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Mammography screening: Only 1 in 3 women is well-informed

November 04, 2015

Only one in three women participating in Germany's mammography screening programme (MSP) is well-informed about it: the higher the level of education, the greater the chance of women making an informed decision. These are the results of a study that health care researchers at Bielefeld University are publishing today (03.11.2015) in the international specialist journal PLOS ONE. 'Further information and support services are needed to spread more knowledge about the programme - especially to women with little education and women with a Turkish migration background,' sums up Junior professor Jacob Spallek, who ran the study together with Professor Petra Kolip.

The mammography screening programme (MSP) is open for all women in Germany over the age of 50. It can help detect and therefore treat breast cancer at an early stage. However, because not every screening delivers a clear outcome, mistakes can sometimes lead to false diagnoses, overtreatment, or stress. Jacob Spallek says, 'That is why every woman should take care to find out about the risks and the benefits before accepting the invitation to attend mammography screening.' The researchers have studied how much women know about the screening and how they then decide in favour of or against it.

Breast cancer is the most frequent type of cancer among women. Early diagnosis through MSP can help to lower the mortality rate. Every two years, women aged between 50 and 69 years are invited to attend MSP. Nonetheless, there is controversy over whether the potential disadvantages of screening possibly outweigh the advantages. This is why the concept of 'informed choice' has become increasingly more important in the health sciences. It states that whoever has sufficient knowledge about a proposal can form her own opinion about it and make a conscious choice. The goal of the research project was to describe which proportion of women in general and which proportion of women with a Turkish migration background decide in favour of or against MSP - and also make an informed choice. 'For the result, it didn't matter whether the choice was for or against the screening,' Spallek explains. 'The only thing that was important was whether the decision was based on sufficient information.'

Participants were approximately 5,000 women in the Westphalia-Lippe region who were invited to attend an MSP for the first time. A total of 27.1 per cent of the invited women made an informed choice for or against participating in the MSP. Whereas 28.2 per cent of the women with no migration background made an informed choice, this was 21.8 per cent among ethnic German immigrants [Spätaussiedlerinnen] and 20.0 per cent among women with other countries of origin. The lowest proportion of informed decisions came from women with a Turkish migration background at 5.0 per cent. 'In sum, there is room for improvement in the proportion of informed choices when it comes to MSP in Germany,' concludes Jacob Spallek.
Original publication: Berens, Eva-Maria; Reder, Maren; Razum, Oliver; Kolip, Petra; Spallek, Jacob (2015) Informed choice in the German mammography screening program by education and migrant status: survey among first-time invitees. PLOS ONE. Nov 3. Doi: 10.1371/journal.pone.0142316

Contact: Jun.-Prof. Dr. Jacob Spallek, Bielefeld University
Faculty of Health Sciences, AG 3 Epidemiology & International Public Health
Telephone: 0521 106-2554

Eva-Maria Berens, Bielefeld University
Faculty of Health Sciences, AG 6 Public Health Nursing & Health Science Research
Telephone: 0521 106-4818

Bielefeld University

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