title: Study of socio-economic characteristics, diagnosis and outcome of women participating or not participating in mammogram screening.
abstract: BACKGROUND
  Breast cancer is the most common cancer and the leading cause of cancer death in women. Early detection is essential to reduce cancer mortality. Studying participation in an organised breast cancer screening program is important in order to evaluate the program effectiveness. Breast screening both enables minimally invasive breast surgery and reduces cause-specific mortality.
  
  
  METHODS
  The main objective of this study was to evaluate, through the use of a questionnaire, the influence of socio-economic characteristics (age, education, occupational status, participation in other screening programs etc.) on participation in a mammography screening program organized by the local health units (LHU) of Novara and Verbano-Cusio-Ossola, located in the Italian region of Piedmont. A sample of 500 women was identified. Eligible participants included women aged 50-69 years, resident in the area of the LHUs of Novara and Verbano-Cusio-Ossola who had been invited to participate in the screening program 2006-2007. Twenty six women were excluded, leaving 474 women in the final analysis: 23 women were unable to be contacted due to incorrect contact details and 3 women were unable to complete the questionnaire due to neurodegenerative diseases. A postal questionnaire was sent by post during 2008-2009. Two postal reminders were sent to non-responders, followed by a phone call. One group of women received an additional copy of the questionnaire with the first postal reminder and another group received only the reminder letter. The socio-personal profiles and their influence in women's participation in the screening program were evaluated.
  
  
  RESULTS
  Among the responders, 93% of the women (348/374) received a mammogram at least once following LHU invitation for check-up. 74.1% of women got a mammogram at least once using the organized screening program, an additional 17.8% got a mammogram in a private clinic, and the type of prevention was unknown for 8.1% of the women. 25.3% began having mammogram for prevention before the age of 45.
  
  
  CONCLUSIONS
  A screening program is a sanitary intervention of secondary prevention and the identification of the attitude towards this kind of prevention is quite complex. Some causes of non-participation in this screening program were the belief that mammogram is not necessary, fear of pain, and presence of family problems. This study obtained a higher response than expected and the data also allowed an assessment of the degree of participation of women in the prevention services, identifying that most of them carried out a mammogram using an organized screening program.
authors.affiliation: Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, CPO Piemonte and University "Amedeo Avogadro" of Piemonte Orientale, Novara, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Padoan
authors.affiliation: Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, CPO Piemonte and University "Amedeo Avogadro" of Piemonte Orientale, Novara, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Ferrante
authors.affiliation: Medical Management of Hospitals, LHU NO, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Pretti
authors.affiliation: Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, CPO Piemonte and University "Amedeo Avogadro" of Piemonte Orientale, Novara, Italy - Unit of Cancer Epidemiology, CPO Piemonte and University of Turin, Turin, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Magnani
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007558:Italy; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D016730:Program Development; D015397:Program Evaluation; D055502:Secondary Prevention / Q000379:methods; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Mammogram screening; Participation; Questionnaire; Regional programme; Socio-personal characteristics; Survey