Variability in women's desire for information about mammography screening: implications for informed consent.

This study aimed to explore women's desire for information about mammography screening in a population where overly optimistic perceptions of mammography screening were common. A self-administered questionnaire was completed by 2305 women aged 50-69 years, residents of Geneva, Switzerland. The questionnaire assessed the respondents' wish to receive information (detailed, general or none) about seven aspects of mammography screening: personal risk of breast cancer, prevention of breast cancer, benefits of mammography screening, limitations, minor inconveniences, more important problems, why some people oppose screening. The seven items formed a unidimensional scale (Cronbach's alpha=0.91). Women differed considerably in their stated desire for detailed or general information. For instance, whereas 14% wanted detailed information on all items and 36% general information on all items, 39% were not interested in detailed information on the limits and adverse consequences of screening. In multivariate analysis, some women's characteristics were associated with higher scores of desire for information, but little variance was explained (adjusted R=0.05). In conclusion, many women currently decline information about mammography screening that is deemed relevant by public health authorities. This may lead to poorly informed choices in an important area of prevention.

Predicting stages of adoption of mammography screening in a general population.

This study assessed predictions of the Transtheoretical Model (TTM) of behaviour change applied to mammography screening in a random sample of 909 Swiss women aged 40-80 years. We examined stages of mammography adoption, positive and negative attitudes toward screening (pros, cons and decisional balance), and additional predisposing, enabling and reinforcing characteristics. The stage of mammography adoption was defined for 827 women, of whom 46.9% reported on-schedule screening (action 10.2%, maintenance 29.7%, relapse risk 7.0%) and 53% did not (precontemplation 23.1%, contemplation 13.5%, relapse 16.4%). Independent factors associated with more advanced stages (from precontemplation to maintenance) were high pros, low cons, belief that mammography screening is recommended every 2 years, high objective risk of breast cancer, being married and higher income. Independent correlates of stage regression (from action/maintenance to relapse) were high cons, belief that mammography screening is recommended every 4 years or not at all and not being married. Perceived utility of an organised screening programme and reluctance to pay for a mammogram were independently associated with only certain transitions between stages of adoption. Our results confirm the applicability of the TTM to mammography screening in a European context. They also suggest that constructs other than pros and cons may be useful in predicting mammography use.