PREDICTIVE FACTORS OF ENROLLMENT AND ADHERENCE IN A BREAST-CANCER SCREENING-PROGRAM IN BARCELONA (SPAIN)

This paper study the predictive factors associated to enrollment and a dherence in a breast cancer screening program in Barcelona, Spain; the Program is targeted to women 50-70 years of age who are members of a Health Maintenance Organization. Data were collected by personal inter view for the attending women and by telephone in the non-attending gro up. The questionnaire was focused on knowledge, attitudes and practice s related to female cancer prevention and breast cancer risk factors. Data analysis consisted of bivariate and multivariate analysis. Enroll ing in a breast cancer screening program was strongly associated with practices related to cancer prevention in the bivariate analysis. Havi ng had a previous mammography was the only behavioral factor that show ed an independent relationship with enrollment (OR= 6.45, 95% CI=3.35- 12.42) in the multivariate analysis together with being younger than 5 5 and having family history of cancer. Adherence was associated with h aving the best opinion of the program, knowing the preventive role of mammography and performing regular breast self-examination in the biva riate analysis; of these, knowing the preventive role of mammography ( 013-2.66, 95% CI=1.14-6.18) and performing regular breast self-examina tion (OR=1.99, 95% CI=1.23-3.23) were independently associated in the multivariated analysis. Being a relative of a municipal worker and you nger than 55 were also significantly associated with adherence. Gettin g women to participate in a breast cancer screening program is difficu lt-mailed invitation letters are not sufficient. It is not the clinica l procedure itself that inhibits participation, however, since women w ho have had a mammography in the past are more likely to both enroll a nd adhere to the program.