Compliance after 17 years of breast cancer screening: Factors associated with reattendance for periodic breast screening

The motives and reasons for regular attendance, irregular attendanceand drop-out were studied in women who were enrolled in a biennialbreast screening programme in 1975 and who were invited to eachsubsequent screening round until 1992. Three compliance groupswere compared: ‘attended all rounds’ (group A, n=79),‘missed 1 or 2 rounds’ (group B, n=73) and ‘missedmore than 2 rounds’ (group C, n=64). The groups did notdiffer with respect to background variables such as sociodemographiccharacteristics, actual health problems or preventive healthorientations, but significant differences were found in generalattitudes to breast screening and to the organizational aspectsof screening procedures. The results suggest that during thecourse of a screening programme, for a substantial group ofnot strongly motivated women, the recurring negative aspectsof mammography (pain and anxiety) are increasingly becominga burden. ‘Circumstantial factors’ like waitingfor one's turn, the distance to the screening centre and incidentaldissatisfaction with handling by screening staff, appear totrigger the decision to skip screening rounds or to drop outof the programme. From the perspective of maintaining a regularattendance throughout the programme this is an important group.Special efforts must be made to encourage these women to stayin the programme.