Fear as a barrier to mammography

Background: Screening mammography is the single most effective method of early detection of breast cancer however mammography rates in America remain suboptimal among certain groups of women. These vulnerable women may experience both structural and psychosocial barriers to mammography screening. The purpose of this study is to identify predictors of fear as a barrier to mammography in women who use the Emergency Department for non urgent care. Methods: A convenience sample of 90 women who presented to the ED of a public University hospital was surveyed to determine their mammography status, demographic characteristics and barriers to mammography. This report focuses on the most commonly identified barrier, fear, and the characteristics that predict this barrier. Participants were English speaking women over the age of 40 visiting the ED for a non urgent complaint or with a person with a non urgent complaint. Results: The average age of the 90 women surveyed was 54.8 years (SD=9.6). The majority of women were white (55%), not married (56%), with an income of less than $30,000; slightly less than half of them had not had a mammogram in the past year (44%). One-third of women indicated fear of the procedure itself and/or fear of the results as barriers to mammography receipt. Predictors of fear as a barrier were age and income. Younger women and women with lower incomes were more likely to choose fear as a barrier to mammography. Women who had not had a mammogram in the past year were no more likely than women who had to be afraid. Fear status was also not predicted by race/ethnicity, marital status, having insurance, or having access to a primary care provider. Conclusion: Women who visit the ED for non urgent complaints are a vulnerable population. Future interventions for this group should focus not only on obvious concrete barriers to mammography but should explore psychosocial barriers such as fear. Public health practitioners should be aware of which women are most likely to experience this barrier and tailor interventions accordingly.