Factors associated with lack of mammography: National health survey, 2013

Abstract

Introduction: Mammography is the main screening test for early detection of breast cancer; however, its access is not equal for all women in Brazil. The objective of this study was to analyze the factors associated with not having this examination done in a period of less than two years in Brazil and according to macro-region, considering sociodemographic characteristics, health conditions, lifestyle, and the use of health services. Method: Cross-sectional study using data from the National Health Survey in Brazil (Pesquisa Nacional de Saúde-PNS). The sample consisted of 10,571 women (≥40 years old) living in all Brazilian regions. Poisson regression model with hierarchical approach was used to estimate prevalence ratios. Results: The characteristics associated with not getting a mammogram were: Age ≥60 years, low schooling, living without a partner, negative health self-rating, having some chronic disease, no regular exercise, not getting a clinical breast examination for up to one year or a Pap smear for up to three years, not seeing a doctor in the last year, not having health insurance, feeling discriminated by a health professional, and being enrolled in a family care unit. Sociodemographic factors were prominent in the North and Northeast, while in other regions, health conditions and health behavior were predominant. Conclusion: Variables related to the use of health services were especially important in not getting a mammogram. Measures should be taken in each macro-region of Brazil to reduce disparities in access to mammography.