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Hann, A. P. "The politics of breast cancer screening." Thesis, University of East Anglia, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.309962.
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Miller, Anthony Bernard. "The Canadian National Breast Screening Study." Thesis, University of Cambridge, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.614122.
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Kan, Sik-yau Anita. "A clinical audit of mammography screening." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B41710113.
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Song, Ningning. "Quantitative photoacoustic tomography for breast cancer screening." Thesis, Ecole centrale de Marseille, 2014. http://www.theses.fr/2014ECDM0005/document.
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Ces travaux de thèse sont motivés par le développement de techniques d’imagerie alternatives pour le diagnostic précoce du cancer du sein. Parmi celles-ci, l’imagerie photoacoustique couple potentiellement les avantages de deux modalités d’imagerie non-invasives, à savoir la quantification de contrastes physiologiques du fait de l’excitation optique et la haute résolution du fait d’un sondage acoustique.Le but de ces travaux est de proposer une modélisation multiondes du phénomène photoacoustique, et d’incorporer ce modèle dans un algorithme de reconstruction efficace pour résoudre le problème inverse. Celui-ci se rapporte à la reconstruction de cartes de propriétés physiques (optique et/ou acoustiques) de l’intérieur du sein. La Méthode des Eléments Finis (MEF) a été retenue pour résoudre l’équation de propagation optique. Pour la résolution de l’équation de propagation acoustique, une méthode semi-analytique, basée sur des calculs par transformées de Fourier (méthod k-space), a été choisie. Pour la résolution du problème inverse, deux approches ont été étudiées : i) un sondage passif, permettant de remonter à la distribution de pression initiale, à l’aide de la méthode de retournement temporel ; ii) un sondage actif, où l’on interroge le milieu sélectivement sous différentes excitations, permettant de remonter quantitativement aux propriétés optiques du milieu. On appelle cette dernière approche Tomographie PhotoAcoustique Quantitative (TPAQ). Une étude spécifique sur le protocole d’illumination/détection a été conduite, prenant également en compte les contraintes expérimentalesThe present work was motivated by the development of alternative imaging techniques for breast cancer early diagnosis, that is photoacoustic imaging, which potentially couples the merits of optical imaging and ultrasound imaging, that is high optical functional contrasts brought by optical probing and high spatial resolution by ultrasound detection. Our work aims at modeling the photoacoustic multiwave phenomenon and incorporate it in an efficient reconstruction algorithm to solve the inverse problem. The inverse problem consists in the recovery of interior maps of physical properties of the breast. The forward model couples optical and acoustic propagations. The Finite Element Method (FEM) was chosen for solving the optical propagation equation, while a semi-analytical method based on Fourier transforms calculations (k-space method) was preferred for solving the acoustic propagation equation. For the inverse model, time reversal method was adopted to reconstruct the initial pressure distribution, an active approach of the inverse problem was also achieved, which decoupled the optical properties from measured photoacoustic pressure, this approach is called quantitative photoacoustic tomography (QPAT), in this approach, illumination/detection protocol was studied, and the experimental set up is also take into consideration. In the last step, photoacoustic pressure measurements obtained from experiment and simulation are studied and compared
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Santorelli, Adam. "Breast screening with custom-shaped pulsed microwaves." Thesis, McGill University, 2012. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=107686.
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Microwave imaging has been proposed as a possible complimentary imaging technique to X-ray mammography for early-stage breast cancer detection and screening. Based on the intrinsic differences in the various tissues of the breast at microwave frequencies, microwave imaging offers an imaging modality that is safe, pain-free, and without limitations on the frequency of the exam.An initial time domain microwave imaging system has been previously developed within our group. Accurate numerical models, for finite-difference time-domain simulations, matched to the experimental system have been developed. Numerical simulations are used to assess the safety of the microwave imaging technique. We calculate the maximum energy absorbed by the breast when exposed to incident microwaves and ensure that these values fall within the established thresholds.In this thesis we will test our hypothesis that an augmented microwave imaging system can improve tumour detection by making use of custom-made pulses with critical frequency content. We integrate passive microwave circuitry with a previously designed experimental microwave imaging system in order to create a new system that transmits an optimized pulse. We contrast measurement results of this newly developed system with those of the previously developed experimental system when imaging various tissue phantoms.L'imagerie micro-ondes a été proposée comme une nouvelle technique pour la détection du cancer du sein qui est complémentaire au mammographie. Cette technique est basée sur les differences intrinsèques des tissus mammaires différents à des frequences micro-ondes. L'imagerie mirco-onde est une technique qui est sûr, sans douleur, et sans limitations sur la fréquence de l'examen.Un système préliminaire pour l'imagerie micro-ondes dans le domaine temporel a déjà été mis au point. Des modèles numériques précis , pour les simulations avec la "finite-difference time-domain" technique, qui sont en accorde avec la système expérimental sont construit.Des simulations sont utilisé pour évaluer la sécurité de la technique d'imagerie micro-ondes. Nous calculons le maximum d'énergie absorbée par le sein quand il est exposé aux micro-ondes incidentes et nous s'assure que les résultats sont en accord avec les normes établis. Dans cette thèse, nous allons tester notre hypothèse que un système d'imagerie micro-ondes augmentée peut améliorer la détection des cancers en utilisant des impulsions fait sur-mesure. Nous utilisons des circuits micro-ondes passives, avec le système déjà développé, pour créer un nouveau système qui transmet un impulsion optimisé. On compare les résultats de nos mesures avec les deux systèmes quand on utilise des fantômes de tissus divers.
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Chang, Sue-Ling. "Breast cancer subtypes and screening mammography sensitivity." Thesis, Université Laval, 2014. http://www.theses.ulaval.ca/2014/30680/30680.pdf.
