Non-participation in breast screening in Denmark: Sociodemographic determinants.
Breast cancer
Epidemiology
Mammography
Participation
Screening
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
29 Jul 2024
29 Jul 2024
Historique:
received:
11
03
2024
accepted:
22
07
2024
medline:
30
7
2024
pubmed:
30
7
2024
entrez:
29
7
2024
Statut:
epublish
Résumé
Internationally, non-participation in breast screening increased with decreasing level of education indicating importance of information campaigns to enhance awareness of screening. However, in Denmark in the 1990s the association between education and non-participation was U-shaped. We therefore analyzed recent Danish data. Data derived from the Capital Region of Denmark, biennial, organized breast screening program 2008-2020, where women aged 50-69 were personally invited to screening. Non-participation was measured as number of women with no participation out of women eligible for at least three invitations. Sociodemographic determinants were identified by linkage to public registers. Results were reported as age adjusted odds ratios (OR) of non-participation including 95% confidence intervals (CI). Among 196,085 women, 86% participated. Using women with low education as baseline, the OR for professional bachelors was 0.64; and for academics 0.75. The strongest determinants of non-participation were being non-married OR 2.03; born outside Denmark OR 2.04; being self-employed OR 1.67; retired OR 3.12; on public support OR 3.66; or having co-morbidity OR 1.56. The U-shaped association between education and non-participation in breast screening prevailed. The data further indicated that screening participation was low in women with pertinent health and social problems.
Sections du résumé
BACKGROUND
BACKGROUND
Internationally, non-participation in breast screening increased with decreasing level of education indicating importance of information campaigns to enhance awareness of screening. However, in Denmark in the 1990s the association between education and non-participation was U-shaped. We therefore analyzed recent Danish data.
METHODS
METHODS
Data derived from the Capital Region of Denmark, biennial, organized breast screening program 2008-2020, where women aged 50-69 were personally invited to screening. Non-participation was measured as number of women with no participation out of women eligible for at least three invitations. Sociodemographic determinants were identified by linkage to public registers. Results were reported as age adjusted odds ratios (OR) of non-participation including 95% confidence intervals (CI).
RESULTS
RESULTS
Among 196,085 women, 86% participated. Using women with low education as baseline, the OR for professional bachelors was 0.64; and for academics 0.75. The strongest determinants of non-participation were being non-married OR 2.03; born outside Denmark OR 2.04; being self-employed OR 1.67; retired OR 3.12; on public support OR 3.66; or having co-morbidity OR 1.56.
CONCLUSION
CONCLUSIONS
The U-shaped association between education and non-participation in breast screening prevailed. The data further indicated that screening participation was low in women with pertinent health and social problems.
Identifiants
pubmed: 39075424
doi: 10.1186/s12889-024-19547-x
pii: 10.1186/s12889-024-19547-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2024Informations de copyright
© 2024. The Author(s).
Références
GLOBOCAN. https://gco.iarc.fr/ [Accessed 3 Jan 2023].
Olsen AH, Njor SH, Vejborg I, Schwartz W, Dalgaard P, Jensen M-B, et al. Breast cancer mortality in Copenhagen after introduction of mammography screening: cohort study. BMJ. 2005;330:220–4.
doi: 10.1136/bmj.38313.639236.82
pubmed: 15649904
pmcid: 546064
Njor SH, Schwartz W, Blichert-Toft M, Lynge E. Decline in breast cancer mortality: how much is attributable to screening? J Med Screen. 2015;22(1):20–7. pmid:25492943.
doi: 10.1177/0969141314563632
pubmed: 25492943
Hanley JA, Hannigan A, O’Brien KM. Mortality reductions due to mammography screening: contemporary population-based data. PLoS ONE. 2017;12(12):e0188947.
doi: 10.1371/journal.pone.0188947
pubmed: 29261685
pmcid: 5737972
Council Recommendation on strengthening prevention through early detection. A new EU approach on cancer screening replacing Council Recommendation 2003/878/EC. https://data.consilium.europa.eu/doc/document/ST-14770-2022-INIT/en/pdf [Accessed 25 August 2023].
Ding L, Wang J, Greuter MJW, Goossens M, Van Hal G, de Bock GH. Determinants of Non-participation in Population-based breast Cancer screening: a systematic review and Meta-analysis. Front Oncol. 2022;12:817222. https://doi.org/10.3389/fonc.2022.817222 . PMID: 35311110; PMCID: PMC8924365.
doi: 10.3389/fonc.2022.817222
pubmed: 35311110
pmcid: 8924365
von Euler-Chelpin M, Olsen AH, Njor S, Jensen A, Vejborg I, Schwartz W, Lynge E. Does educational level determine screening participation? Eur J Cancer Prev. 2008;17(3):273-8. https://doi.org/10.1097/CEJ.0b013e3282f0c017 . PMID: 18414200.
Gøtzsche PC, Olsen O. Is screening for breast cancer with mammography justifiable? Lancet. 2000;355(9198):129 – 34. https://doi.org/10.1016/S0140-6736(99)06065-1 . PMID: 10675181.
