FACTORS AFFECTING PARTICIPATION IN MAMMOGRAPHY SCREENING

Aims. To assess factors influencing attendance or nonattendance at the first round of a population based mammography screening programme, in New Zealand. Method Representative samples of women who responded to an invitation to attend screening, and women who did not respond, were interviewed by telephone, by an interviewer independent of the screen ing programme. The response rates in those identified were 98% for att enders and 86% for nonattenders, giving final samples of 191 and 174 r espectively. However, more nonattenders could not be contacted or had no known phone number. Results. Reasons given for attendance were prim arily the need for reassurance, to detect breast cancer early, and the fact that the programme was free, a pilot programme, or recommended b y their family doctor. Seventeen percent of attenders had been influen ced by positive reports from other women. Of the nonattenders; 7% were ineligible for mammography, 20% did not attend because of practical d ifficulties and convenience, and 20% expressed concern or fear of the procedure or were influenced by negative reports from other women. Att enders and nonattenders did not differ in regard to age, education, in come, socioeconomic status, degree of worry when the invitation was re ceived, or physical distance from their home to the screening centre, although nonattenders estimated the travel would take considerably lon ger than did attenders. Ninety percent of attenders intend to come to the second round of screening. Forty three percent-of nonattenders int end to participate at future rounds of screening, this figure being 80 % in those who did not attend because of logistic or convenience reaso ns, and 27% for those who did not attend because of fear or negative r eports. Conclusions. The main reasons given for nonattendance are appr oximately equally divided between practical difficulty, and negative a ttitude towards the process. Most of those who did not attend for reas ons of convenience intend to participate at future rounds, so that ove rall almost half of nonattenders intend to participate at future round s. Therefore we recommend that invitations for future screening rounds should be sent to women who do not participate in the first round of population based screening.