Factors determining acceptability of mammography in an Asian population: a study among women in Singapore

Abstract

Population-based mammographic screening has been shown to beeffective in reducing breast cancer mortality in the West. In Singapore, aproject carried out to determine the effectiveness of implementing such aprogram locally invited 28,000 women between the ages of 50 and 64 years formammography. The current study, which was part of this larger project, wasintended to determine factors contributing to the acceptance of mammographicscreening among women in Singapore. A questionnaire was administeredin-person to 300 attenders and 260 non-attenders. The respondents werecompared with respect to basic demographic characteristics, previouspreventive behavior, informal social support, and attitudes towards earlydetection. We found that screening attenders were more likely to be Chinesethan Malays (14 percent of the population) or Indians (seven percent), and tobe working outside the home (adjusted odds ratio [OR]) = 4.5, 95 percentconfidence interval [CI] = 2.6-7.9). A grea ter proportion of attenders had ahistory of other screening tests such as the Pap smear (OR = 4.7, CI =2.6-8.7 for recent smear compared with never having had a smear). They werealso more likely to indicate a sense of personal susceptibility to cancer,but did not differ from non-attenders in terms of believing in cancerprevention, or of preferring to be told if they did have cancer. Thestrongest independent predictor of attendance, however, was encouragement byher spouse or family member. For women in this population to be persuadedeffectively to participate in mammographic screening, it would be importantto convince family members of the benefits of the test. At the same time,education targeted specifically at women of the appropriate age group shouldaddress the issue of the personal relevance of screening for breastcancer.