The Library
Mammography screening: views from women and primary care physicians in Crete
Tools
Trigoni, Maria, Griffiths, Frances, Tsiftsis, Dimitris, Koumantakis, Eugenios, Green, Eileen and Lionis, Christos. (2008) Mammography screening: views from women and primary care physicians in Crete. BMC Women's Health, Vol.8 (No.20). ISSN 1472-6874
|
Text
WRAP_Griffiths_Mammography_1472-6874-8-20.pdf - Draft Version Download (285Kb) |
Official URL: http://dx.doi.org/10.1186/1472-6874-8-20
Abstract
Background: Breast cancer is the most commonly diagnosed cancer among women and a leading cause of death from cancer in women in Europe. Although breast cancer incidence is on the rise worldwide, breast cancer mortality over the past 25 years has been stable or decreasing in some countries and a fall in breast cancer mortality rates in most European countries in the 1990s was reported by several studies, in contrast, in Greece have not reported these favourable trends. In Greece, the age-standardised incidence and mortality rate for breast cancer per 100.000 in 2006 was 81,8 and 21,7 and although it is lower than most other countries in Europe, the fall in breast cancer mortality that observed has not been as great as in other European countries. There is no national strategy for screening in this country. This study reports on the use of mammography among middleaged women in rural Crete and investigates barriers to mammography screening encountered by women and their primary care physicians. Methods: Design: Semi-structured individual interviews. Setting and participants: Thirty women between 45–65 years of age, with a mean age of 54,6 years, and standard deviation 6,8 from rural areas of Crete and 28 qualified primary care physicians, with a mean age of 44,7 years and standard deviation 7,0 serving this rural population. Main outcome measure: Qualitative thematic analysis. Results: Most women identified several reasons for not using mammography. These included poor knowledge of the benefits and indications for mammography screening, fear of pain during the procedure, fear of a serious diagnosis, embarrassment, stress while anticipating the results, cost and lack of physician recommendation. Physicians identified difficulties in scheduling an appointment as one reason women did not use mammography and both women and physicians identified distance from the screening site, transportation problems and the absence of symptoms as reasons for non-use. Conclusion: Women are inhibited from participating in mammography screening in rural Crete. The provision of more accessible screening services may improve this. However physician recommendation is important in overcoming women's inhibitions. Primary care physicians serving rural areas need to be aware of barriers preventing women from attending mammography screening and provide women with information and advice in a sensitive way so women can make informed decisions regarding breast caner screening.
| Item Type: | Journal Article |
|---|---|
| Subjects: | R Medicine > RC Internal medicine |
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
| Library of Congress Subject Headings (LCSH): | Breast -- Radiography |
| Journal or Publication Title: | BMC Women's Health |
| Publisher: | BioMed Central Ltd. |
| ISSN: | 1472-6874 |
| Date: | 7 November 2008 |
| Volume: | Vol.8 |
| Number: | No.20 |
| Identification Number: | 10.1186/1472-6874-8-20 |
| Status: | Peer Reviewed |
| Publication Status: | Published |
| Access rights to Published version: | Open Access |
