Jefferson University Philadelphia, PA.
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Myers
authors.affiliation: Department of Nuclear Medicine, Shariati Hospital Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seid-Kazem
authors.initials: SK
authors.lastname: Razavi-Ratki
authors.affiliation: Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Alborzi
keywords: Attitude; breast cancer screening; decision making; knowledge