Attitudes, age, and participation in mammographic screening: a prospective analysis

To address the needs of older women, we investigated age-specific attitudes toward mammography that might be influenced by written or verbal communications.

Attitudinal scores for women aged 40 through 64 years and 65 years and older were calculated prospectively from responses to a mailed questionnaire based on the theory of reasoned action. Age-group mean scores were compared using t-tests for eight components of the attitude measure. Score correlations with participation were compared between age groups using multivariate analysis.

Of the 919 eligible women, 666 (72 percent) completed the study questionnaire, and 433 (65 percent) of the 666 women obtained mammograms. A woman aged 65 years or older was less likely to believe that mammography could find a cancer that she (P < 0.01) or her physician (P < 0.05) could not find, and she valued this characteristic less than a younger woman in each instance (P < 0.01). The belief that mammography involved asymptomatic detection was more highly correlated with participation in older women (P < 0.05), as was the attitude that mammography was unfamiliar, but acceptable (P < 0.05).

Older women are less likely to understand that mammography can find cancers that might be missed by other screening methods. Communications to encourage mammography among older women should explain its strengths and familiarize them with the procedure. Communications to younger women need to consider other factors.