Published in Cancer Detection and Prevention 2001; 25(2):132-137.

Nonattendance in Mammographic Screening: A Study of Intraurban Differences in Malmo, Sweden, 1990-1994

Sophia Matson, MDa, Ingvar Andersson MD, PhDb, Göran Berglund MD, PhDc, Lars Janzon MD, PhDa, and Jonas Manjer, MDa

Departments of aCommunity Medicine, bRadiology and c Medicine, Lund University, Malmö University Hospital, Malmö, Sweden

Address all correspondence and reprint requests to: Sophia Matson, MD, Department of Community Medicine. Unit of Epidemiology, Malmö University Hospital, Lund University, S-205 02 Malmö, Sweden.

ABSTRACT: Mammographic screening may reduce breast cancer mortality. Far from all women do however come for examination. The objective in this study from Malmö has been to assess extent to which the rate of nonattendance varies between residential areas with different sociodemographic profiles. The study is based on 32,605 women, 45 to 68 years old and living in 17 areas, who between 1990 and 1994 were invited to screening. Between age groups, the age-specific nonattendance rate ranged from 31% to 35 % (P < .01). The nonattendance rate was highest for women 65 years or older. Between residential areas, age-adjusted nonattendance rates ranged from 23% to 43% (P < .01). A socioeconomic score was developed to express the socioeconomic circumstances in the residential areas and ranged from -7.18 in the most deprived area to 5.01 in the least. Nonattendance covaried in an inverse fashion with the socioeconomic score (r = -0.78; P < .01). One of three women in this urban population did not accept the invitation to mammographic screening. Our conclusion is that women in areas with less favorable circumstances seem to be less willing to participate.

KEY WORDS: geographic pattern, nonparticipation, residential area, socioeconomic score.