Evaluating the impact of a promotional campaign for screening mammography: who attends?

The Breast X-ray Programme of the Central Sydney Health Service is one of 11 pilot programs in Australia assessing the best methods of delivering population-based mammographic screening. The aim of this study was to determine the attendance rate and to describe sociodemographic predictors of attendance in an area serviced by the program. A well-defined population of approximately 4500 women aged 45 to 70 was identified within the Central Sydney area for intensive testing of recruitment strategies. After four visits (spanning two years) to the area by a mobile screening van, 48% of the women were screened. Women from non-English-speaking backgrounds were just as likely to attend as women from English-speaking backgrounds, probably because special attention was given to recruiting these women. Older women from English-speaking backgrounds were less likely to attend, whereas no age trend existed for women of non-English-speaking backgrounds. Sampled attendance data of women from English-speaking backgrounds showed that women with more education were more likely to attend screening. Women who were employed were just as likely to attend as those who were not. In order to screen 70% of the targeted population as set forth for a national mammography screening program, it appears that community recruitment efforts alone will not be sufficient. With special attention to recruitment coverage, older women and women from non-English-speaking backgrounds can be successfully recruited. Special attention will also need to be focused on encouraging attendance in women who have less formal education.