The Relationship Between Participation in Mammography Screening Program and Health Literacy

Background/Aim: Breast cancer is the most common type of cancer in women around the world. This study aimed to determine the factors that affect participation in a mammography screening program, and analyze the effect of health literacy on women’s level of participation in this program.Methods: The study was planned as a case-control study. Women aged 40-69 years were included in the study. The cases consisted of women who had never participated in the mammography screening program before, and controls consisted of women who had participated in the mammography screening program in the last two years. The study used Turkey Health Literacy Scale and a data form that included questions about participants’ sociodemographic characteristics and reasons for not having participated in the screening program. The data were collected in a family health center and the Cancer Early Diagnosis Screening and Training Centers (CEDSTC) between April and June 2017 during individual interviews.Results/Findings: A total of 619 individuals (case group: 212; control group: 407) participated in this study. The scores of the women that had not participated in the mammography screening program on health literacy scale (29.2±6.8) were lower than that of the women that had participated in this program (33.7±4.8) (p<0.05). In logistic regression analysis, having benign breast diseases (OR: 0.04) and breast cancer history of their family (OR: 0.36) and friends (OR: 0.22) decrease the risk of avoiding mammography screening. This risk of not participating in screening was higher among the women that were working in jobs bringing income to them (OR: 1.74). In addition, the numerical variables, health literacy score (OR: 0.84), age (OR: 0.96) and number of children (OR: 0.62) increased, the risk of not participating in the screening program was found to decrease.Conclusion: Improving health literacy in women is a factor that positively affects participation in breast cancer screening program. It is also necessary to plan support for women in working life to increase participation in the screening programs. Giris/Amac: Meme kanseri, dunyada kadinlarda en sik gorulen kanser turudur. Bu calismada, kadinlarin ulusal meme kanseri tarama programina katilimini etkileyen faktorleri belirlemek ve saglik okuryazarliginin katilim uzerindeki etkisini incelemek amaclanmistir. Yontem: Calisma, olgu kontrol calismasi olarak plandi. Calismaya, 40-69 yas arasindaki kadinlar dahil edildi. Olgular daha once tarama programina katilmamis kadinlardan, kontroller ise son iki yil icerisinde meme kanseri tarama programina katilan kadinlardan olusuyordu. Arastirmada, Turkiye Saglik Okuryazarligi Olcegi ve katilimcilarin sosyodemografik ozellikleri ve tarama programina katilmama nedenleri hakkinda sorular iceren bir veri formu kullanilmistir. Veriler Nisan-Haziran 2017 aylari arasinda bir aile sagligi merkezi ve Kanser Erken Teshis, Tarama ve Egitim Merkezi (KETEM)’nde yuz yuze gorusme yontemi ile toplanmistir. Bulgular: Calismaya toplam 619 kisi (olgu grubu: 212; kontrol grubu: 407) katilmistir. Saglik okuryazarligi olceginde meme kanseri tarama programina katilmayan kadinlarin skoru (29,2 ± 6,8), tarama programa katilanlarin skorundan daha dusuktu (33,7 ± 4,8) (p <0,05). Lojistik regresyon analizinde, iyi huylu meme hastaliklarina sahip olma (OR: 0.04), ailede (OR: 0.36) veya arkadaslari arasinda meme kanserinin gorulmesi (OR: 0.22) durumunda meme kanseri taramasina katilmama riskinin azaldigi saptandi. Bu risk, gelir getirici islerde calisan kadinlarda yuksek saptandi (OR: 1.74). Ek olarak, numerik degiskenler olan saglik okuryazarligi skoru (OR: 0.84), yas (OR: 0.96) ve cocuk sayisinin artisi (OR: 0.62), tarama programina katilmama riskini azalttigi saptandi.Sonuc: Kadinlarda saglik okuryazarliginin gelistirilmesi meme kanseri tarama programi katilimina olumlu etki yapan bir faktordur. Ayrica tarama programina katilimi artirmak icin calisma hayatindaki kadinlara yonelik desteklerin planlanmasi gereklidir.