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Les cancers du sein peuvent être classifiés selon le statut de récepteur d’estrogène (RE), de récepteur de progestérone (RP), de récepteur HER2, ou selon quatre sous-types (Luminal A, Luminal B, HER2-enrichi, Triple-négatif) ayant des propriétés biologiques et cliniques différentes. La sensibilité du dépistage par mammographie pourrait varier selon ces types de cancers mais ceci n’est pas encore clair. L’agressivité de la tumeur, mesurée par le grade histologique pourrait expliquer cette association. Les types de cancers d’intervalle ont été comparés à ceux de cancers détectés par dépistage parmi 1536 cas infiltrants provenant d’un centre de référence de Québec. Les tumeurs RE-négatif, RP-négatif, HER2-positif, Luminal B, HER2-enrichi et TPN étaient tous plus fréquentes chez les femmes avec cancers d’intervalle que chez celles avec cancers détectés par dépistage. À l’exception des tumeurs HER2-positif et HER2-enrichi, le grade histologique expliquait en grande partie la variabilité observée entre les types de cancer et la sensibilité.Breast cancers can be classified according to tumour estrogen (ER) and progesterone (PR) receptors, human epidermal growth factor receptor 2 (HER2), and according to four subtypes (Luminal A, Luminal B, HER2-enriched, Triple-negative), each with different biological and clinical profiles. These tumour types may also influence screening mammography sensitivity but this is still not clear. Tumour aggressiveness, measured by the histological grade, may also play a role in explaining this association. Interval cancer types were compared to screen-detected cancer types in 1536 invasive cases obtained from a reference center in Quebec. ER-negative, PR-negative and HER2-positive, Luminal B, HER2-enriched and TPN tumours were all more frequent in women with interval cancers than in women with screen-detected cancers. Except for HER2-positive and HER2-enriched tumours, histological grade explained most of the variability observed between tumour receptor status, subtypes and sensitivity.
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Brown, Wendy L. "Emotional and pain responses to screening mammography /." [St. Lucia, Qld.], 2002. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16300.pdf.
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簡適悠 and Sik-yau Anita Kan. "A clinical audit of mammography screening." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B41710113.
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Purtzer, Mary Anne. "Processes inherent in mammography-screening decisions of rural, low-income women." Laramie, Wyo. : University of Wyoming, 2007. http://proquest.umi.com/pqdweb?did=1338920401&sid=1&Fmt=2&clientId=18949&RQT=309&VName=PQD.
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Maloy, Frances. "The demand for breast cancer screening services : an inquiry into the importance of cost as an impediment to use /." Thesis, Connect to this title online; UW restricted, 1999. http://hdl.handle.net/1773/7389.
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Puig, Vives Montserrat. "Breast cancer epidemiology: mammographic screening and molecular subtypes." Doctoral thesis, Universitat de Girona, 2015. http://hdl.handle.net/10803/289426.
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The aim of this thesis is to carry out an in-depth study of various aspects of breast cancer epidemiology. Firstly, we have confirmed that DCIS incidence in Girona has increased over recent decades. Proportions of screen-detected cancers, interval cancers and non-screen-detected cancers during the start-up phase of the mammographic screening programme were found to be 42.2%, 5.8% and 52.2%, respectively. Secondly, we have found that luminal A-like was the most frequent subtype associated with the best survival rate, while triple-negative breast cancer was related to the lowest survival rate. Importantly, we have concluded that breast cancer molecular subtype defined by IHC biomarkers provides prognostic value, regardless of age, tumour size, histological grade, lymph node involvement and method of detection. Finally, we have demonstrated that method of detection also provides prognostic value regardless of age, tumour size, histological grade, lymph node involvement and breast cancer molecular subtype defined by IHC biomarkers.L’objectiu d’aquesta tesi és realitzar aprofundir en diversos aspectes de l'epidemiologia del càncer de mama. Hem confirmat que la incidència del DCIS a Girona ha augmentat en les últimes dècades. Les proporcions dels càncers detectats mitjançant el programa de cribratge, fora d’aquest i els càncers d'interval van ser del 42,2%, 52,2% i 5,8%, respectivament. Per altra banda, el subtipus amb la supervivència més elevada i més baixa van ser el luminal A-like i el triple negatiu, respectivament. És important destacar que el subtipus molecular de càncer de mama definit per biomarcadors determinats amb tècniques d’IHC proporciona valor pronòstic, independentment de l'edat, la mida, el grau histològic, l’afectació dels ganglis i el mètode de detecció. Finalment, hem demostrat que el mètode de detecció del càncer també proporciona valor pronòstic independentment de l'edat, la mida, el grau histològic, l'afectació dels ganglis i el subtipus molecular.
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Iliouchina, Natalia V. (Natalia Vladimirovna) 1979. "Models for the effectiveness of breast cancer screening." Thesis, Massachusetts Institute of Technology, 2001. http://hdl.handle.net/1721.1/86804.
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Thesis (M.Eng. and S.B.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2001.Includes bibliographical references (leaf 72).
by Natalia V. Iliouchina.
M.Eng.and S.B.
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Hammond, Marsha V. "Breast Cancer Screening Health Behaviors in Older Women." Thesis, University of North Texas, 1994. https://digital.library.unt.edu/ark:/67531/metadc278973/.
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Health beliefs of 221 postmenopausal women were assessed to predict the Breast Cancer Screening Behaviors of breast self-examination (BSE) and utilization of mammography. Champion's (1991) revised Health Belief Model (HBM) instrument for BSE, which assesses the HBM constructs of Seriousness, Susceptibility, Benefits, Barriers, Confidence and Health Motivation, was utilized along with her Barriers and Benefits instrument for mammography usage. Ronis' and Harel's (1989) constructs of Severity-Late and Severity-Early were evaluated along with Cuing and demographic variables. These exogenous latent constructs were utilized in a LISREL path model to predict Breast Cancer Screening Behavior.
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Goldzahl, Léontine. "A behavioral approach to breast cancer screening decision." Thesis, Paris 1, 2015. http://www.theses.fr/2015PA010011.
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Cette thèse étudie les facteurs d’offre et de demande associés au recours au dépistage du cancer du sein. Parmi les facteurs d’offre, j’examine comment la coexistence du dépistage organisé au côté du dépistage individuel influence le contenu de l’examen de dépistage ainsi que le recours régulier au dépistage. En plus des facteurs de demande tels les caractéristiques socioéconomiques, une attention particulière est portée à la possibilité d’expliquer le recours régulier au dépistage par les préférences face au risque et temporelles ainsi que les perceptions. À partir de régularités psychologiques identifiées dans les travaux d’économie comportementale et de psychologie, trois interventions de type nudge sont testées dans le cadre d’une expérience randomisée sur le terrain visant à augmenter le taux de dépistage dans le programme nationalThis thesis explores supply and demand factors associated with the use of breast cancer screening. Among the supply factors, I examine how the coexistence of organized and opportunistic screenings influences the content of the screening exam and screening regularity. Besides the usual demand factors such as socioeconomic characteristics, a special attention is being given to the possibility of explaining screening regularly by individuals’ risk and time preferences and perceptions. Based on psychological patterns identified in the literature in behavioral economics and psychology, three nudge interventions are tested in a randomized field experiment to increase the national program uptake rate
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Chen, Hsiu-Hsi. "Mathematical models for progression of breast cancer and evaluation of breast cancer screening." Thesis, University of Cambridge, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.388263.
