Determinants for participation in The Norwegian Breast Cancer Screening Programme

Abstract

Background: Breast cancer is the most frequent cancer among women worldwide, and the second most important cause of cancer death in developed countries after lung cancer. Early detection with mammographic screening reduces breast cancer mortality. Few studies have investigated factors associated with participation in The Norwegian Breast Cancer Screening Programme. Objective: To identify determinants for participation in the breast cancer screening programme in Norway by demographic, lifestyle and socioeconomic factors. Material and method: Cross-sectional study with data from the Norwegian Women and Cancer Study. Data collected in 2011, 8938 women aged 54-69 years. Self-reported behavior on lifestyle and socioeconomic factors collected by questionnaires. Logistic regression analysis with forward stepwise (likelihood ratio) selection was used to calculate odds ratios. Results: Approximately four of five women have participated in the Norwegian Breast Cancer Screening Programme. After covariates were adjusted for, determinants for participation in the screening program were young age, OR 0.57 (CI 0.49-0.66), having a mother without breast cancer, OR 1.60 (CI 1.26-2.04), high socioeconomic status and living in the western region of Norway. Abstaining from alcohol gave lower odds of participation. Conclusion: Our study found several determinants for participation in the screening program. There is a social gradient associated with participation, with increased participation in higher social classes. Measures to increase it should be directed specifically at women in lower social classes. Demography is also decisive for participation, while lifestyle factors were of less importance.

Key words: Breast cancer, mammography, socioeconomic status, screening