Lynge E, Bak M, von Euler-Chelpin M, Kroman N, Lernevall A, Mogensen NB, Schwartz W, Wronecki AJ, Vejborg I. Outcome of breast cancer screening in Denmark. BMC Cancer. 2017;17(1):897. https://doi.org/10.1186/s12885-017-3929-6 . PMID: 29282034; PMCID: PMC5745763.
doi: 10.1186/s12885-017-3929-6
pubmed: 29282034
pmcid: 5745763
Larsen SH, Virgilsen LF, Kristiansen BK, Andersen B, Vedsted P. Strong association between cervical and breast cancer screening behaviour among Danish women; a register-based cohort study. Prev Med Rep. 2018;12:349–54. https://doi.org/10.1016/j.pmedr.2018.10.017 . PMID: 30450274; PMCID: PMC6234495.
doi: 10.1016/j.pmedr.2018.10.017
pubmed: 30450274
pmcid: 6234495
Jensen LF, Pedersen AF, Andersen B, Vedsted P. Identifying specific non-attending groups in breast cancer screening–population-based registry study of participation and socio-demography. BMC Cancer. 2012;12:518. https://doi.org/10.1186/1471-2407-12-518 . PMID: 23151053; PMCID: PMC3526420.
doi: 10.1186/1471-2407-12-518
pubmed: 23151053
pmcid: 3526420
Jensen LF, Pedersen AF, Andersen B, Vestergaard M, Vedsted P. Non-participation in breast cancer screening for women with chronic diseases and multimorbidity: a population-based cohort study. BMC Cancer. 2015;15:798. https://doi.org/10.1186/s12885-015-1829-1 . PMID: 26502879; PMCID: PMC4623919.
doi: 10.1186/s12885-015-1829-1
pubmed: 26502879
pmcid: 4623919
Viuff JH, Vejborg I, Schwartz W, Bak M, Mikkelsen EM. Morbidity as a predictor for participation in the Danish National Mammography Screening Program: a cross-sectional study. Clin Epidemiol. 2020;12:509–18. PMID: 32547242; PMCID: PMC7259444.
doi: 10.2147/CLEP.S250418
pubmed: 32547242
pmcid: 7259444
Jensen LF, Pedersen AF, Andersen B, Vedsted P. Social support and non-participation in breast cancer screening: a Danish cohort study. J Public Health (Oxf). 2016;38(2):335–42. https://doi.org/10.1093/pubmed/fdv051 . Epub 2015 Apr 28. PMID: 25922368.
doi: 10.1093/pubmed/fdv051
pubmed: 25922368
Jensen LF, Pedersen AF, Andersen B, Vedsted P. Self-assessed health, perceived stress and non-participation in breast cancer screening: a Danish cohort study. Prev Med. 2015;81:392–8. https://doi.org/10.1016/j.ypmed.2015.10.004 . Epub 2015 Oct 19. PMID: 26494608.
doi: 10.1016/j.ypmed.2015.10.004
pubmed: 26494608
Egsgaard SD, Røssell EL, Sørensen JB, Støvring H. Women’s health literacy and attendance in breast cancer screening: a Danish population-based study combining survey and register data. Scand J Public Health. 2023:14034948231171442. https://doi.org/10.1177/14034948231171442 . Epub ahead of print. PMID: 37151045.
Horsbøl TA, Michelsen SI, Lassen TH, Juel K, Bigaard J, Hoei-Hansen CE, Vejborg I, Thygesen LC. Breast Cancer Screening among Women with Intellectual disability in Denmark. JAMA Netw Open. 2023;6(1):e2248980. https://doi.org/10.1001/jamanetworkopen.2022.48980 . PMID: 36595297; PMCID: PMC9856850.
doi: 10.1001/jamanetworkopen.2022.48980
pubmed: 36595297
pmcid: 9856850
Larsen MB, Vejborg I, Njor SH. Participation in breast cancer screening among breast cancer survivors. A nationwide register-based cohort study. Breast. 2020;54:31–6. https://doi.org/10.1016/j.breast.2020.08.012 . Epub 2020 Aug 30. PMID: 32898786; PMCID: PMC7486472.
doi: 10.1016/j.breast.2020.08.012
pubmed: 32898786
pmcid: 7486472
Damiani G, Basso D, Acampora A, Bianchi CBNA, Silvestrini G, Frisicale EM, et al. The impact of level of education on adherence to breast and cervical cancer screening: evidence from a systematic review and meta-analysis. Prev Med. 2015;81:281–9.
doi: 10.1016/j.ypmed.2015.09.011
pubmed: 26408405
Statistics Denmark. https://www.statistikbanken.dk/20014 [Accessed 30 June 2023].
Russo J, Moral R, Balogh GA, Mailo D, Russo IH. The protective role of pregnancy in breast cancer. Breast Cancer Res. 2005;7(3):131–42. https://doi.org/10.1186/bcr1029 . Epub 2005 Apr 7. PMID: 15987443; PMCID: PMC1143568.
doi: 10.1186/bcr1029
pubmed: 15987443
pmcid: 1143568
Njor SH, Søborg B, Tranberg M, Rebolj M. Concurrent participation in breast, cervical, and colorectal cancer screening programmes in Denmark: a nationwide registry-based study. Prev Med. 2023;167:107405. https://doi.org/10.1016/j.ypmed.2022.107405 . Epub 2022 Dec 26. PMID: 36581010; PMCID: PMC10265133.
doi: 10.1016/j.ypmed.2022.107405
pubmed: 36581010
pmcid: 10265133
Tabatabai MK, Lophaven S, Lauenborg J, Holmager T, Jepsen R, Lynge E. Socioeconomic, lifestyle and biological determinants of cervical screening coverage: Lolland-Falster Health Study, Denmark. Eur J Public Health. 2023 Jun 9:ckad091. https://doi.org/10.1093/eurpub/ckad091 . Epub ahead of print. PMID: 37295965.