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Linton, Mary Jane Overbay Kennedy Larry DeWitt. "Education, an approach to break down the barriers to breast screening in medically underserved women." Normal, Ill. Illinois State University, 1997. http://wwwlib.umi.com/cr/ilstu/fullcit?p9803727.
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Thesis (Ed. D.)--Illinois State University, 1997.Title from title page screen, viewed June 5, 2006. Dissertation Committee: Larry Kennedy (chair), John Goeldi, Barbara Nourie, William Tolone. Includes bibliographical references (leaves 84-87) and abstract. Also available in print.
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Želvienė, Aušra. "Women beliefs towards breast cancer, breast self-examination and mammography in connection with participation in breast cancer screening." Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2008. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2008~D_20080129_121108-78281.
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The aim of the study is to assess the connection between women’s participation in breast cancer screening and beliefs towards breast cancer, breast self-examination and mammography.
The objectives of the study:
1. To assess validity and reliability of Champion Health Belief Model Scale for beliefs towards breast cancer, breast self-examination and mammography screening for Lithuanian women.
2. To estimate perceived susceptibility, perceived severity, perceived benefits, perceived barriers, confidence and health motivation.
3. To compare beliefs towards breast cancer, breast self-examination and mammography screening of participant and non-participant women in the screening program.
4. To assess perceived barriers towards mammography screening.
5. To investigate the role of information about breast cancer and mammography screening for women‘s beliefs towards breast cancer, breast self-examination and mammography screening.
CONCLUSIONS
1. Champion Health Belief Model Scale is a valid and reliable to assess beliefs towards breast cancer, breast self- examination and mammography. The barriers- mammography item “Regular mammography screening would make me worry about breast cancer” was inappropriate to the scale and expunged from the questionnaire.
2. Surveyed women did not feel much threat to get breast cancer. They overvalued benefits of breast self-examination and positively rated mammography screening. However, confidence to perform breast self-examination was properly low... [to full text]Šio darbo tikslas buvo įvertinti atvykusių ir neatvykusių tikrintis mamografiškai moterų nuostatų į krūties vėžį, krūtų savityrą ir atrankinę mamografinę patikrą skirtumus. Tikslui pasiekti iškelti tokie uždaviniai: 1. Įvertinti Champion VL sveikatos įsitikinimų modelio klausimyno tinkamumą tirti Lietuvos moterų nuostatoms į krūties vėžį, krūtų savityrą ir atrankinę mamografinę patikrą. 2. Nustatyti moterų suvoktą krūties vėžio grėsmę, apsaugančios nuo krūties vėžio pasekmių elgsenos naudą ir kliūtis šiai veiklai, sveikos gyvensenos motyvaciją. 3. Palyginti atvykusių ir neatvykusių tirtis mamografiškai dėl krūties vėžio moterų nuostatas į krūties vėžį, krūtų savityrą ir atrankinę mamografinę patikrą. 4. Įvertinti dalyvavusių atrankinėje mamografinėje patikroje dėl krūties vėžio moterų kliūtis tirtis mamografiškai. 5. Ištirti papildomos informacijos apie krūties vėžį, mamografinę patikrą įtaką moterų nuostatoms į krūties vėžį, savityrą bei atrankinę mamografinę patikrą ir moterų dalyvavimui atrankinės patikros programoje. Išvados: 1. Patikrintas ir įteisintas VL Champion sveikatos įsitikinimų modelio skalės klausimynas yra tinkamas Lietuvos moterų nuostatoms į krūties vėžį, krūtų savityrą ir atrankinę mamografinę patikrą tirti. Sveikos gyvensenos motyvacijos skalė turi būti padalinta į požiūrio į sveiką gyvenseną ir veiklos sveikatos labui subskales. Kliūčių tirtis mamografiškai teiginys “reguliarus mamografinis ištyrimas verstų mane nerimauti dėl krūties vėžio” išbrauktas... [toliau žr. visą tekstą]
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Martinez, Lynn Janette. "The role of physics testing in breast cancer screening." Thesis, City University London, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.294409.
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Rashidnasab, Alaheh. "Simulation of breast lesions in x-ray mammography screening." Thesis, University of Surrey, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.659000.
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X-ray mammography is the imaging modality of choice in screening to detect breast cancer in its early stages. In recent years, film-screen systems have been replaced by various digital mammography technologies as these can deliver better performance than conventional film-screen technology. However, it remains unclear how the physical performance of such systems and the choice of their operating parameters is correlated with the ,ability to detect early breast cancer. While clinical trials are used to address this issue, they have many associated limitations such as unethical extra exposure, time consuming data collection and completion of trials. Alternatively, a simulation framework whereby suitably realistic synthetic breast cancer pathology is inserted into normal clinical mammograms to form a large database can enable a more efficient comparison of multiple systems and study of technical parameters which influence the detection task. This thesis presents a novel computational model of breast mass appearance using fractal growth which can exhibit a range of lesion appearances. Masses generated using Random Walk (RW) and Diffusion Limited Aggregation (DLA) models were inserted into raw digital 2D mammograms using a physical model of the imaging process, thus avoiding ad hoc post-processing of the final image. The simulation framework accounted for local glandularity, polychromatic X-ray spectra, image degradation caused by the imaging system acquisition process, scatter and finally processing with manufacturer's image processing software to produce realistic lesion attenuation and contrast. An ROe study of realism gave an average AUC and corresponding 95% CIs of 0.55 (0.51, 0.59) for DLA masses. This suggests that the DLA approach appears to produce a more realistic range of mass appearances compared to the RW approach, which achieved an AUC of 0.60 (0.56, 0.63). Both results demonstrate improvement compared to previously published ROe studies of realism of the simulated masses. The mass simulation models may be used subsequently as part of a tool to evaluate different breast imaging technologies (2D and 3D) and their performance in the detection task. Digital breast tomosynthesis (DBT) may have superior performance compared to 2D mammography in terms of cancer visibility, especially in dense breasts. Lesions grown using the DLA method, previously validated in 2D mammograms, were used to simulate breast masses into clinical DBT projection images. A pilot study was performed where radiologists feedback suggests that DLA masses can be successfully embedded in DBT projections and can produce visually authentic DBT images containing synthetic pathology. However, mass appearance whilst entirely satisfactory in 2D, does not always reliably infer satisfactory appearance in DBT.
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Patino, Patricia. "Breast cancer : relationship betweern acculturation and barriers to breast cancer screening in Southwest Florida Latinas." [Tampa, Fla] : University of South Florida, 2006. http://purl.fcla.edu/usf/dc/et/SFE0001867.
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Patino, Patricia. "Breast cancer: Relationship between acculturation and barriers to breast cancer screening in Southwest Florida Latinas." Scholar Commons, 2006. http://scholarcommons.usf.edu/etd/2656.
