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Satisfaction With Initial Screen and Compliance With Biennial Breast Screening at Centers With and Without Nurses

Edwards, Sarah A. MHSc; Chiarelli, Anna M. PhD; Ritvo, Paul PhD; Stewart, Lindsay MSc; Majpruz, Vicky MSc; Mai, Verna MD, MHSc, FRCP

doi: 10.1097/NCC.0b013e3181f96bef

Background: A woman's experience during her initial breast screen can influence her participation in subsequent screening.

Objective: The purpose of this study was to determine the association between a woman's satisfaction with her initial screening experience and compliance to biennial screening at centers with and without nurses.

Methods: A stratified random sample of compliers and noncompliers to biennial screening was selected from a cohort of 16 858 eligible women aged 50 to 65 years attending centers with and without nurses for their initial screen at the Ontario Breast Screening Program in 2002. Of these eligible women, 3387 were sent questionnaires, 2640 (77.9%) were contacted, and 1901 (72.0%) were interviewed. The association between satisfaction with initial screen and compliance was estimated separately for centers with and without nurses using logistic regression.

Results: Women attending centers with nurses were significantly less likely to comply with their next screen after their clinical breast examination if they were not completely satisfied with the service they received (odds ratio, 0.21; 95% confidence interval, 0.08-0.57) or agreed that the clinical breast examination caused discomfort to their breasts (odds ratio, 0.65; 95% confidence interval, 0.45-0.94). In addition, women attending centers with or without nurses were significantly less likely to comply if they did not understand why they needed to return for screening.

Conclusions: Nurses at screening centers have an opportunity to significantly impact a woman's compliance to biennial breast screening by providing a positive initial screening experience.

Implications for Practice: Emphasis should be placed on improving a woman's overall satisfaction with her initial screening experience.

Author Affiliations: Cancer Care Ontario, Dalla Lana School of Public Health, University of Toronto (Mrs Edwards and Mss Stewart, Majpruz and Drs Chiarelli, Mai and Ritvo), and School of Kinesiology and Health Science and Department of Psychology, York University (Dr Ritvo), Toronto, Ontario, Canada.

This project was made possible with the generous support of the Canadian Breast Cancer Foundation-Ontario Chapter.

Correspondence: Sarah A. Edwards, MHSc, Population Studies and Surveillance, Cancer Care Ontario, 620 University Ave, Toronto, ON, Canada M5G 2L7 (

Accepted for publication August 24, 2010.

© 2011 Lippincott Williams & Wilkins, Inc.