title: Do women who intermittently attend breast screening differ from those who attend every invitation and those who never attend?
abstract: OBJECTIVE
  Analysis of screening uptake usually dichotomizes women into attenders and non-attenders, though many women respond positively to some but not all invitations. This paper studies these intermittent attenders.
  
  
  METHODS
  A cohort of 8,571 women invited for consecutive breast screens in the Northern Ireland Breast Screening Programme were followed in a study linking screening and census records. Multivariate logistic analysis was used to analyze the characteristics of those who attended both times (consistent), once (intermittent or 'one-time only'), or not at all (non-attenders).
  
  
  RESULTS
  Overall, 15.5% of women attended once and 13.4% were non-attenders. Non-attenders were characteristically disadvantaged (as measured by social renting, car access, and employment status), less likely to be married, and more likely to be healthy. One-time attenders were younger, and suffering poor health, though there was no association with either social renting or employment status. Privately rented accommodation and city living was associated with both one-time attendance and non-attendance.
  
  
  CONCLUSIONS
  One-time attenders are an important and distinct subgroup of screening invitees in this analysis. Their distinct characteristics suggest that transitory factors, such as change in marital status, ill-health, or addressing difficulties through change of residence are important. These distinct characteristics suggest the need for different approaches to increase attendance, among both intermittent attenders and those not attending at all.
authors.affiliation: Registrar in Public Health, Public Health Agency, Belfast.
authors.forename: C
authors.initials: C
authors.lastname: Coyle
authors.affiliation: Post Doctoral Research Fellow, Centre for Public Health, Queen's University Belfast h.kinnear@qub.ac.uk.
authors.forename: H
authors.initials: H
authors.lastname: Kinnear
authors.affiliation: Senior Research Fellow; Bamford Centre for Mental Health and Wellbeing; University of Ulster; Northern Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Rosato
authors.affiliation: Director Breast Screening Service Northern Ireland, Public Health Agency, Belfast, Northern Ireland.
authors.forename: A
authors.initials: A
authors.lastname: Mairs
authors.affiliation: Information Officer, Quality Assurance Reference Centre, Public Health Agency, Belfast, Northern Ireland.
authors.forename: C
authors.initials: C
authors.lastname: Hall
authors.affiliation: Senior Lecturer, Centre for Public Health, Queen's University Belfast.
authors.forename: D
authors.initials: D
authors.lastname: O'Reilly
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009660:Northern Ireland / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D014932:Women's Health Services
keywords: Breast Screening; attendance; re-attendance; record linkage