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Despite multiple campaigns by the American Cancer Society, reports indicate that Latinas living in the United States who contract breast cancer are more likely than Anglos to die. These findings correlate with low participation in breast cancer screenings among Latinas. The objective of this study was to identify key obstacles that influence Latinas' low participation in breast cancer screenings, based on their health beliefs, knowledge of screenings, acculturation, and socio-economic factors.The study was a face-to-face informal interview, combined with a survey questionnaire conducted at churches, social clubs and/or at the participants' homes in a southwest Florida urban community. The sample consisted of a total of 50 women: all of the participants were Latinas 40 years of age and over; they had to be fluent in Spanish or English or both. A Spanish-English bilingual individual conducted a personal interview in the preferred language of each participant.
The first part of the interview was to identify barriers that affect screenings. The second part used a survey to weigh the identified factors in order to determine their importance to the participants' health decisions. This study used a health belief model scale to evaluate women's beliefs about breast cancer, and the benefits of screenings.The research results revealed that Latinas who participated in this study were acculturated to the United States culture; the largest group of participants reported being from Colombia, followed by Cuba and Puerto Rico; only two of the participants were Mexican. Seventy-eight percent of the participants self- reported having yearly mammograms, and 74% performed monthly breast self examination BSE; 60% were bilingual; 68% had some kind of health insurance. These results differ from earlier studies from the western United States where the majority of Latinas were of Mexican or Central American origin.
This suggested that Latinas from Southwest Florida are different from Latinas in other areas of the United States. A weak but significant correlation was found between acculturation and perceived barriers to breast cancer screenings, (r = 0.45, p = .01); Latinas who are more acculturated perceived more barriers than those who are less acculturated. There was not significant difference between participants who had health insurance and those who did not (t = 0.96, p = .35). The results of this study are significant for nurses and especially for advanced practice nurses, who can assess patients' knowledge about cancer in general, and breast cancer in particular when caring for Latinas; of particular concern should be the evaluation of patients' levels of acculturation, health beliefs, and understanding of the English language. Still the fundamental barrier to Latinas not bilingual in Spanish and English may be the lack of resources and information in Spanish.
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Cowley, Helen Claire. "Assessment and training in breast cancer detection." Thesis, University of Derby, 1999. http://hdl.handle.net/10545/552395.
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Wang, Ya-Ching. "Factors associated with Taiwanese lesbians' breast healthcare behaviour and intentions." Thesis, University of Manchester, 2015. https://www.research.manchester.ac.uk/portal/en/theses/factors-associated-with-taiwanese-lesbians-breast-healthcare-behaviour-and-intentions(2abb2fc5-9f97-42bc-a958-b464e7ba9c26).html.
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Taiwanese lesbians have been found to utilize screening tests for breast cancer at lower rates when compared to women in general in Taiwan. However, there is a lack of evidence regarding the factors which influence Taiwanese lesbians' breast healthcare behaviour and intentions. A two-phase sequential exploratory mixed-methods study was employed to explore the factors influencing Taiwanese lesbians' breast healthcare behaviour and intentions, including semi-structured interviews and an online survey. Taiwanese women aged 20 years or above and who self-identified themselves as lesbians or as partnered with the same gender were targeted and recruited, using purposive and snowball sampling. Thirty-seven semi-structured interviews were conducted initially. According to the interview findings and two existing health psychology models (the health belief model and the theory of reasoned action), a questionnaire was developed and an online questionnaire survey was undertaken with a larger population. A total of 284 women completed the online survey. The findings showed that the lesbians' breast healthcare behaviour and intentions were directly or indirectly affected by their gender identity, gender role expression, patient-provider interaction and partners' support. In addition, it was also found that the lesbians may share similar views about breast cancer and breast cancer screenings, self-efficacy and cues to action with women in general in Taiwan. Some of these factors had an important effect on the lesbians' breast healthcare behaviour and/or intentions, in particular the perceived barriers to performing and/or having breast cancer screenings, the perceived susceptibility to breast cancer, self-efficacy and cues to action. Based on the PhD findings and social-ecological model, four levels of recommendations were proposed in order to encourage Taiwanese lesbians' utilization of breast cancer screenings and to promote their breast health.
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De, Grasse Catherine. "Women's breast cancer screening practices, knowledge, attitudes, and decisional conflict." Thesis, University of Ottawa (Canada), 1995. http://hdl.handle.net/10393/10151.
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Morbidity and mortality from breast cancer can be reduced by early detection through screening. Despite recommended guidelines for breast screening since 1988, participation rates have been suboptimal. The objectives of the current study were to describe: (1) changes in breast cancer screening knowledge, attitudes, decisional conflict, intentions and practices among women aged 50-69 years since initiation of a regional mass screening program in Ottawa-Carleton in 1991; and (2) breast cancer screening knowledge attitudes, intentions, and practices among women aged 40-49 years compared to women aged 50-69 years. Among women aged 50-69 years, the percentage ever having had a mammogram increased from 60% in 1991 to 83% in 1994. There were commensurate increases in the percentage reporting mammography within two years from 47% to 74%. There was an insignificant improvement in the annual professional breast examination (PBE) rate from 57% to 59%. A small, but statistically significant increase occurred in monthly breast self-examination (BSE) rate from 46% to 54%. Women in their forties continue to overutilize screening mammography; 63% reported ever having had a mammogram and 44% reported having had a mammogram within the past two years. Reported annual PBE and monthly BSE rates of women aged 40-49 years were comparable to the rates of women aged 50-69 years; 63% versus 59% and 48% versus 54% respectively. Intentions to have mammography every two years once they are 50 years and to have annual PBE were similar to those of women 50-69 years, however, they were more likely to accept an invitation to screening (71% versus 56%). Women 40-49 years were more knowledgeable than women 50-69 years while they had similar concerns about future mammography as the women over 50 years. (Abstract shortened by UMI.)
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Tilanus-Linthorst, Madeleine Marie Antoinette. "The impact of tumour characteristics on hereditary breast cancer screening." [S.l.] : Rotterdam : [The Author] ; Erasmus University [Host], 2006. http://hdl.handle.net/1765/10755.
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Hudson, Joshua. "A Partially Observable Markov Decision Process for Breast Cancer Screening." Thesis, Linköpings universitet, Statistik och maskininlärning, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-154437.
