Abstract
Background
The retention rate or the percentage of women who return to screening within 30 months of a previous screening is an important measure of screening success and the acceptability of the screening program to women. The objective of this study was to investigate variables associated with the retention of women 50 to 68 years of age who were screened by the Manitoba Breast Screening Program (MBSP) during 2002 and 2003.
Methods
All women screened by the MBSP in 2002 and 2003 who were eligible for re-screening in 2 years were included in the study. Data were extracted from the MBSP database which contains demographic, screening, diagnostic follow-up, and diagnosis information for all women screened by the program. Contingency tables, ?2 tests, and logistic regression were used to investigate variables that were associated with retention.
Results
Retention was related to screen type (first or return), screen result (normal or abnormal), family history of breast cancer (risk or no risk), education (less than grade 9 or some high school or more), and ethnicity (Asian, First Nations, other). Retention was not related to residence (rural or urban).
Conclusions
Overall screening retention at the MBSP was 80% which meets national standards. However, additional efforts may be required to improve the retention rate of Asian and First Nations women as well as women who had an abnormal screening result or less than a grade 9 level of education.
Key words: Screening, breast cancer, retention
Résumé
Contexte
Le taux de persévérance (le pourcentage des femmes qui se soumettent de nouveau à un examen de dépistage dans les 30 mois qui suivent un examen antérieur) est un indicateur important du succès d’un programme de dépistage et de son acceptabilité auprès des femmes. Cette étude avait pour objectif d’examiner les variables associées à la persévérance chez les femmes de 50 à 68 ans ayant subi un examen de dépistage du Programme manitobain de dépistage du cancer du sein (PMDCS) en 2002 et 2003.
Méthode
L’étude a tenu compte de toutes les femmes qui ont subi un examen de dépistage du PMDCS en 2002 et 2003 et qui étaient admissibles à un redépistage après 2 ans. Les données ont été extraites de la base du PMDCS, qui contient des données démographiques, de dépistage, de suivi diagnostique et de diagnostic sur toutes les femmes ayant subi un examen de dépistage dans le cadre du programme. Pour examiner les variables associées à la persévérance, on a utilisé les tableaux de contingence, le test du khi-carré et la régression logistique.
Résultats
La persévérance a été associée au type d’examen de dépistage (premier ou subséquent), au résultat de l’examen (normal ou anormal), aux antécédents familiaux de cancer du sein (à risque ou non), à la scolarité (8e année ou moins, certaines études secondaires, études supérieures) ainsi qu’à l’origine ethnique (asiatique, Premières nations, autre). La persévérance n’a pas été associée au lieu de résidence (milieu rural ou urbain).
Conclusions
Dans l’ensemble, le taux de persévérance en ce qui concerne les examens de dépistage du PMDCS était de 80%, ce qui satisfait aux normes nationales. Toutefois, il faudrait peut-être déployer davantage d’efforts pour améliorer le taux de persévérance chez les femmes asiatiques et des Premières nations ainsi que chez les femmes dont l’examen de dépistage s’est traduit par un résultat anormal ou qui ont moins de 9 ans de scolarité.
Mots clés: dépistage, cancer du sein, persévérance
References
- 1.Kerlikowske K, Grady D, Rubin SM, Sandrock C, Ernster VL. Efficacy of screening mammogra-phy. A meta-analysis. JAMA. 1995;273:149–54. doi: 10.1001/jama.1995.03520260071035. [DOI] [PubMed] [Google Scholar]
- 2.Health Canada. Organized breast cancer screening programs in Canada. 1999 and 2000 report. Ottawa, ON: Minister of Public Works and Government Services Canada; 2003. [Google Scholar]
- 3.Evaluation Indicators Working Group . Health Canada. Guidelines for monitoring breast screening program performance. Ottawa: Minister of Public Works and Government Services Canada; 2002. [Google Scholar]
- 4.Decker KM, Harrison M, Watters K. Manitoba Breast Screening Program Biennial Report, 2004–2006. Winnipeg, MB: Manitoba Breast Screening Program, CancerCare Manitoba; 2007. [Google Scholar]
- 5.Gail MH, Costanino JP. Validating and improving models for projecting absolute risk of breast cancer. J Natl Cancer Inst. 2001;93(5):334–35. doi: 10.1093/jnci/93.5.334. [DOI] [PubMed] [Google Scholar]
- 6.SAS version 9.1. Carey, NC: SAS Institute, 2002.
- 7.Johnson MM, Hislop TG, Kan L, Coldman AJ, Lai A. Compliance with the Screening Mammography Program of British Columbia: Will she return? Can J Public Health. 1996;87(3):176–80. [PubMed] [Google Scholar]
- 8.Hofvind SS, Wang H, Thoresen S. The Norwegian Breast Cancer Screening Program: Re-attendance related to the woman’s experiences, intentions, and previous screening result. Cancer Causes and Control. 2003;14(4):391–98. doi: 10.1023/A:1023918610664. [DOI] [PubMed] [Google Scholar]
- 9.Lampic C, Thurfjell E, Sjoden PO. The influence of false-positive mammogram on a woman’s subsequent behaviour for detecting breast cancer. Eur J Cancer. 2003;39:1730–37. doi: 10.1016/S0959-8049(02)00451-3. [DOI] [PubMed] [Google Scholar]
- 10.Burman ML, Taplin SH, Herta DF, Elmore JG. Effect of false-positive mammograms on interval breast cancer screening in a health maintenance organization. Ann Intern Med. 1999;131(1):1–6. doi: 10.7326/0003-4819-131-1-199907060-00002. [DOI] [PubMed] [Google Scholar]
- 11.Pisano ED, Earp J, Schell M, Vokaty K, Denham A. Screening behaviour of women after a false-positive mammogram. Radiology. 1998;208:245–49. doi: 10.1148/radiology.208.1.9646820. [DOI] [PubMed] [Google Scholar]
- 12.Decker K, Harrison M, Tate R. Satisfaction of women attending the Manitoba Breast Screening Program. J Prev Med. 1999;29:22–27. doi: 10.1006/pmed.1999.0497. [DOI] [PubMed] [Google Scholar]
- 13.Marc D. Manitoba Health. 2006. [Google Scholar]
- 14.Lerman C, Daly M, Sands C, Balshem A, Lustbader E, Heggan T, et al. Mammography adherence and psychological distress among women at risk for breast cancer. J Natl Cancer Inst. 1993;85(13):1074–80. doi: 10.1093/jnci/85.13.1074. [DOI] [PubMed] [Google Scholar]
- 15.Phillips KA, Kerlikowske K, Baker LC, Chang SW, Brown ML. Factors associated with women’s adherence to mammography screening guidelines. Health Serv Res. 1998;33(1):29–53. [PMC free article] [PubMed] [Google Scholar]
- 16.O’Byrne A-M, Kavanagh AM, Ugoni A, Diver F. Predictors of non-attendance for second round mammography in an Australian mammographic screening programme. J Med Screening. 2000;7:190–94. doi: 10.1136/jms.7.4.190. [DOI] [PubMed] [Google Scholar]
- 17.Elwood M, NcNoe B, Smith T, Bandaranayake M, Doyle TC. Once is enough: Why some women do not continue to participate in a breast screening programme. N Z Med J. 1998;111(1066):180–83. [PubMed] [Google Scholar]