Factors associated with women's decision to undergo early mammography contrary to guidelines

Background For young women, mammography has limited effectiveness and entails exposure to radiation, discomfort and additional costs. As in other countries, the Israel Ministry of Health does not officially recommend mammograms for women under age 50 who do not belong to risk groups. The study identifies factors associated with the willingness to undergo mammography, contrary to the official guidelines. Methods Using the Health Belief Model (HBM), we surveyed Israeli women aged 40-51 who are not at high risk for developing breast cancer and who had or had never undergone mammography. Results The results show that socio-demographic characteristics, private insurance coverage, out-of-pocket payments to physicians, and two HBM categories-lower levels of perceived barriers to mammography (OR = 0.70, 95% CI = 0.53-0.92) and higher levels of health motivation (OR = 1.65, 95% CI = 1.19-2.29) - are associated with the decision to undergo mammogram. In addition, higher levels of perceived susceptibility to illness (OR = 1.32, 95% CI = 1.00-1.73) and previous experience with mammography (OR = 8.26, 95% CI = 3.71-18.41) are significant predictors of women's intentions to undergo early mammography. Conclusions Understanding the factors associated with women's tendency to have mammograms contrary to recommendations can help nurses and healthcare policymakers in creating health-promotive programs targeting this group of women. Taking policy steps to increase women's confidence in Ministry of Health guidelines will reduce the potential damage of cumulative radiation over the lifetime of young women and lower the number of false positives. Preventing unnecessary mammograms might reduce costs to households and HMOs, lessen ineffective use of medical facilities and help relieve the burden on the health system. Key messages Taking policy steps to increase women's confidence in Ministry of Health guidelines will reduce the potential damage of cumulative radiation over lifetime and lower the number of false positives. Preventing unnecessary mammograms will reduce costs to households and HMOs, lessen ineffective use of medical facilities and help relieve the burden on the health system.