Association between preceding mammography results and the breast cancer-screening adherence among the first cohort of women enrolled in the organized screening program in Latvia

In Latvia, the participation rate in a nationally organized breast cancer screening remains low, but the underlying factors are not studied sufficiently. The study aimed to investigate the association between the preceding screening results and breast cancer-screening adherence among the cohort of women participating in breast cancer-screening program from 2009 to 2017. The screening mammography results are measured from R1 to R5, where R1 means no changes in breast tissue and R5 – proved malignancy. If the screening result is higher than R3, women are offered to do the post-screening examination to establish the cancer diagnosis; however, if the examination reveals false positive screening results, these women tend to have lower chances to participate in the followings screening rounds. A cohort of 140 781 women (aged 50–69) who were enrolled in the breast cancer screening program for the first time in Latvia was analysed cross-sectionally for every two years. Result of the screening mammography was measured from R1 to R5. The odds of breast cancer screening adherence in association with the previous mammography results were analysed with a binary logistic regression.  In 2009, the proportion of screening results R3-R5 was 18.7%, and it followed to exceed the acceptable level of 5% in the following study years. In every studied year women with previous screening results R2-R5 had lower chances (9%-74%) to be screened for breast cancer than the women with last screening results R1 by adjusting for age. A strong association between the result of the previous screening mammography and future screening adherence rates was found - the more serious the result was, the less likely it was that a woman would undergo repeated screening mammography. The findings suggest that particular attention should be paid to the mammography description quality in the breast cancer screening program.