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Open Access Research article

Beliefs about optimal age and screening frequency predict breast screening adherence in a prospective study of female relatives from the Ontario Site of the Breast Cancer Family Registry

Paul Ritvo12*, Sarah A Edwards13, Gord Glendon4, Lucia Mirea35, Julia A Knight35, Irene L Andrulis456 and Anna M Chiarelli13

Author Affiliations

1 Research, Prevention and Cancer Control, Cancer Care Ontario, 620 University Ave, Toronto, ON, M5G 2L7, Canada

2 School of Kinesiology and Health Science, York University, 4700 Keele St, 138 Chemistry, Toronto, ON, M3J 1P3, Canada

3 Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada

4 Ontario Cancer Genetics Network, Cancer Care Ontario, 620 University Ave, Toronto, ON, M5G 2L7, Canada

5 Samuel Lunenfeld Research Institute, Mount Sinai Hospital, 600 University Ave, Toronto, ON, M5G 1X5, Canada

6 Department of Molecular Genetics, University of Toronto, 1 King’s College Circle, Toronto, ON, M5S 1A8, Canada

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BMC Public Health 2012, 12:518  doi:10.1186/1471-2458-12-518

Published: 12 July 2012



Although few studies have linked cognitive variables with adherence to mammography screening in women with family histories of breast and/or ovarian cancer, research studies suggest cognitive phenomena can be powerful adherence predictors.


This prospective study included 858 women aged 30 to 71 years from the Ontario site of the Breast Cancer Family Registry with at least one first-degree relative diagnosed with breast and/or ovarian cancer. Data on beliefs about breast cancer screening and use of mammography were obtained from annual telephone interviews spanning three consecutive years. Self-reported mammogram dates were confirmed with medical imaging reports. Associations between beliefs about breast cancer screening and adherence with annual mammography were estimated using polytomous logistic regression models corrected for familial correlation. Models compared adherers (N = 329) with late-screeners (N = 382) and never-screeners (N = 147).


Women who believed mammography screening should occur annually were more likely to adhere to annual screening recommendations than women who believed it should happen less often (OR: 5.02; 95% CI: 2.97-8.49 for adherers versus late-screeners; OR: 6.82; 95% CI: 3.29-14.16 for adherers versus never-screeners). Women who believed mammography screening should start at or before age 50 (rather than after) (OR: 9.72; 95% CI: 3.26-29.02) were significantly more likely to adhere when compared with never-screeners.


Study results suggest that women with a family history of breast cancer should be strongly communicated recommendations about initial age of screening and screening intervals as related beliefs significantly predict adequate adherence.

Breast cancer; Breast screening; Family history; Beliefs; Adherence