Skip to main content
PMC home page
British Journal of Cancer logoLink to British Journal of Cancer
. 1998 Jun;77(11):2014–2019. doi: 10.1038/bjc.1998.335

Psychological predictors of attendance at annual breast screening examinations.

M V Burton 1, R Warren 1, D Price 1, H Earl 1
PMCID: PMC2150324  PMID: 9667685

Abstract

This retrospective analysis of psychological predictors of attendance studied the women from the annual screening arm of the United Kingdom Coordinating Committee on Cancer Research (UKCCCR) trial of annual screening mammography for the early detection of breast cancer. Some women attended screening at the first invitation in year 1 (attenders), others did not attend for screening at any time (non-attenders), whereas a third group delayed attending until year 2 (ambivalent attenders). A total of 147 women were recruited to the study: 80 attenders, 28 non-attenders and 39 ambivalent attenders. It proved extremely difficult to contact non-attenders to take part in the study. Non-attenders were significantly more depressed on the Hospital Anxiety and Depression Scale; had experienced more miscarriages, stillbirths or terminations of pregnancy; were less knowledgeable about mammography; and were displeased to have received an invitation to screening. Whereas non-attenders are unlikely ever to attend breast screening because of their long-standing attitudes and preferred coping styles, ambivalent attenders may become more amenable to screening with the passage of time. In this study such women were persuaded to attend in year 2 with a simple, cost-effective intervention: an additional invitation letter after a year.

