Determinants of Participation in a Breast Cancer Screening Trial in Trivandrum District, India


Background: Conspicuous differences in participation rates for breast self-examination (BSE), clinical breastexamination (CBE), and referral for further investigations have been observed indicating involvement of anumber of different factors. This study analysed determinants for participation in different levels of the breastcancer screening process in Indian females. Materials and
Methods: An intervention group of 52,011 womenwas interviewed in a breast cancer screening trial in Trivandrum district, India. In order to assess demographic,socio-economic, reproductive, and cancer-related determinants of participation in BSE, CBE, and referral,uni- and multi-variate logistic regression was employed.
Results: Of the interviewed women, 23.2% reportedpracticing BSE, 96.8% had attended CBE, and 49.1% of 2,880 screen-positives attended referral. Results showedan influence of various determinants on participation; women who were currently not married or who had nofamily history of cancer were significantly less likely to attend the screening process at any level.
Conclusions:Increasing awareness about breast cancer, early detection methods, and the advantages of early diagnosesamong women, and their families, as well as health care workers offering social support, could help to increaseparticipation over the entire screening process in India.