| References: | 1. Parkin DM, Pisani P, Ferlay J: Estimates of the worldwide incidence of 25 major cancers in 1990. Int J Cancer 1999, 80:827-841. 2. Cortesi L, Chiuri VE, Ruscelli S, Bellelli V, Negri R, Rashid I, Cirilli C, Fracca A, Gallo E, Federico M: Prognosis of screen-detected breast cancers: results of a population based study. BMC Cancer 2006, 6:17. 3. Keller B, Zemp Stutz E, Tibblin M, Ackermann-Liebrich U, Faisst K, Prbst-Hensch N: Screening mammography in Switzerland: what makes female and male physicians prescibe them. Swizz Med Wkly 2001, 131:311-319. 4. Santora L, Mahoney CM, Lawvere S, Englert J, Symons BA, Mirand LA: Breast cancer screening beliefs by practice location. BMC Bublic Health 2003, 3:9. 5. Duffy SW, Tabár L, Chen HH, Holmqvist M, Yen MF, Abdsalah S, Epstein B, Frodis E, Ljungberg E, Hedborg-Melander C, Sundbom A, Tholin M, Wiege M, Akerlund A, Wu HM, Tung TS, Chiu YH, Chiu CP, Huang CC, Smith RA, Rosén M, Stenbeck M, Holmberg L: The impact of organized mammography service screening on breast carcinoma mortality in seven Swedish countries. Cancer 2002, 95:458-69. 6. Akker-van Marle E Van den, de Koning H, Boer R, Maas P van der: Reduction in breast cancer mortality due to the introduction of mass screening in The Netherlands: comparison with the United Kingdom. J Med Screen 1999, 6:30-4. 7. Beckett JR, Kotre CJ, Michaelson JS: Analysis of benefit:risk ratio and mortality reduction for the UK Breast Screening Programme. British Journal of Radiology 2003, 76:309-320. 8. Day N, Warren R: Mammographic screening and mammographic patterns. Breast Cancer Res 2000, 2:247-51. 9. Blanks RG, Moss SM, McGahan CE, Quinn MJ, Babb PJ: Effect of NHS breast screening programme on mortality from breast cancer in England and Wales, 1990–8: comparison of observed with predicted mortality. BMJ 2000, 321:665-669. 10. Hackshaw A: EUSOMA review of mammography screening. Annals of Oncology 2003, 14:1193-1195. 11. Ferlay J, Autier P, Boniol M, Heanue M, Colombet M, Boyle P: Estimates of the cancer incidence and mortality in Europe in 2006. Annals of Oncology 2007, 18:581-592. 12. Levi F, Bosetti C, Lueechini F, Negri E, La Vecchia C: Monitoring the decrease in breast cancer mortality in Europe. Eur J Cancer Prev 2005, 14:497-502. 13. Garas I, Pateras H, Tiandafilou D, Georgountzos V, Mihas , Abatzoglou M, Trichopoulos D: Breast cancer screening in Southern Greece. European Journal of cancer prevention 2004, 3:35-39. 14. Souliotis K, Lionis C: Creating an Intergrated Health Care System in Greece: A Primary Care Perspective. Journal of Medical Systems 2004, 28:643-52. 15. Pappa E, Niakas D: Assessment of health care needs and utilization in a mixed public – private system: the case of Athens area. BMC Health Services Research 2006, 6:146. 16. Mousiama T, Loakimidou S, Largatzi E, Kaitelidou D, Liaropoulus L: Health technology assessment in the area of prevention: selected screening cases in Greece. Int J Technol Assess Health Care 2001, 17:338-57. 17. Brotons C, Bjorkelund C, Bulc M, Clurana R, Godycki-Cwirko M, Jurgova E, Kloppe P, Lionis C, Mierzecki A, Pineiro R, Pullerits L, Sammut M, Sheehan M, Tataradze R, Thireos E, Vuchak J: Prevention and health promotion in clinical practice: the views of general practitioners in Europe. Preventive Medicine 2005, 40:595-601. 18. Griffiths FE, Green EE, Bendelow G, Blackett-Milburn K, Thompson D, Tsouroufli M: Innovative Health Technologies at Women's Midlife; Theory and Diversity among women and Experts. 2003. (L218252038), ESRC. 19. Duport N, Ancelle-Park R: Do socio-demographic factors influence mammography use of French women? Analysis of a French cross-sectional survey. Eur J Cancer Prev 2006, 15:219-24. 20. Alcaraz M, Liuch A, Miranda J, Salas MD: Study if non participation in the breast cancer screening program in the city of Valencia (Spain). Gac Sanit 2002, 16:230-5. 21. Robin Yabroff K, Jeanne Mandelblatt S: Interventions targeted toward patients to increase mammography use. Cancer Epidemiology Biomarkers & Prevention 1999, 8:749-757. 22. Maxwell CJ, Bancej CM, Snider J: Predictors of mammography use among Canadian women aged 50–69: findings from the 1996/97 National Population Health Survey. CMAJ 2001, 164:329-34. 23. Flynn BS, Gavin P, Worden JK, Ashikaga T, Gautam S, Carpenter J: Community education programs to promote mammography participation in rural New York State. Prev Med 1997, 26:102-8. 24. Ogedegbe G, Cassells AN, Robinson CM, DuHamel K, Tobin JN, Sox CH, Dietrich AJ: Perceptions of barriers and facilitators of cancer early detection among low-income minority women in community health centers. J Natl Med Assoc 2005, 97:162-70. 