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Predictors of breast and cervical cancer screening uptake prior to the introduction of centralised nationwide screening in Poland

Starczewska, JM 2013, Predictors of breast and cervical cancer screening uptake prior to the introduction of centralised nationwide screening in Poland , PhD thesis, University of Salford.

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Background Introduction of nationwide breast and cervical screening programmes in Poland (2006) created an unprecedented opportunity to explore the predictors of breast and cervical cancer prophylactic behaviours in a society unexposed to population screening. The study aims to add to the body of knowledge on predictors that could be common for other countries in a similar geo-political situation, aiming to introduce nationwide breast and cervical screening programmes. Methods A data subset (N=4,290) from a large representative survey (N=7,948) on cancer knowledge and prophylaxis, conducted by the Cancer Oncology Institute in Warsaw close to the introduction of nationwide breast and cervical cancer screening, was used in this thesis. Behaviours and knowledge were described and logistic regression used to identify predictors of mammography and cytology uptake. Results Women’s level of cancer knowledge was evenly distributed (49.2% low and 50.8% high scores). However, knowledge on cervical cancer was lower than for breast. Higher knowledge was linked to higher education, better material conditions, cancer diagnosis, or practicing any type of the studied prophylaxis and lower levels of knowledge was associated with being aged 18-24 or ≥70 y.o., being widowed, and living in village. Even though 93% (N=3,970) of respondents were aware of the need for breast self-examination (BSE), only 32.3% regularly practiced BSE. Majority (92.3%, N=3,943) knew that mammography can allow early cancer detection but only 52.5% ≥ 50 y.o. (32.1% all ages) declared ever having it. Similarly, 90.7% (N=3,871) knew that cytology allows early detection of cancer and 78.8% have ever undertaken it cytology but only 53.6% had it done every 1-3 years. Up to 4% indicated test unavailability of either test as the reason for non-attendance. The most common barriers included: feeling of no need for such test (37.9-44.9%) and lack of referral (28.7%-39.2%). Women with the highest education levels, the 3 ones living in cities above 100,000 inhabitants, or with highest cancer knowledge were the most likely to ever get screened for breast and cervical cancers. Additionally BSE was found to predict mammography whilst cytology was also predicted by: household size, marital status, having a family member or a friend with cancer. Conclusions Low screening uptake could be reflective of the fact that there was no nationally available screening but only a small proportion reported non-attendance due to unavailability of tests. This suggests that the uptake was driven by other factors (e.g., cancer knowledge, education) than population screening availability. Particular attention should be paid to the provision of cancer related knowledge. A follow up study is recommended to assess whether women’s knowledge and screening behaviours improved since the conduct of this survey.

Item Type: Thesis (PhD)
Themes: Health and Wellbeing
Schools: Schools > School of Health Sciences
Depositing User: RH Shuttleworth
Date Deposited: 30 Apr 2014 17:06
Last Modified: 30 Nov 2015 23:43

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