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

Starczewska, JM

Abstract

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.

Citation

Starczewska, J. Predictors of breast and cervical cancer screening uptake prior to the introduction of centralised nationwide screening in Poland. (Thesis). University of Salford

• Thesis Type: Thesis
• Deposit Date: Apr 30, 2014
• Publicly Available Date: Apr 30, 2014