25. Young FR, Severson KR: Breast Cancer screening barriers and mammography completion in order minority women. Breast Cancer Research an Treatment 2005, 89:111-118. 26. Marlén Oliver-Vázquez, Sánchez-Ayéndez Melba, Suárez-Pérez Erick, Vélez-Almodóvar Himilce, Arroyo-Calderón Yamilet: Breast cancer health promotion model for older Puerto Rican women: results of a pilot programme. Health Promotion International 2002, 17:3-11. 27. Halabi S, Skinner CS, Samsa GP, Strigo TS, Crawford YS, Rimer BK: Factors associated with repeat mammography screening. J Fam Pract 2000, 49:1104-12. 28. Bazargan M, Bazargan SH, Calderon JL, Husaini BA, Baker RS: Mammography screening and breast self-examination among minority women in public housing projects: the impact of physician recommendation. Cell Mol Biol (Noisy-le-grand) 2003, 49:1213-8. 29. Mandelblatt JS, Yabroff KR: Breast and cervical cancer screening for older women: recommendations and challenges for the 21st century. Am Med Womens Assoc 2000, 55:210-5. 30. Tolma EL, Reininger BM, Ureda J: What predicts a Cypriot woman's decision to obtain or not obtain a screening mammogram? Implications for the promotion of screening mammography in Cyprus. Eur J Cancer Prev 2006, 15:149-57. 31. Ganry O, Boche T: Prevention practices and cancer screening among general practitioners in Picardy, France. Public Health 2005, 119:1023-30. 32. Kloppe P, Brotons C, Anton JJ, Ciurana R, Iglesias M, Pineiro R, Fornasini M: Preventive care and health promotion in primary care: comparison between the views of Spanish and European doctors. Aten Primaria 2005, 36:144-51. 33. Herman CJ, Lengerich EJ, Stoodt G: Variation in recommendations for breast and cervical cancer screening among primary care physicians in North Carolina. South Med J 1991, 89:583-90. 34. Lurie N, Slater J, McGovern P, Ekstrum J, Quam L, Margolis K: Preventive care for women. Does the sex of physician matter? N Engl J Med 1993, 329:47882. 35. Franks P, Clancy CM: Physicians gender bias in clinical decisionmaking: screening for cancer in primary care. Med Care 1993, 31:2138. 36. Slikkerveer LJ: Plural Medical Systems in the Horn of Africa London and New York: KPI; 1990:70-71. 37. Lionis C, Vivilaki V, Slikkerveer JL: abstract in the proceedings, EGPRN meeting in Antwerp, 15th May presentation 23. [http://www.egprn.org]. 38. Green J, Thorogood N: Qualitative Methods for Health Research London, Sage; 2004. 39. [http://www.esrcsocietytoday.ac.uk]. 40. Patton M: Qualitative research and evaluation methods London, Sage publications; 2002. 41. Silverman D: Interpreting qualitative data London: Sage; 1993. 42. Ogedegbe G, Cassells AN, Robinson CM, DuHamel K, Tobin JN, Sox CH, Dietrich AJ: Perceptions of barriers and facilitators of cancer early detection among low-income minority women in community health centers. J Natl Med Assoc 2005, 97:162-70. 43. Payne S: The health of Men and Women Cambridge: Polity Press; 2006. 44. Coughlin SS, Thompson TD, Hall HI, Logan P, Uhler R: Breast and cervical carcinoma screening practices among women in rural and nonrural areas of the United States, 1998–1999. Cancer 2002, 94:2801-12. 45. Engelman KK, Ellerbeck EF, Perpich D, Nazir N, McCarter K, Ahluwalla JS: Office systems and their influence on mammography use in rural and urban primary care. J Rural Health 2004, 20:36-42. 46. Engelman KK, Hawley DB, Gazaway R, Mosier MC, Ahluwalia JS, Ellerbeck EE: Impact of geographic barriers on the utilization of mammorgams by older rural women. Journal American Geriatrics Society 2002, 50:62-68. 47. Lagerlund M, Anna Hedin A, Sparén P, Erik Thurfjell E, Mats Lambe L: Attitudes, Beliefs, and Knowledge as Predictors of Nonattendance in a Swedish Population-Based Mammography Screening Program. Prev Med 2000, 31:417-28. 48. Beaulieu MD, Beland F, Roy D, Falardeau M, Hebert G: Factors determining compliance with screening mammography. CMAJ 1996, 154:1335-43. 49. Bekker H, Morrison L, Marteau TM: Breast screening: GPs' beliefs, attitudes and practices. Family Practice 1999, 16:60-65. |
| URI: | http://wrap.warwick.ac.uk/id/eprint/517 |
Actions (login required)
![]() |
View Item |
Tools
Tools

