Investigating young women's motivations to engage in early mammography screening in Switzerland: results of a crosssectional study

Background: The scientific and public debate concerning organized mammography screening is unprecedentedly strong. With research evidence concerning its efficacy being ambiguous, the recommendations pertaining to the age-thresholds for program inclusion vary between - and even within - countries. Data shows that young women who are not yet eligible for systematic screening, have opportunistic mammograms relatively often and, moreover, want to be included in organized programs. Yet, to date, little is known about the precise motivations underlying young women's desire and intentions to go for, not medically indicated, mammographic screening. Methods: A cross-sectional online survey was carried out among women aged 30-49 years (n = 918) from Switzerland. Results: The findings show that high fear (beta=.08, p <=.05), perceived susceptibility (beta=.10, p <=.05), and ego-involvement (beta=.34, p <=.001) are the main predictors of screening intentions among women who are not yet eligible for the systematic program. Also, geographical location (Swiss-French group: beta=.15, p <=.001; Swiss-Italian group: beta=.26, p <=.001) and age (beta=.11, p <=.001) play a role. In turn, breast cancer knowledge, risk perceptions, and educational status do not have a significant impact. Conclusions: Young women seem to differ inherently from those who are already eligible for systematic screening in terms of the factors underlying their intentions to engage in mammographic screening. Thus, when striving to promote adherence to systematic screening guidelines - whether based on unequivocal scientific evidence or policy decisions - and to allow women to make evidence-based, informed decisions about mammography, differential strategies are needed to reach different age-groups.