title: Quantifying independent risk factors for failing to rescreen in a breast cancer screening program in Flanders, Belgium.
abstract: BACKGROUND
  Mammographic screening may reduce breast cancer mortality by about 20%, provided participation is high and women screen regularly. We quantified independent risk factors for failing to rescreen and built a model to predict how rescreening rates change if these risk factors would be modified.
  
  
  METHODS
  Multivariate analysis was used to analyze data from a prospective study which included a self-administered questionnaire and rescreening status 30months after a t0 mammogram, using a random sample of women 50-67years (Belgium 2010-2013).
  
  
  RESULTS
  A false positive result at the most recent past mammogram (Odds Ratio=5.0, 95% Confidence Interval 3.6-6.8), an interval until new invitation greater than 25months (Odds Ratio=4.8 for >29months, 95% Confidence Interval 2.9-8.1), waiting times in the mammography unit >1h (Odds Ratio=2.1, 95% Confidence Interval 1.2-3.7) and difficulties in reaching the unit (Odds Ratio=2.5, 95% Confidence Interval 1.4-4.4) were the strongest independent predictors for failing to rescreen. The area under the curve of the receiver operating characteristic analysis was 0.705 for the model development stage and 0.717 for the validation stage and goodness-of-fit was good.
  
  
  CONCLUSIONS
  Maintaining an invitation cycle of maximum 25months, limiting waiting time in the mammography unit and lowering the number of false positives could increase breast cancer screening compliance.
authors.affiliation: Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; Centrum voor kankeropsporing (Center for Cancer Detection), Ruddershove 4, 8000 Brugge, Belgium. Electronic address: Mathieu.Goossens@uzbrussel.be.
authors.forename: M
authors.initials: M
authors.lastname: Goossens
authors.affiliation: Centrum voor kankeropsporing (Center for Cancer Detection), Ruddershove 4, 8000 Brugge, Belgium; University of Antwerp, Medical Sociology and Health Policy, Universiteitsplein 1, 2610 Antwerp, Belgium. Electronic address: https://www.bevolkingsonderzoek.be.
authors.forename: G
authors.initials: G
authors.lastname: Van Hal
authors.affiliation: Centrum voor kankeropsporing (Center for Cancer Detection), Ruddershove 4, 8000 Brugge, Belgium; University of Antwerp, Medical Sociology and Health Policy, Universiteitsplein 1, 2610 Antwerp, Belgium. Electronic address: https://www.bevolkingsonderzoek.be.
authors.forename: M
authors.initials: M
authors.lastname: Van der Burg
authors.affiliation: Centrum voor kankeropsporing (Center for Cancer Detection), Ruddershove 4, 8000 Brugge, Belgium; University Hospital Leuven, Campus St. Rafael, Kapucijnenvoer 33, 3000 Leuven, Belgium. Electronic address: https://www.bevolkingsonderzoek.be.
authors.forename: E
authors.initials: E
authors.lastname: Kellen
authors.affiliation: Centrum voor kankeropsporing (Center for Cancer Detection), Ruddershove 4, 8000 Brugge, Belgium; Ghent University, Department of Public Health, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: https://www.bevolkingsonderzoek.be.
authors.forename: K
authors.initials: K
authors.lastname: Van Herck
authors.affiliation: Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: De Grève
authors.affiliation: Centrum voor kankeropsporing (Center for Cancer Detection), Ruddershove 4, 8000 Brugge, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Martens
authors.affiliation: Centrum voor kankeropsporing (Center for Cancer Detection), Ruddershove 4, 8000 Brugge, Belgium; University Hospital Leuven, Campus St. Rafael, Kapucijnenvoer 33, 3000 Leuven, Belgium. Electronic address: https://www.bevolkingsonderzoek.be.
authors.forename: E
authors.initials: E
authors.lastname: Van Limbergen
mesh_terms: D000368:Aged; D001530:Belgium; D001943:Breast Neoplasms / Q000175:diagnosis; D005189:False Positive Reactions; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008327:Mammography / Q000523:psychology* / Q000706:statistics & numerical data*; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: Adherence; Breast cancer screening; Rescreening; Risk factors