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In the US, breast cancer is one of the most common forms of cancer and the most lethal. There are many decisions that must be made by the doctor and/or the patient when dealing with a potential breast cancer. Many of these decisions are made under uncertainty, whether it is the uncertainty related to the progression of the patient's health, or that related to the accuracy of the doctor's tests. Each possible action under consideration can have positive effects, such as a surgery successfully removing a tumour, and negative effects: a post-surgery infection for example. The human mind simply cannot take into account all the variables involved and possible outcomes when making these decisions. In this report, a detailed Partially Observable Markov Decision Process (POMDP) for breast cancer screening decisions is presented. It includes 151 states, covering 144 different cancer states, and 2 competing screening methods. The necessary parameters were first set up using relevant medical literature and a patient history simulator. Then the POMDP was solved optimally for an infinite horizon, using the Perseus algorithm. The resulting policy provided several recommendations for breast cancer screening. The results indicated that clinical breast examinations are important for screening younger women. Regarding the decision to operate on a woman with breast cancer, the policy showed that invasive cancers with either a tumour size above 1.5 cm or which are in metastasis, should be surgically removed as soon as possible. However, the policy also recommended that patients who are certain to be healthy should have a breast biopsy. The cause of this error was explored further and the conclusion was reached that a finite horizon may be more appropriate for this application.
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McDonald, Marian. "Breast screening and the consequences of recall for further assessment." Thesis, University of Huddersfield, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.285587.
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Parker, Lisa Michelle. "An empirical ethics analysis of breast cancer screening in Australia." Thesis, The University of Sydney, 2016. http://hdl.handle.net/2123/15596.
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Breast screening is controversial. Despite many supporters and a large evidence base, some experienced breast screening experts disagree with selected policies and practices. I sought to examine the reasoning of people who have influenced breast screening in Australia. I used an empirical ethics approach, combining empirical study with theoretical analysis. I interviewed Australians with expertise and influence in breast screening across a range of professional roles. I found that participants drew on values as well as evidence when talking and reasoning about breast screening. Participants expressed a range of interpretations and prioritisations for each value and experts’ disagreements were based, at least in part, on these differences. Experts did not always acknowledge the role of values in shaping their views or recognise different ways of conceptualising or prioritising values. I recommend including values in decision making for breast screening policy and practice. I provide guidance about formats for values based discussions. I conclude that values play an important but often unrecognised role in shaping breast screening policy and practice, and propose regular review of values to deliver breast screening in the most ethically sound manner.
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Jacklyn, Gemma. "The benefits and harms of breast cancer screening in Australia." Thesis, The University of Sydney, 2017. http://hdl.handle.net/2123/17977.
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The introduction of screening mammography in Australia has been associated with an increase in the incidence of early-stage breast cancer. Concern is growing about the problems caused when women are diagnosed with breast cancer and undergo treatments that do not benefit them because their cancer would not progress, or would progress, but would not become symptomatic within the remaining lifetime of the patient. This is known as overdiagnosis. Screening mammography aims to decrease breast cancer morbidity and mortality by advancing in time the diagnosis and thereby increasing the chance of successful treatment. But overdiagnosis and the consequent overtreatment can cause serious lifelong harm and are therefore considered the major downsides of breast screening. Mounting evidence of the extent of overdiagnosis has led to the recognition that the benefits and harms of breast screening are finely balanced, and women need to know the magnitude of the trade-offs. The extent of overdiagnosis due to breast screening is contested, with published estimates ranging from 1% to 57%. There is a critical need for research investigating the harm to benefit ratio in Australia and quantification of the effects of screening mammography on the incidence of stage-specific breast cancer and overdiagnosis. Individual women require information about the impact of regularly attending screening mammography on breast cancer mortality and overdiagnosis to make informed decisions. A challenge to estimating this in a randomised controlled trial is nonadherence to the trial protocol. Previous systematic reviews have provided estimates of the effect of receiving an invitation to screening on the risk of dying due to breast cancer. Chapter 2 presents a meta-analysis of the screening mammography trials using a simple adjustment that estimates the probability of a reduction in breast cancer mortality and risk of overdiagnosis due to the effect of receiving screening by regularly participating in a breast screening program. Adjustment for nonadherence increased the size of the size of the effect by up to 50%. The prevented fraction of breast cancer mortality at 13-year follow-up increased from 0.22 to 0.30 with deattenuation. The percentage risk of overdiagnosis during the screening period in women invited to screening increased from 19.0% to 29.7%. From 2013 through 2017, the Australian national breast cancer screening programme gradually invited women aged 70 to 74 years to attend screening, following a policy decision to extend invitations to older women. Yet no formal evaluation of the effects of the change in policy on outcomes for women was undertaken. Building on my meta-analysis, in Chapter 3 I used a Markov model and applied the breast cancer mortality reduction and overdiagnosis estimates reported in Chapter 2 to Australian breast cancer incidence and mortality data to estimate the benefits and harms of the new package of biennial screening from age 50 to 74 compared with the previous programme of screening from age 50 to 69. I found that the extra five years of screening results in approximately seven more overdiagnosed cancers to avert one more breast cancer death. Thus extending screening mammography in Australia to older women results in a less favourable harm to benefit ratio than stopping at age 69. To identify temporal trends in stage-specific breast cancer in Australia, I used an observational study design to analyse data on women who received a diagnosis of breast cancer from 1972 to 2012 as recorded in the New South Wales Cancer Registry (Chapter 4). I explored trends in stage-specific incidence before screening and compared them to periods after screening began. I found that screening was not associated with lower incidence of late-stage breast cancer at diagnosis and incidence for all stages remained higher than prescreening levels. In women aged 50 to 69 years, the incidence of carcinoma in situ, localised and regional breast cancer has more than doubled compared to the prescreening era. The data presented in Chapter 4 indicate that excess detection of breast cancer is a problem in New South Wales. Thus I designed an ecological study to quantify overdiagnosis. I estimated the background trend of increasing incidence using two approaches, the first based on the prescreening trend in women of screening age (50 years and older), and the second based on the contemporary trend in women too young to be screened (40 to 44 years of age). From these trends, I estimated the expected age-standardised incidence of breast cancer, by stage at diagnosis, in the absence of screening, for women aged 50 years and over in the years since the national screening mammography program, BreastScreen, was introduced (1988 to 2012). I then calculated the difference in observed and expected incidence rates to determine the excess incidence of early-stage breast cancer and reduction in the incidence of late-stage disease. I found that screening mammography has resulted in overdiagnosis of early-stage and regional breast cancer. I estimate that around six additional cases of early and regional breast cancer are detected for every distant metastatic breast cancer prevented. Due to the substantial increase in detection of carcinoma in situ of the breast observed in Chapter 4, I explored sub-types and causes of this. Chapter 6 presents a descriptive analysis of temporal trends in the incidence of ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS) in women who received a diagnosis from 1972 to 2012, recorded in the NSW Cancer Registry. Carcinoma in situ as a proportion of all breast cancer increased dramatically, and incidence of DCIS across all ages rose from 0.15 per 100,000 during 1972 to 1983 to 16.81 per 100,000 over 2006 to 2012, with the greatest increase seen among women in the target age group for screening (50 to 69 years). DCIS incidence has not stabilized despite screening being well established for over 20 years, and participation rates in the target age range remaining stable. Our observational estimate of overdiagnosis from Chapter 5 is different to those from meta-analyses of randomised controlled trials of screening mammography and some other observational studies. Thus the final paper in this thesis presents a Cochrane Protocol on Overdiagnosis due to screening mammography for women aged 40 years and older (Chapter 7). We present methodology to identify and evaluate all primary epidemiological studies that have quantified overdiagnosis resulting from screening mammography and provide estimates of its frequency (including randomised and observational studies). An approach to assessing the risk of bias due to lead time is also discussed. Trying to quantify the benefits and harms of screening mammography and present them to women using natural frequencies should better enable informed choice, and is consistent with the international shift towards promoting and supporting shared decision making for screening. This thesis provides valuable new evidence about the trade-offs of screening mammography in Australia. The finding that risk of harm is greater than the chance of benefit is consistent with international studies of breast screening and demonstrates the importance of continuing this work to better quantify overdiagnosis for women, clinicians, and policymakers.
