Predictors of under-screening and lapse in BreastScreen NSW

Characteristics of under screeners

Key groups of under screeners Based on key groups statistical analysis of NSW population health survey The largest group of women more likely to under screen in NC was the low health service users followed by private service users. The remaining groups are not really relevant to NC. December 2014

Attitudes and beliefs and their influence on screening From the literature review the following factors were identified as barriers to screening: Lack of family history of breast cancer means women think they are not at risk Fear and concern about breast cancer and fear the results. Less likely to hold positive attitudes towards preventative health programs, or in efficacy of screening Cultural barriers Previous poor experience Fear and concern about screening may be enhanced by campaign messages that highlight the prevalence of breast cancer December 2014

Cues to action Under screeners report a lack of external prompts and reminders as a key barrier – in spite of many women receiving invitations or reminders from BreastScreen Women who have internalised the routine nature of screening are significantly more likely to be regular screeners, than women who respond to external prompts External prompts, such as from GPs or campaigns, are necessary to remind those women who are unlikely to remember themselves M&R and GPs need to emphasize the routine of screening, even in the absence of any symptoms

Self efficacy to screen and cues to action Barriers that negatively impact on engaging in regular screening: working full time (more than 31 hours per week) inconvenience of screening location; and lack of transportation Perceived lack of prompts Convenience of services may play a key role in enabling screening December 2014