Full text

PDF
2014

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aiken L. S., West S. G., Woodward C. K., Reno R. R. Health beliefs and compliance with mammography-screening recommendations in asymptomatic women. Health Psychol. 1994 Mar;13(2):122–129. doi: 10.1037//0278-6133.13.2.122. [DOI] [PubMed] [Google Scholar]
  2. Austoker J. Screening and self examination for breast cancer. BMJ. 1994 Jul 16;309(6948):168–174. doi: 10.1136/bmj.309.6948.168. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Beaulieu M. D., Béland F., Roy D., Falardeau M., Hébert G. Factors determining compliance with screening mammography. CMAJ. 1996 May 1;154(9):1335–1343. [PMC free article] [PubMed] [Google Scholar]
  4. Bostick R. M., Sprafka J. M., Virnig B. A., Potter J. D. Predictors of cancer prevention attitudes and participation in cancer screening examinations. Prev Med. 1994 Nov;23(6):816–826. doi: 10.1006/pmed.1994.1139. [DOI] [PubMed] [Google Scholar]
  5. Bowling A. Implications of preventive health behaviour for cervical and breast cancer screening programmes: a review. Fam Pract. 1989 Sep;6(3):224–231. doi: 10.1093/fampra/6.3.224. [DOI] [PubMed] [Google Scholar]
  6. Bull A. R., Campbell M. J. Assessment of the psychological impact of a breast screening programme. Br J Radiol. 1991 Jun;64(762):510–515. doi: 10.1259/0007-1285-64-762-510. [DOI] [PubMed] [Google Scholar]
  7. Bundek N. I., Marks G., Richardson J. L. Role of health locus of control beliefs in cancer screening of elderly Hispanic women. Health Psychol. 1993 May;12(3):193–199. doi: 10.1037//0278-6133.12.3.193. [DOI] [PubMed] [Google Scholar]
  8. Calle E. E., Flanders W. D., Thun M. J., Martin L. M. Demographic predictors of mammography and Pap smear screening in US women. Am J Public Health. 1993 Jan;83(1):53–60. doi: 10.2105/ajph.83.1.53. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Cassileth B. R. Breast cancer surveillance: on increasing its effectiveness while reducing its negative psychological effects. J Natl Cancer Inst. 1992 Jan 1;84(1):2–3. doi: 10.1093/jnci/84.1.2. [DOI] [PubMed] [Google Scholar]
  10. Champion V. L. Beliefs about breast cancer and mammography by behavioral stage. Oncol Nurs Forum. 1994 Jul;21(6):1009–1014. [PubMed] [Google Scholar]
  11. Dolan N. C., Reifler D. R., McDermott M. M., McGaghie W. C. Adherence to screening mammography recommendations in a university general medicine clinic. J Gen Intern Med. 1995 Jun;10(6):299–306. doi: 10.1007/BF02599947. [DOI] [PubMed] [Google Scholar]
  12. Donato F., Bollani A., Spiazzi R., Soldo M., Pasquale L., Monarca S., Lucini L., Nardi G. Factors associated with non-participation of women in a breast cancer screening programme in a town in northern Italy. J Epidemiol Community Health. 1991 Mar;45(1):59–64. doi: 10.1136/jech.45.1.59. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Eardley A., Elkind A. A pilot study of attendance for breast cancer screening. Soc Sci Med. 1990;30(6):693–699. doi: 10.1016/0277-9536(88)90254-7. [DOI] [PubMed] [Google Scholar]
  14. Fallowfield L. J., Rodway A., Baum M. What are the psychological factors influencing attendance, non-attendance and re-attendance at a breast screening centre? J R Soc Med. 1990 Sep;83(9):547–551. doi: 10.1177/014107689008300905. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Frazier T. G., Cummings P. D. Motivational factors for participation in breast cancer screening. J Cancer Educ. 1990;5(1):51–54. doi: 10.1080/08858199009528035. [DOI] [PubMed] [Google Scholar]
  16. Fulton J. P., Buechner J. S., Scott H. D., DeBuono B. A., Feldman J. P., Smith R. A., Kovenock D. A study guided by the Health Belief Model of the predictors of breast cancer screening of women ages 40 and older. Public Health Rep. 1991 Jul-Aug;106(4):410–420. [PMC free article] [PubMed] [Google Scholar]
  17. Glockner S. M., Holden M. G., Hilton S. V., Norcross W. A. Women's attitudes toward screening mammography. Am J Prev Med. 1992 Mar-Apr;8(2):69–77. [PubMed] [Google Scholar]
  18. Gordon D. R., Venturini A., Del Turco M. R., Palli D., Paci E. What healthy women think, feel and do about cancer, prevention and breast cancer screening in Italy. Eur J Cancer. 1991;27(7):913–917. doi: 10.1016/0277-5379(91)90146-5. [DOI] [PubMed] [Google Scholar]
  19. Greer S. Psychological aspects: delay in the treatment of breast cancer. Proc R Soc Med. 1974 Jun;67(6 Pt 1):470–473. [PMC free article] [PubMed] [Google Scholar]
  20. Haiart D. C., McKenzie L., Henderson J., Pollock W., McQueen D. V., Roberts M. M., Forrest A. P. Mobile breast screening: factors affecting uptake, efforts to increase response and acceptability. Public Health. 1990 Jul;104(4):239–247. doi: 10.1016/s0033-3506(05)80472-x. [DOI] [PubMed] [Google Scholar]
  21. Hammond J. A., Stewart M. Female patients' attitudes to mammography screening. Can Fam Physician. 1994 Mar;40:451–455. [PMC free article] [PubMed] [Google Scholar]