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TAPIA, KRISCIA ANGELES. "Northern Territory Indigenous and Non-Indigenous women: Mammographic density profiles and breast screening characteristics." Thesis, The University of Sydney, 2019. https://hdl.handle.net/2123/21989.
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Background: Indigenous Australians have lower breast cancer rates but higher mortality rates compared with other women. With evidence of ethnic variations in MD globally, investigating MD in Indigenous women may provide insight into optimising diagnosis and care for an underserved population. Aims: To investigate the MD and BreastScreen attendance of Indigenous and non-Indigenous women in the NT and assess the diagnostic efficacy of radiologists in cases with varying breast densities. Methods: Indigenous status, age, postcode, HRT, family history of breast cancer, symptoms and language spoken at home from self-reported 857 Indigenous and 3236 non-Indigenous women were analysed for associations with MD (study 1) and screening attendance (study 2). ROC analyses were used to determine cut-off points for age and numbers of screening visits. Logistic regression analyses were used to determine odds ratios and p≤0.05 were considered significant. In study 3, mammography test scores of 273 radiologists were assessed on low MD (LMD) vs high MD (HMD) cases. Sensitivity, lesion sensitivity, specificity, ROC and JAFROC FOM were compared using Mann-Whitney U or unpaired t-tests. Results: MD was lower for Indigenous women. For non-Indigenous women, HMD was associated with ≤55 years of age, no family history of breast cancer, speaking mainly English, and living remotely. For Indigenous women, HMD was associated with younger age. Indigenous women have fewer visits to screening and non-English speaking was mainly associated for Indigenous women only. Remoteness was associated with fewer visits for non-Indigenous women only. Shared predictors were ≤55 years and no family history of breast cancer. Radiologists had better lesion sensitivity and specificity in LMD vs HMD cases in 3 of 5 tests. ROC and JAFROC were better in LMD vs HMD cases for 1 of 5 tests. Conclusions: Indigenous women have lower MD and lower attendance to BreastScreen than non-Indigenous women. Breast cancer detection is more effective in LMD cases indicating that Indigenous women would benefit from better program engagement given their density profile and high death rates from breast cancer.
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Turnbull, Deborah Anne. "Psychosocial issues in implementing mammography screening in Australia." Phd thesis, Faculty of Arts, 1992. http://hdl.handle.net/2123/8575.
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Obikunle, Abosede Francisca. "Barriers to Breast Cancer Prevention and Screening among African American Women." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/1979.
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Breast cancer is a serious illness that often has fatal consequences. Adherence to the recommendations for breast cancer surveillance is poorly practiced among African American women. The purpose of this phenomenological study was to seek individual professed barriers to breast cancer screening among African American women to better understand why breast cancer continues to be one of the principal basis of mortality among African American women. The theoretical framework for this study was the behavioral model of health services use. Purposeful selection was used to invite 14 African American women to participate in the in-depth interview process. Interview data were transcribed and then coded for recurring themes and meaning. The findings of this study demonstrate that these women's perceived barriers to breast cancer screening were lack of information, a belief that genetics dictates who gets breast cancer, embarrassment, a norm of people not going for health checkups, the procedure of breast cancer screening, and fear. Participants noted that the improved method of mammography may promote utilization within the population. Breast cancer disparities among African American women may decline if healthcare providers promote awareness of the availability and accessibility of breast cancer prevention resources and if African American women understand the barriers to breast cancer prevention and change their own screening practices.
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Batcha, Jacqueline. "Assessing Breast Cancer Screening Among Cameroonian Women in the United States of America." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7529.
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Breast cancer is the second leading cause of cancer death among women in the United States. Nonadherence to recommended screening guidelines and lack of screening contribute to late stage diagnosis and increased morbidity and mortality among racial and ethnic women in the United States. The purpose of this study was to assess breast cancer screening practices, knowledge, and beliefs among Cameroonian immigrant women who were 40 years and older living in the metropolitan Washington, D.C. region. This quantitative cross-sectional study was guided by the health belief model and used the revised version of Champion's health belief model scale. A convenience sample (N=267) responded to a 60-item self-administered online survey that assessed knowledge of breast cancer screening, demographic variables, constructs of the health belief model and adherence (defined as obtaining a mammogram within two years). Data analyses performed included descriptive analysis, correlational and multiple linear regression. Results of this study revealed that increased level of education and self-efficacy were associated with greater knowledge of the benefits of mammography. Additionally, women who had more self-efficacy in obtaining a mammogram, perceived less cultural barriers, lived longer in the United States, and who had a regular healthcare provider were more likely to be adherent. Study findings suggest that positive social change can be achieved by empowering women to take control of their health. Efforts promoting awareness of breast cancer screening guidelines and facilitating access to a regular healthcare provider could significantly increase uptake of screening services and lead to better health outcomes and reduced mortality.
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Bovis, Keir Jonathan. "An adaptive knowledge-based model for detecting masses in screening mammograms." Thesis, University of Exeter, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.269735.
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Fung, King-yip. "Screening of recurrent BRCA gene mutations in Chinese breast and ovarian cancer." Hong Kong : University of Hong Kong, 2000. http://sunzi.lib.hku.hk/hkuto/record.jsp?B23829837.
