Motivational factors for participation in breast cancer screening

To evaluate motivational factors for participation in a breast cancer screening program and concurrently to examine beliefs regarding carcinoma of the breast held by those participants, we interviewed 135 consecutive women who took part in an American Cancer Society-sponsored breast screening project in an affluent suburb of Philadelphia. Ages were equally distributed between 30 and 69. Interestingly, cost was the greatest priority for patients, regardless of income. Even 50% of those patients reporting incomes in excess of $100,000 were concerned about cost. Additional motivating factors included reassurance if normal, media advertising, physician referral, and family history of breast cancer. Concerns about actually having breast cancer was least important. Additional questions indicated a number of fallacies regarding breast cancer, including relationships to smoking, caffeine, and trauma. We conclude that even in affluent, upper-middle-class populations, problems with education regarding breast cancer exist, and cost remains a primary deterrent to screening. Efforts must be increased to lower the cost of mammography and, at the same time, to improve patient education, perhaps through the appropriate use of the media.