COMPLIANCE AFTER 17 YEARS OF BREAST-CANCER SCREENING - FACTORS ASSOCIATED WITH REATTENDANCE FOR PERIODIC BREAST SCREENING

The motives and reasons for regular attendance, irregular attendance a nd drop-out were studied in women who were enrolled in a biennial brea st screening programme in 1975 and who were invited to each subsequent screening round until 1992. Three compliance groups were compared: 'a ttended all rounds' (group A, n=79), 'missed 1 or 2 rounds' (group B, n=73) and 'missed more than 2 rounds' (group C, n=64). The groups did not differ with respect to background variables such as sociodemograph ic characteristics, actual health problems or preventive health orient ations, but significant differences were found in general attitudes to breast screening and to the organizational aspects of screening proce dures. The results suggest that during the course of a screening progr amme, for a substantial group of not strongly motivated women, the rec urring negative aspects of mammography (pain and anxiety) are increasi ngly becoming a burden. 'Circumstantial factors' like waiting for one' s turn, the distance to the screening centre and incidental dissatisfa ction with handling by screening staff, appear to trigger the decision to skip screening rounds or to drop out of the programme. From the pe rspective of maintaining a regular attendance throughout the programme this is an important group. Special efforts must be made to encourage these women to stay in the programme.