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Mizukoshi, Miwa Mia. "Mammography for Japanese women living in Australia: are current breast screening targets appropriate?" Thesis, University of Sydney, 2020. https://hdl.handle.net/2123/23245.
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Introduction: Breast cancer is one of the most common types of cancer among women globally and screening by mammography plays a crucial role in detecting cancer. However, screening target ages may differ between countries. For example, the target group is 50-74 years in Australia and 40+ years in Japan, reflecting differences in age-specific incidence rates (ASIR). Breast cancer risk is related to the volume of mammographic breast density (MBD), which has been found to differ among ethnic groups, hence impacting on national screening policies. The thesis is aimed to investigate whether Japanese women living in Australia (JWA) are best served by the current screening policy of BreastScreen Australia. Methods: The thesis is based on findings from two studies: 1. ASIR in Australia and Japan based on secondary data; 2. The comparison of MBD between Australian women (AW), JWA and Japanese women living in Japan (JWJ). De-identified mammography is categorised independently by three specialist clinicians using the BI-RADS® (5th ed.). Bivariate and multivariate analysis were undertaken using SPSS® Statistics. Results: The results show that Australian ASIR rose sharply from age 40 years and peaked at 65-69 years. While in Japan, the highest incidence occurred at 45-49 years and declined after 50 years. In the second study, more than 65% of AW were found in the low MBD category while the majority of JWJ were in the high MBD category. The ORs demonstrated that JWA were approximately 5 times more likely and JWJ were about 15 times more likely to have high MBD compared to AW. These findings have policy implications in the context of setting breast screening targets. Conclusion: The results indicated two critical implications. Firstly, JW aged 40-49 should be included in the screening target age group. Secondly, supplemental screening should be suggested for JW mainly aged 40-49 years. The findings are also crucial for other ethnic migrant women living in Australia.
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Chapple, Bronwyn. "Breast cancer screening and medical negligence : 'waiting for something to happen'." Title page, contents and abstract only, 2000. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmc467.pdf.
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Cheffins, Tracy. "Hormone replacement therapy and breast cancer in a mammographic screening program /." Title page, table of contents and abstract only, 1997. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmc515.pdf.
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Johnston, Katharine. "The cost and production of breast screening in the United Kingdom." Thesis, Brunel University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.324647.
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Abrahamsson, Linda. "Statistical models of breast cancer tumour growth for mammography screening data." Thesis, Uppsala universitet, Matematisk statistik, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-171980.
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Larrier, Nicole A. (Nichole Alison). "Screening for apoptosis in breast cancer cell lines using gel electophoresis." Thesis, Massachusetts Institute of Technology, 1995. http://hdl.handle.net/1721.1/37030.
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Hurrell, Karen Tracy. "Screening for serious disease : modelling the early detection of breast cancer." Thesis, University of Leicester, 1989. http://hdl.handle.net/2381/34546.
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Mandal, Adhip. "Leukocyte based biomarkers as screening and prognostic tools for breast cancer." Thesis, University of Essex, 2011. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.548601.
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Zaro, Maren Lothyan. "Breast Cancer Risk Assessment: Evaluation of Screening Tools for Genetics Referral." BYU ScholarsArchive, 2016. https://scholarsarchive.byu.edu/etd/8824.
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Purpose: This study assessed effectiveness of five tools recommended by the US Preventive Services Task Force (USPSTF), designed to help primary care clinicians determine which unaffected patients to refer to genetics specialists for breast cancer risk assessment based on concerning family history. Design: This descriptive secondary analysis included 85 women aged 40-74. All participants had a first-degree female relative previously diagnosed with breast cancer who also had uninformative negative BRCA1/2 tests. Methods: Each pedigree was evaluated using the five tools including the Family History Screen-7 (FHS-7), Pedigree Assessment Tool (PAT), Manchester Scoring System, Referral Screening Tool (RST), and Ontario-Family History Assessment Tool (Ontario-FHAT). All five tools were applied to each study participant. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated to describe each tool’s ability to identify women with elevated risk as calculated by the Claus model. Receiver operating curves (ROC) were also plotted. Differences between areas under the curve (AUCs) for all possible pairs of tools were estimated through logistic regression to assess for differences in tool performance. Results: Claus calculations identified 14 women out of 85 whose lifetime risk of breast cancer was elevated at > 15%. Only two tools, the Ontario-FHAT and FHS-7, identified all 14 women with elevated risk, a sensitivity of 100%. The FHS-7 tool flagged all 85 participants, meaning its specificity was zero. The Ontario-FHAT flagged 59 participants as needing referral (specificity 36.2%) and had a negative predictive value (NPV) of 100%, indicating that if a woman was not found to need a referral to a genetics professional, it is likely she did not have an elevated lifetime risk of developing breast cancer. AUC values were not significantly different between tools (all p values > .05), and thus were not helpful in discriminating between the tools. Conclusion: In this population, the Ontario-FHAT out-performed other tools in terms of sensitivity and negative predictive value; however, low specificity and positive predictive value must be balanced against these findings. Thus, the Ontario-FHAT can help determine which women would benefit from referral to a genetics specialist.
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Payne, Cynthia. "Cultural Sensitivity and African American Women's Compliance With Breast Cancer Screening." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5769.
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Although the incidence of breast cancer is almost the same for middle-aged African American and Caucasian women, the rate of patients' following breast cancer screening and following up recommendations differs. African American women are less likely to follow recommendations and have higher mortality rates when compared to Caucasian women. One factor thought to affect compliance with breast cancer screening and follow up is culturally sensitive communication. This purpose of this quantitative correlational study was to determine if the culturally sensitive communication of a medical center influenced compliance with breast cancer screening and follow up and if compliance has an effect on the stage of breast cancer when diagnosed for African American women between the ages of 50 and 74. The research questions were aligned with the theoretical pathways of the Patient-Centered Culturally Sensitive Healthcare Model. This quantitative cross-sectional study was based on secondary data of African American women aged 50-74 from electronic systems for each Southern California location of a national health maintenance organization between the years 2012-2016. The results of the regression analysis from averages of the scores from the Member Appraisal of Physician/Provider Services questionnaire, determined associations between the cultural sensitivity scores of the African American woman's medical center and their compliance with recommendations for breast cancer screening and follow up after screening. However, no association between the stage of cancer and medical center's cultural sensitivity was found. Results can be used to develop cultural sensitivity interventions at medical centers aimed to enhance African American women's compliance with breast cancer screening and follow-up recommendations.
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Fields, Cheryl B. "Predicting Breast Cancer Screening Among African American Lesbians and Bisexual Women." ScholarWorks, 2011. https://scholarworks.waldenu.edu/dissertations/926.
