Breast cancer screening services in three areas: uptake and satisfaction

The objective of our study was to test whether attendance for breast cancer screening and satisfaction with the service could be predicted from a knowledge of the woman's social and psychological characteristics. In a prospective design, demographic characteristics, self-reported health status and behaviour, expectations and attitudes were examined through postal questionnaires sent out shortly before the invitation to screening, and the measures were used to predict subsequent attendance and satisfaction. The sample was taken from three areas in the South-East Thames Regional Health Authority providing a Forrest service--one rural, one provincial and one inner city--and consisted of 3160 women aged 50-64 invited routinely for screening. The main predictors of attendance were the woman's attitude to being screened and her belief that 'salient others' wanted her to attend. The main predictors of satisfaction with the service were the behaviour of the staff and the facilities at the centre. Three implications of the findings are discussed: (a) health education should include partners, relatives and friends of the target women, as their views had as much effect on attendance as did the women's attitudes; (b) staff training and development should focus on communication with the patient; (c) further research should examine the precursors of reported discomfort and pain.