Screening behaviors and long-term compliance with mammography guidelines in a breast cancer screening program

Screening for breast cancer is generally underused. In an effort to remove common barriers to screening, a free breast cancer screening and education program was created for the employees of a large hospital, incorporating mammography, clinical breast examination (CBE), and breast self-examination (BSE).

The present study was conducted to evaluate the screening behaviors and long-term compliance of asymptomatic women over age 50 who participated in the program. Data were obtained from questionnaires administered at the time of enrollment (time 1) and annual reenrollment, as well as from radiology records. (Time 2 represents the most recent data.) Long-term compliance with mammography guidelines was measured by calculating a compliance quotient (CQ) for each participant.

From time 1 to time 2, subjects significantly increased their use of mammography, CBE, and BSE. At time 2, 89.5% of women had ever received a mammogram, 42.7% had gotten one in the last year, nearly all women (94.6%) had received at least one CBE, 58.0% reported annual CBE, and 44.6% of women practiced monthly BSE. CQ was higher among women who remained in the program longer, were still active in the program at the time of the study, and used screening prior to enrollment. It was also higher in Caucasians and women with a family history of breast cancer.

These results show that a worksite program that eliminates common barriers to screening can significantly increase use of early detection practices. It also demonstrates one method of quantifying long-term compliance with mammography guidelines.