Abstract
Background
Early detection of breast cancer is effective for prolonging survival, but the participation rate in breast cancer screening among target Japanese women remains low. This study examined the relationships between tendencies in decision-making under uncertainty conditions, health behaviors, demographics, and breast cancer screening participation in Japanese women.
Methods
Data for women aged 40 years or older obtained in the 2017 Keio Household Panel Survey were analyzed. Participants answered questions about breast cancer screening attendance in the last year, risk aversion, time preference, health behaviors (e.g., smoking habit, alcohol consumption, and medical treatment received in the last year), and demographic variables. Responses were analyzed using chi-squared tests, t-tests, and logistic regression analysis. Variables were entered into the regression model if they were significantly associated with breast cancer screening participation in univariate analysis.
Results
A total of 2,729 of 2,945 households responded to the questionnaire. Data from 708 questionnaires were analyzed. Among the respondents, 28.8% had participated in breast cancer screening in the past year. Factors found to significantly contribute to breast cancer screening participation included higher risk aversity (odds ratio [OR], 2.34; 95% confidence interval [CI] = 1.03–5.32; p = 0.043), medical treatment received in the last year (OR, 1.56; 95%CI = 1.06–2.30; p = 0.026), higher self-rated health (OR, 1.47; 95% CI = 1.18–1.83; p = 0.001), living above the poverty line (OR, 2.31; 95% CI = 1.13–4.72; p = 0.022), and having children (OR, 1.57; 95% CI = 1.02–2.42; p = 0.042). Factors not significantly associated with screening participation were smoker (OR, 0.20; 95% CI = 0.10–0.42; p < 0.000), alcohol drinker (OR, 0.56; 95% CI = 0.37–0.86; p = 0.007), self-employed (OR, 0.22; 95% CI = 0.10–0.46; p < 0.000), and unemployed (OR, 0.48; 95% CI = 0.26–0.90; p = 0.022). No significant relationship was observed between time preference and screening participation.
Conclusions
The results indicate that women who recognize the actual risk of developing breast cancer or have high awareness of breast cancer prevention tend to participate in breast cancer screening. Barriers to screening participation are not working for an enterprise that encourages screening and low income.
Relationship of attitudes toward uncertainty and preventive health behaviors with breast cancer screening participation
