What motivates women to participate in mammography screening? Results of a qualitative analysis of interviews

Introduction About 49% of the women in Germany take part in the German national mammography screening program. Reasons (not) to participate are still not well understood.Materials and methods Women were recruited from the participants of a former questionnaire study on the same issue. Considering their willingness to participate (6 yes, 2 no), level of education (6 high, 2 low) and confidence in their decision-making (6 high, 2 low), 8 women were selected and questioned in 2014 individually in problem-centered interviews. Sequences of the interview transcripts were evaluated by a multidisciplinary team using the content analysis approach.Results All 8 women had undergone mammography before. Analysis identified six overarching categories: sense of duty, autonomy, doubt, uncertainty, role of the physician, institutional setting. The women perceived screening as a chance to avoid the risk of being affected by breast cancer. Experience with breast cancer in their family or acquaintances influenced their decision. They put great emphasis on self-determination, but on the other hand they followed the advice of their trusted physician. During the screening procedure, they felt that they were exposed to an impersonal procedure that was painful.Conclusion Women tend to decide to participate in mammography screening on the emotional level. To enable women the opportunity to make an informed consent/refusal to mammography screening, physicians should discuss women's perceptions and experiences, and also provide factual information.