Can Flemish women in semi-rural areas be motivated to attend organized breast cancer screening?

Background: The implementation of organized breast cancer screening in Flan ders was prepared by means of pilot projects within a multicenter study. In the semi-rural district of Kontich (Province of Antwerp, Flanders) a pilot project was performed using a mobile screening unit. Compared to internati onal standards, the attendance rate for this pilot project (i.e. 34%) was l ow. Non-organized screening, which already exists in Flanders, at least par tly explains this low attendance rate for the organized screening. The main purpose of our study was to investigate rite experience of the pilot targe t group with respect to the organized breast cancer screening in the distri ct of Kontich, in order to maximize the conditions for a high attendance ra te in the organized breast cancer screening programme throughout Flanders. Methods: With a random numbers procedure, performed by the computer 500 wom en were selected among those who were invited to the first screening round of the breast cancer screening programme in the district of Kontich (n=6,89 7). These 500 randomly selected women were asked to cooperate with a face-t o-face interview. The questionnaire used dealt with the different aspects o f the organized mammographic screening which were expected to influence the decision to attend. Results: There were 348 women who responded to the questionnaire (69.6%): 1 38 of them were attenders and 210 were non-attenders at the organized breas t cancer screening. Attenders and nonattenders at the organized breast canc er screening in the district of Kontich had different views about various a spects of the screening programme. The percentages of those who thought tha t an item was important or very important to them, were for the 138 attende rs and the 210 non-attenders respectively: "to receive a personal invitatio n letter": 90.6 vs. 48.1% (p<0.05); "a preliminary visit to the GP": 9.4 vs . 34.3% (p<0.05), "possibility of examination outside business hours": 15.9 vs. 30.0% (p<0.05). Conclusions: Although the putting into action of a mobile unit in the semi- rural area of the district of Kontich was productive, the attendance rate w as still too low compared to international standards. To increase the atten dance rate, the following interventions should be considered: devising the personal invitation letter in a more attractive way, activating and stimula ting the important motivational role of the GP in persuading women to atten d the organized screening programme and offering the invited population the possibility to have a mammographic examination performed outside business hours. Appropriate measures are being explored.