Abstract
Background Reaching an acceptable participation rate in screening programs is challenging. With the objective of supporting the Belarus government to implement mammography screening as a single intervention, we analyse the main determinants of breast cancer screening participation. Methods We developed a discrete choice experiment using a mixed research approach, comprising a literature review, in-depth interviews with key informants (n = 23), “think aloud” pilots (n = 10) and quantitative measurement of stated preferences for a representative sample of Belarus women (n = 428, 89% response rate). The choice data were analysed using a latent class logit model with four classes selected based on statistical (consistent Akaike information criterion) and interpretational considerations. Results Women in the sample were representative of all six geographic regions, mainly urban (81%), and high-education (31%) characteristics. Preferences of women in all four classes were primarily influenced by the perceived reliability of the test (sensitivity and screening method) and costs. Travel and waiting time were important components in the decision for 34% of women. Most women in Belarus preferred mammography screening to the existing clinical breast examination (90%). However, if the national screening program is restricted in capacity, this proportion of women will drop to 55%. Women in all four classes preferred combined screening (mammography with clinical breast examination) to single mammography. While this preference was stronger if lower test sensitivity was assumed, 28% of women consistently gave more importance to combined screening than to test sensitivity. Conclusion Women in Belarus were favourable to mammography screening. Population should be informed that there are no benefits of combined screening compared to single mammography. The results of this study are directly relevant to policy makers and help them targeting the screening population.
| Original language | English |
|---|---|
| Article number | e0224667 |
| Journal | PLoS ONE |
| Volume | 14 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - 1 Nov 2019 |
Bibliographical note
Funding Information:Financial support for this study was provided entirely by a Junior Investigator Award to Dr. Olena Mandrik from the International Agency for the Research on Cancer of the World Health Organization, Lyon, France. The funding agreement ensured the authors? independence in designing the study, interpreting the data, and writing the report; the sponsorship of the study required approval of the publication by the Sponsor. The following author(s) were/are employed by the sponsor: Mandrik O. and Herrero R.
Publisher Copyright:
© 2019 Mandrik et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
