Perceptions and understanding of mammography as an early detection method among women aged 40 and older: Systematic Review

Abstract

Background: Breast cancer is the most common disease that harms women after lung cancer, and it is a major public health issue around the world. The aim of this study was to investigate women’s perceptions and understanding related to mammography screening as a method for the early detection of breast cancer. Another aim was to identify all related studies that have discussed implemented interventions based on women’s perceptions and their understanding regarding the mammography procedure as an early detection method among women aged 40 and older.In addition, barriers and facilitators to the delivery and implementation of mammography interventions have been explored. Moreover, the role of health care workers regarding practice, guidelines and policy in the implementation of mammography programmes for breast cancer has been examined. To conclude, the study results provide a set of recommendations for both research and practice that can be applied to increase and to promote the use of mammography screening among women aged 40 and older. Method: The search for the systematic review was performed using three databases, MEDLINE, CINAHL and PubMed, and inclusion and exclusion criteria were applied. Papers were required to be published within the last 10 years (2010-2020), and all the studies were required to be written in the English language. The quality of this review and its studies was assessed using the Critical Appraisal Skills Programme (CASP) tool. Data were analysed following the approach of the thematic analysis. Result/Discussion: Twelve studies were identified for review, which included one qualitative study and 11 quantitative studies. The CASP assessment indicated that these studies had a moderate to high risk of bias. The thematic analysis revealed three main themes: 1) insufficient information provision and education (subtheme: misconceptions/lack of information by health care providers), 2) fear of mammography results and 3) exposed dignity and embarrassment related to mammography testing. Overall, the barriers to mammographs were found to be connected to insufficient knowledge related to breast cancer risk and mammographies due to a lack of education provisions, which generates anxiety and fear regarding screening. These feelings were also exacerbated by concerns regarding embarrassment and a perceived loss of dignity. 8 Conclusion: The findings of this review have some pertinent implications for mammography screening practice, guidelines and policy as well as for future research. It is imperative that care providers provide intensive levels of person-centred support to help reduce the perceived barriers to screening. The evidence-based recommendations identified during this study can play a role in improving breast cancer care and outcomes.