RESEARCH – March 2020

Possible reasons why women in Estonia refrain from taking part in breast cancer screening

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Background and aims. Breast cancer is the most common form of cancer in women worldwide. Despite the promotion of breast cancer screening programmes, only 53­62% of invited Estonian women have participated
in them during the period of the last seven years and the recommended target of 70­75% has not been reached. The aim of the study was to examine the reasons why a relatively big number of women refrain from taking part in the breast cancer screening procedure. The study investigates whether and how existing habits might influence breast cancer screening related decision­making and what kind of breast cancer screening related health communicative problems women might perceive in developing their participation decision .

Methods. Data was collected using semistructured in­depth interviews among nine women (6 women aged between 50 and 55 and 3 women aged between 58 and 65 years) who received the invitation but did not participate in the procedure. Study participants were identified using comfort­ and snowball­sampling methods. The interviews lasted 20­60 minutes, were audio­recorded and transcribed verbatim. The interviews were read by all authors after which thematic textual analysis was performed. The categories of the analysis were agreed by the authors. This study was granted ethical approval from the Tallinn Medical Research Ethics Committee (resolution no. 2650, Mar. 05, 2019).

Results. The findings showed that habitual, practical and emotional reasons might affect women’s final decision to take part in or to refrain from breast cancer screening. Habitual reasons were related to existing routine and unconscious ways of visiting and communicating with physicians. Practical reasons were related to everyday aspects and arrangements and emotional reasons were handled as different (health) beliefs, fears and cognitive aspects. There were also a few combined reasons identified as a whole reason. Existing communication has not addressed sufficiently the arguments covering the whole range of the target group.

Conclusions. The decision about whether to participate or not in a breast cancer screening is formed as a result of different reasons. Future communication about breast cancer screening should address these different reasons as well as women in different age groups.