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In 2009, 713,220 new cases of cancer were diagnosed for women in the United States with more than a quarter million deaths. African American women and lesbians exhibit behavioral risk factors as well as diminished access to and utilization of breast cancer screening that reduces opportunities for early detection. This secondary analysis of a national convenience-based study examined screening compliance among 647 African American lesbian and bisexual women. Barriers to accessing screening represented the theoretical framework for this study. Bivariate chi square analysis was used to assess the association between independent variables: sociodemographic characteristics; participation in wellness activities; sexual orientation/gender identity; and experience with health care providers and the three dependent breast cancer screening compliance variables: breast self-examination (BSE), clinical breast examination (CBE), and mammography screening. Statistically significant associations between dependent and independent variables at the .05 level were further analyzed with logistic regression. Results of the ten regression models found that BSE was predicted by socioeconomic characteristics and participation in wellness activities. Compliance with CBE guidelines was predicted by sociodemographic characteristics, wellness activities, sexual orientation/gender identity and provider experience. Sociodemographic variables and provider experience also predicted mammography screening. Overall compliance was predicted by sociodemographic characteristics, namely insurance status. The social change implications of this research are an improved understanding of African American lesbian and bisexual women's screening behavior and guidance toward interventions that can improve and breast cancer screening compliance with guidelines.
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DeBoard, Ruth Ann. "Breast Abnormalities: Identification of Indicators that Facilitate Use of Health Services for Diagnosis and Treatment of Breast Cancer." Diss., The University of Arizona, 2010. http://hdl.handle.net/10150/195625.
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Problem: There is a lack of knowledge about women who are screened for breast cancer, have an abnormal finding on mammogram, and then do not return in a timely manner for diagnostics and treatment. Lack of follow- up likely constitutes delayed treatment and poorer outcomes. Delays may result in later entry into the health system with advanced disease, more extensive and expensive care, burdening resources. Late stage breast cancer likely results in poorer health outcomes or early death.Purpose and Aims: The purpose of this research is to describe contextual characteristics at the health delivery level as well as individual characteristics of women with abnormal mammography, and their association with use of follow- up health services. Particularly, this research examines the differences between women who are early and late responders after an abnormal mammogram.Population: The participants were a convenience sample of 380 women who participated in mobile breast cancer screening. A subset of women with inconclusive or abnormal mammogram findings was the focus of analysis.Methods: This research utilized a descriptive design with quantitative data collection through participant survey at mobile mammogram screening events in multiple urban and rural Arizona sites. Participants requiring further health care were followed by chart review. Analysis of correlations with the outcome variable: time to first follow- up appointment for recommended health care in women with abnormal mammograms was conducted.Findings: Data indicated the time to the first follow- up appointment ranged from 1- 110 days with follow- up for 77.4% of participants within 60 days, 6.5% within 60-90 days, and 16.1% without follow- up after 90 days. Significant relationships between contextual and individual characteristics and follow- up were found. Categories included organizational health system characteristics of geographic location, clinical breast exam and shared case management; individual characteristics of beliefs including value of health care; finance including out of pocket costs and perceptions of financial assistance; perceived needs including breast symptoms; and satisfaction with the last health visit and mammograms in general.Implications: Recognition of barriers to follow- up after breast cancer screening is important for development of interventions to improve outcomes and has implications for screening and treatment management programs, community health centers and private practice. Health disparity related to screening without adequate options for access to health care is ethically untenable. Nurses are well positioned to reduce barriers to health care.
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Savant, Abhishek. "Examining factors associated with utilization of mammography screening for women of age 40-74 years in Washington State." Pullman, Wash. : Washington State University, 2009. http://www.dissertations.wsu.edu/Thesis/Spring2009/A__Savant_060509.pdf.
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Thesis (Master of Health Policy and Administration)--Washington State University, May 2009.Title from PDF title page (viewed on July 13, 2009). "Department of Health Policy and Administration." Includes bibliographical references (p. 60-73).
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Ouinten, Y. "Models to evaluate schemes for an early detection of breast cancer." Thesis, University of Southampton, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.380582.
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Starczewska, J. M. "Predictors of breast and cervical cancer screening uptake prior to the introduction of centralised nationwide screening in Poland." Thesis, University of Salford, 2013. http://usir.salford.ac.uk/30863/.
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Background: Introduction of nationwide breast and cervical screening programmes in Poland (2006) created an unprecedented opportunity to explore the predictors of breast and cervical cancer prophylactic behaviours in a society unexposed to population screening. The study aims to add to the body of knowledge on predictors that could be common for other countries in a similar geo-political situation, aiming to introduce nationwide breast and cervical screening programmes. Methods: A data subset (N=4,290) from a large representative survey (N=7,948) on cancer knowledge and prophylaxis, conducted by the Cancer Oncology Institute in Warsaw close to the introduction of nationwide breast and cervical cancer screening, was used in this thesis. Behaviours and knowledge were described and logistic regression used to identify predictors of mammography and cytology uptake. Results: Women’s level of cancer knowledge was evenly distributed (49.2% low and 50.8% high scores). However, knowledge on cervical cancer was lower than for breast. Higher knowledge was linked to higher education, better material conditions, cancer diagnosis, or practicing any type of the studied prophylaxis and lower levels of knowledge was associated with being aged 18-24 or ≥70 y.o., being widowed, and living in village. Even though 93% (N=3,970) of respondents were aware of the need for breast self-examination (BSE), only 32.3% regularly practiced BSE. Majority (92.3%, N=3,943) knew that mammography can allow early cancer detection but only 52.5% ≥ 50 y.o. (32.1% all ages) declared ever having it. Similarly, 90.7% (N=3,871) knew that cytology allows early detection of cancer and 78.8% have ever undertaken it cytology but only 53.6% had it done every 1-3 years. Up to 4% indicated test unavailability of either test as the reason for non-attendance. The most common barriers included: feeling of no need for such test (37.9-44.9%) and lack of referral (28.7%-39.2%). Women with the highest education levels, the 3 ones living in cities above 100,000 inhabitants, or with highest cancer knowledge were the most likely to ever get screened for breast and cervical cancers. Additionally BSE was found to predict mammography whilst cytology was also predicted by: household size, marital status, having a family member or a friend with cancer. Conclusions: Low screening uptake could be reflective of the fact that there was no nationally available screening but only a small proportion reported non-attendance due to unavailability of tests. This suggests that the uptake was driven by other factors (e.g., cancer knowledge, education) than population screening availability. Particular attention should be paid to the provision of cancer related knowledge. A follow up study is recommended to assess whether women’s knowledge and screening behaviours improved since the conduct of this survey.