  22. Hurley S. F., Huggins R. M., Jolley D. J., Reading D. Recruitment activities and sociodemographic factors that predict attendance at a mammographic screening program. Am J Public Health. 1994 Oct;84(10):1655–1658. doi: 10.2105/ajph.84.10.1655. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Johnson M. M., Hislop T. G., Kan L., Coldman A. J., Lai A. Compliance with the screening mammography program of British Columbia: will she return? Can J Public Health. 1996 May-Jun;87(3):176–180. [PubMed] [Google Scholar]
  24. Kang S. H., Bloom J. R., Romano P. S. Cancer screening among African-American women: their use of tests and social support. Am J Public Health. 1994 Jan;84(1):101–103. doi: 10.2105/ajph.84.1.101. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Kash K. M., Holland J. C., Halper M. S., Miller D. G. Psychological distress and surveillance behaviors of women with a family history of breast cancer. J Natl Cancer Inst. 1992 Jan 1;84(1):24–30. doi: 10.1093/jnci/84.1.24. [DOI] [PubMed] [Google Scholar]
  26. Kee F., Telford A. M., Donaghy P., O'Doherty A. Attitude or access: reasons for not attending mammography in Northern Ireland. Eur J Cancer Prev. 1992 Jun;1(4):311–315. [PubMed] [Google Scholar]
  27. Kendall C., Hailey B. J. The relative effectiveness of three reminder letters on making and keeping mammogram appointments. Behav Med. 1993 Spring;19(1):29–34. doi: 10.1080/08964289.1993.9937562. [DOI] [PubMed] [Google Scholar]
  28. Kruse J., Phillips D. M. Factors influencing women's decision to undergo mammography. Obstet Gynecol. 1987 Nov;70(5):744–748. [PubMed] [Google Scholar]
  29. Lerman C., Daly M., Sands C., Balshem A., Lustbader E., Heggan T., Goldstein L., James J., Engstrom P. Mammography adherence and psychological distress among women at risk for breast cancer. J Natl Cancer Inst. 1993 Jul 7;85(13):1074–1080. doi: 10.1093/jnci/85.13.1074. [DOI] [PubMed] [Google Scholar]
  30. Lerman C., Rimer B. K., Engstrom P. F. Cancer risk notification: psychosocial and ethical implications. J Clin Oncol. 1991 Jul;9(7):1275–1282. doi: 10.1200/JCO.1991.9.7.1275. [DOI] [PubMed] [Google Scholar]
  31. Lerman C., Trock B., Rimer B. K., Jepson C., Brody D., Boyce A. Psychological side effects of breast cancer screening. Health Psychol. 1991;10(4):259–267. doi: 10.1037//0278-6133.10.4.259. [DOI] [PubMed] [Google Scholar]
  32. Magarey C. J., Todd P. B., Blizard P. J. Psycho-social factors influencing delay and breast self-examination in women with symptoms of breast cancer. Soc Sci Med. 1977 Mar;11(4):229–232. doi: 10.1016/0037-7856(77)90069-5. [DOI] [PubMed] [Google Scholar]
  33. Mandelblatt J., Traxler M., Lakin P., Kanetsky P., Kao R. Mammography and Papanicolaou smear use by elderly poor black women. The Harlem Study Team. J Am Geriatr Soc. 1992 Oct;40(10):1001–1007. doi: 10.1111/j.1532-5415.1992.tb04476.x. [DOI] [PubMed] [Google Scholar]
  34. McEwen J., King E., Bickler G. Attendance and non-attendance for breast screening at the south east London breast screening service. BMJ. 1989 Jul 8;299(6691):104–106. doi: 10.1136/bmj.299.6691.104. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Miller A. M., Champion V. L. Mammography in women > or = 50 years of age. Predisposing and enabling characteristics. Cancer Nurs. 1993 Aug;16(4):260–269. [PubMed] [Google Scholar]
  36. Montano D. E., Taplin S. H. A test of an expanded theory of reasoned action to predict mammography participation. Soc Sci Med. 1991;32(6):733–741. doi: 10.1016/0277-9536(91)90153-4. [DOI] [PubMed] [Google Scholar]
  37. Morgan C., Park E., Cortes D. E. Beliefs, knowledge, and behavior about cancer among urban Hispanic women. J Natl Cancer Inst Monogr. 1995;(18):57–63. [PubMed] [Google Scholar]
  38. Munn E. M. Nonparticipation in mammography screening: apathy, anxiety or cost? N Z Med J. 1993 Jul 14;106(959):284–286. [PubMed] [Google Scholar]
  39. Murray M., McMillan C. Health beliefs, locus of control, emotional control and women's cancer screening behaviour. Br J Clin Psychol. 1993 Feb;32(Pt 1):87–100. doi: 10.1111/j.2044-8260.1993.tb01032.x. [DOI] [PubMed] [Google Scholar]
  40. Polednak A. P., Lane D. S., Burg M. A. Mail versus telephone surveys on mammography utilization among women 50-75 years old. Med Care. 1991 Mar;29(3):243–250. doi: 10.1097/00005650-199103000-00006. [DOI] [PubMed] [Google Scholar]
  41. Potvin L., Camirand J., Béland F. Patterns of health services utilization and mammography use among women aged 50 to 59 years in the Québec Medicare system. Med Care. 1995 May;33(5):515–530. doi: 10.1097/00005650-199505000-00006. [DOI] [PubMed] [Google Scholar]
  42. Rakowski W., Fulton J. P., Feldman J. P. Women's decision making about mammography: a replication of the relationship between stages of adoption and decisional balance. Health Psychol. 1993 May;12(3):209–214. doi: 10.1037//0278-6133.12.3.209. [DOI] [PubMed] [Google Scholar]
