Predictors of Mammography Uptake among Omani Women: A National Cross-Sectional Survey Using the HINTS Framework

Breast cancer is the most common malignancy among women globally and a leading cause of cancer mortality. In Oman, breast cancer incidence has risen sharply over the past decade, yet mammography uptake remains suboptimal, despite free nationwide availability of screening services. Understanding the determinants of screening behavior is critical for designing effective interventions.

We conducted a cross-sectional national survey between March and August 2023 across all 11 governorates of Oman. Omani women aged ≥18 years were recruited through convenience sampling via social media and Ministry of Health channels. Data were collected using a structured questionnaire adapted from the U.S. National Cancer Institute's Health Information National Trends Survey (HINTS), which was translated and pilot-tested for cultural appropriateness. The survey covered sociodemographic characteristics, health and risk factors, knowledge and attitudes, healthcare system factors, and prior screening practices. The primary outcome was self-reported history of ever having undergone a mammogram. Bivariate associations were tested using chi-square analysis, and predictors were examined in multivariable logistic regression.

Among 469 participants, 21.5% (n=101; 95% CI 17.8%-25.2%) reported ever having undergone a mammogram. In adjusted models, three factors were independently associated with uptake: age ≥40 years (adjusted odds ratio [aOR] = 7.83; 95% CI: 4.48-13.71), residence in Muscat governorate (aOR = 3.13; 95% CI: 1.76-5.57), and receiving a healthcare provider's recommendation (aOR 9.34, 95% CI 4.54-19.23). Other sociodemographic variables (marital status, education, employment), risk perceptions, and health beliefs were not significantly associated.

Mammography uptake among Omani women remains low. Provider recommendation and geographic access were the most powerful determinants, underscoring the need for system-level interventions such as integrating provider prompts into primary care and scaling mobile mammography services. Addressing these barriers is essential to improve early detection and reduce breast cancer mortality in Oman.