Keywords: breast cancer screening, early diagnosis, access to screening programs, prevention
Aim:
The National Cancer Control Program in Türkiye was initiated in 2008. The program’s population-based breast cancer screening objective is for 70% of women aged 40-69 years to have mammograms performed once every 2 years. Although free screening tests have been provided to the target population since 2008, the compliance rate is only 37.9% (2.829.261/2023). This study set out to examine barriers to women’s compliance with the National Cancer Control Program’s guidelines and recommend improvements to the Program.
Method:
Qualitative data were collected through in-depth interviews via telephone with women aged 40-69 who had not had a mammogram in the last 2 years and were living in five different regions in Turkiye during 16.08.2023-31.01.2024 (Ethics-approval:03.03.2023/09.2023.405). Participating women were asked about the barriers to their participation in breast cancer screening programs. Interviews were recorded with their consent, transcribed, coded, and analyzed using atlas.ti.
Results:
In this research, a total of 51 women were interviewed. The median age of the women was 55.0 (54.2±7.8, range:41-69). Participants included women living in rural(19.6%) and urban(80.4%) areas. The most commonly cited barriers to getting mammograms were related to health motivation, access, shame, availability, and lack of information regarding where to go and how to get appointments.
Conclusions:
Although free mammograms are available to women nationally, only a third of women utilize the service. The Turkish National Cancer Control Program may improve utilization through increasing public health informational campaigns to address common barriers related to access (better appointment systems and invitation messages/letters to screening), lack of information (more frequent multi-media awareness campaigns), availability (extended hours/days), and shame (only female health workers for breast cancer screening services). The barriers women face related to fear and health motivation can be addressed through continuous in-service training of healthcare providers and mammography technicians.
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