  43. Rakowski W., Pearlman D., Rimer B. K., Ehrich B. Correlates of mammography among women with low and high socioeconomic resources. Prev Med. 1995 Mar;24(2):149–158. doi: 10.1006/pmed.1995.1028. [DOI] [PubMed] [Google Scholar]
  44. Rimer B. K., Keintz M. K., Kessler H. B., Engstrom P. F., Rosan J. R. Why women resist screening mammography: patient-related barriers. Radiology. 1989 Jul;172(1):243–246. doi: 10.1148/radiology.172.1.2740510. [DOI] [PubMed] [Google Scholar]
  45. Rimer B. K., Schildkraut J. M., Lerman C., Lin T. H., Audrain J. Participation in a women's breast cancer risk counseling trial. Who participates? Who declines? High Risk Breast Cancer Consortium. Cancer. 1996 Jun 1;77(11):2348–2355. doi: 10.1002/(SICI)1097-0142(19960601)77:11<2348::AID-CNCR25>3.0.CO;2-W. [DOI] [PubMed] [Google Scholar]
  46. Rimer B. K., Trock B., Engstrom P. F., Lerman C., King E. Why do some women get regular mammograms? Am J Prev Med. 1991 Mar-Apr;7(2):69–74. [PubMed] [Google Scholar]
  47. Rodriguez C., Plasencia A., Schroeder D. G. Predictive factors of enrollment and adherence in a breast cancer screening program in Barcelona (Spain). Soc Sci Med. 1995 Apr;40(8):1155–1160. doi: 10.1016/0277-9536(94)00184-u. [DOI] [PubMed] [Google Scholar]
  48. Rothman A. J., Salovey P., Turvey C., Fishkin S. A. Attributions of responsibility and persuasion: increasing mammography utilization among women over 40 with an internally oriented message. Health Psychol. 1993 Jan;12(1):39–47. doi: 10.1037//0278-6133.12.1.39. [DOI] [PubMed] [Google Scholar]
  49. Siegler I. C., Feaganes J. R., Rimer B. K. Predictors of adoption of mammography in women under age 50. Health Psychol. 1995 May;14(3):274–278. doi: 10.1037//0278-6133.14.3.274. [DOI] [PubMed] [Google Scholar]
  50. Sutton S., Bickler G., Sancho-Aldridge J., Saidi G. Prospective study of predictors of attendance for breast screening in inner London. J Epidemiol Community Health. 1994 Feb;48(1):65–73. doi: 10.1136/jech.48.1.65. [DOI] [PMC free article] [PubMed] [Google Scholar]
  51. Taplin S. H., Anderman C., Grothaus L., Curry S., Montano D. Using physician correspondence and postcard reminders to promote mammography use. Am J Public Health. 1994 Apr;84(4):571–574. doi: 10.2105/ajph.84.4.571. [DOI] [PMC free article] [PubMed] [Google Scholar]
  52. Timko C. Seeking medical care for a breast cancer symptom: determinants of intentions to engage in prompt or delay behavior. Health Psychol. 1987;6(4):305–328. doi: 10.1037//0278-6133.6.4.305. [DOI] [PubMed] [Google Scholar]
  53. Vernon S. W., Laville E. A., Jackson G. L. Participation in breast screening programs: a review. Soc Sci Med. 1990;30(10):1107–1118. doi: 10.1016/0277-9536(90)90297-6. [DOI] [PubMed] [Google Scholar]
  54. Vernon S. W., Vogel V. G., Halabi S., Jackson G. L., Lundy R. O., Peters G. N. Breast cancer screening behaviors and attitudes in three racial/ethnic groups. Cancer. 1992 Jan 1;69(1):165–174. doi: 10.1002/1097-0142(19920101)69:1<165::aid-cncr2820690128>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]
  55. Wallston K. A., Wallston B. S., DeVellis R. Development of the Multidimensional Health Locus of Control (MHLC) Scales. Health Educ Monogr. 1978 Spring;6(2):160–170. doi: 10.1177/109019817800600107. [DOI] [PubMed] [Google Scholar]
  56. Wardle J., Pope R. The psychological costs of screening for cancer. J Psychosom Res. 1992 Oct;36(7):609–624. doi: 10.1016/0022-3999(92)90051-3. [DOI] [PubMed] [Google Scholar]
  57. Wardlow H., Curry R. H. "Sympathy for my body": breast cancer and mammography at two Atlanta clinics. Med Anthropol. 1996 Mar;16(4):319–340. doi: 10.1080/01459740.1994.9966120. [DOI] [PubMed] [Google Scholar]
  58. Watson M., Greer S. Development of a questionnaire measure of emotional control. J Psychosom Res. 1983;27(4):299–305. doi: 10.1016/0022-3999(83)90052-1. [DOI] [PubMed] [Google Scholar]
  59. Watson M., Greer S., Rowden L., Gorman C., Robertson B., Bliss J. M., Tunmore R. Relationships between emotional control, adjustment to cancer and depression and anxiety in breast cancer patients. Psychol Med. 1991 Feb;21(1):51–57. doi: 10.1017/s0033291700014641. [DOI] [PubMed] [Google Scholar]
  60. Watson M., Greer S., Young J., Inayat Q., Burgess C., Robertson B. Development of a questionnaire measure of adjustment to cancer: the MAC scale. Psychol Med. 1988 Feb;18(1):203–209. doi: 10.1017/s0033291700002026. [DOI] [PubMed] [Google Scholar]
  61. Williams E. M., Vessey M. P. Compliance with breast cancer screening achieved by the Aylesbury Vale mobile service (1984-1988). J Public Health Med. 1990 Feb;12(1):51–55. doi: 10.1093/oxfordjournals.pubmed.a042506. [DOI] [PubMed] [Google Scholar]
  62. Zigmond A. S., Snaith R. P. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES