BREAST-CANCER SCREENING PROGRAMS AND AVAI LABILITY TO MAMMOGRAPHY IN SPAIN

BACKGROUND: We studied availability to mammography among Spanish women aged 40 to 70 years, variation in use of the mamography by autonomous community, and the situation and importance of breast cancer screenin g programs, among other factors, in the access to mammography. SUBJECT S AND METHODS: A cross-sectional population survey was conducted in 19 94 in a sample of 3,218 women. A questionnaire was used to collect dat a on the variable access (receipt of at least one mammogram in the las t 2 years) as well as different access-related variables. Information on breast cancer screening programs was collected by contacting the re sponsible institutions. We considered that a program had total coverag e if it included all the municipalities in the province and partial if it did not include all municipalities. RESULTS: Twenty-eight percent of women had performed a mammogram. This proportion varied among auton omous communities (AACC) from 11.5 to 73.8%. Breast cancer screening p rograms existed in 8 AACC. The multivariant analysis revealed an assoc iation between access to mammography and the existence of a screening program, especially when the latter had total coverage (OR = 7.64; 95% CI = 5.24-11.10). An association was also found between access to mam mography and physician-related factors, place of residence and attitud es of women toward mammography. CONCLUSIONS: Less than one third of wo men aged 40-70 have performed a mammography in the last 2 years, and t his proportion varies among AACC. Gynecologist visits and the existenc e of breast cancer screening programs are fundamental factors in the a ccess to mammography in Spain.