Psychosocial predictors of first attendance for organised mammography screening

Objective-To study psychosocial predictors of attendance at an organised br east cancer screening programme. Setting-Finnish screening programme based on personal first round invitatio ns in 1992-94, and with 90% attendance rate. Methods-Attenders (n=936) belonged to a 10% random sample (n=1680 women, ag e 50, response rate 64%) of the target population (n=16 886), non-attenders (n=641, 38%) came from the whole target population. Predictors were measur ed one month before the screening invitation. Measures included items for s ocial and behavioural factors, Breast Cancer Susceptibility Scale, Illness Attitude Scale, Health Locus of Control Scale, Anxiety Inventory, and Depre ssion Inventory. Univariate and multivariate logistic regression analyses w ere used to predict attendance. Results-Those most likely to attend were working, middle income, and averag ely educated women, who had not had a mass mammogram recently, but who regu larly visited gynaecologists, attended for Pap smear screening, practised b reast self examination, and who did not smoke. Low confidence in their own capabilities in breast cancer prevention, overoptimism about the sensitivit y of mammography, and perception of breast cancer risk as moderate were als o predictive of attendance. Expectation of pain at mammography was predicti ve of non-attendance. Conclusion-Mammography screening organised as a public health service was w ell accepted. A recent mammogram, high reliance on self control of breast c ancer, and an expectation of pain at mammography deterred attendance at scr eening. Further information about these factors and health information on s creening are needed.