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Evaluation of Attitudes and Related Factors Regarding Mammography Among Women Participating in Screenings at a University Hospital

This cross-sectional study of 300 women at a Turkish university hospital found that physician recommendation, family history of breast cancer, and perceived susceptibility are significant predictors of positive attitudes toward mammography, underscoring the need for targeted awareness campaigns and strengthened primary care roles to improve screening participation.

Original authors: Aysun Aras, Fadime Güven, Metin Kuzulugil

Published 2026-07-02

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CC BY 4.0

Original authors: Aysun Aras, Fadime Güven, Metin Kuzulugil

Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). ✨ This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer

Imagine breast cancer as a hidden storm that can hit women's health. Mammography is like a powerful radar system designed to spot this storm early, before it causes massive damage. However, just because the radar exists doesn't mean everyone is using it.

This study, conducted by researchers at Atatürk University in Turkey, is like a "check-in" with 300 women who walked into a university hospital to use that radar. The researchers wanted to understand: Why do some women use the radar regularly, while others hesitate or skip it?

Here is the story of their findings, broken down into simple concepts:

1. The Knowledge Gap: Missing the Map

Think of mammography guidelines as a map showing you the best route to safety. The study found that many women didn't have this map.

The Reality: Only about 36% of the women knew how often they should get checked (the recommended frequency).
The Metaphor: It's like trying to drive to a destination without knowing the speed limit or the turn-by-turn directions. Even if the car (the hospital) is there, people don't know when to start the engine.

2. The Emotional Hurdles: Fear and Pain

Even with a map, some drivers are too scared to get in the car.

The Reality: Over half the women felt anxious about the procedure, and nearly half thought it would be painful.
The Metaphor: Imagine a rollercoaster that you know is safe but looks terrifying. Many women were afraid of the "ride" itself or, more importantly, afraid of what the ride might reveal (the results). Fear of the diagnosis was a top reason for not going.

3. The "Coach" Effect: Who is the Captain?

The study found that the most powerful force in getting women to the radar wasn't a TV ad or a flyer; it was a doctor.

The Reality: Women were 2.5 times more likely to get screened if a physician told them to do it.
The Metaphor: Think of the doctor as a coach on the sidelines. If the coach points at you and says, "You're up! Go play," you are much more likely to run onto the field than if you are just standing in the stands watching. The doctor's voice acts as a strong nudge that overrides fear.

4. The Family Connection: When the Storm Hits Home

The Reality: Women who had a family member (like a mother or sister) who had breast cancer were almost twice as likely to get screened.
The Metaphor: If you see a neighbor's house get hit by a storm, you are much more likely to reinforce your own roof. Personal risk makes the abstract danger feel real and urgent.

5. The Education Factor: Understanding the Rules

The Reality: Women with higher education levels were more likely to get screened.
The Metaphor: Education acts like a flashlight in a dark room. The brighter the light (knowledge), the easier it is to see the path to the exit (screening) and understand why it's necessary.

6. The "First Time" Surprise

Interestingly, many women in the study were getting their first mammogram during this visit.

The Metaphor: It's like a driver who has never bought a ticket before finally deciding to board the train. While this is good news (they are finally on board), it suggests that for many, screening hasn't yet become a regular habit, like brushing teeth. It's still a special event rather than a routine.

The Bottom Line

The researchers conclude that to get more women on board with this life-saving radar, we need to:

Listen to the Coach: Doctors need to be the ones actively encouraging women to get checked.
Light the Way: We need better education to clear up myths about pain and fear.
Focus on the Risk: Remind women that if their family has a history of the storm, they need to be extra vigilant.

The study admits it only looked at women who were already at the hospital, so it might not represent women in remote villages who never make it to the hospital at all. But for the women who do show up, the message is clear: A doctor's recommendation and a clear understanding of the risks are the keys to unlocking the door to early detection.

Technical Summary: Evaluation of Attitudes and Related Factors Regarding Mammography Among Women Participating in Screenings at a University Hospital

Problem Statement
Breast cancer remains the leading cause of cancer-related deaths among women globally and constitutes approximately 24.9% of all female cancers in Turkey. While mammography is the established standard for early detection and mortality reduction, participation rates in Turkey remain suboptimal despite the existence of national screening programs. The study addresses the persistent gap between the availability of screening services and actual uptake, noting that factors such as low education, limited awareness, cultural beliefs, and low health literacy act as significant barriers. The research aims to investigate the specific attitudes, knowledge levels, and sociodemographic factors influencing mammography screening behavior among women attending a university hospital in Eastern Turkey.

Methodology
This research employed a cross-sectional descriptive design involving 300 women aged 40–69 who presented to the radiology department of a university hospital in Eastern Turkey for mammography screening. Participants were selected via convenience sampling. Data collection was conducted through structured, face-to-face interviews using a questionnaire that assessed sociodemographic characteristics, knowledge regarding breast cancer and mammography, attitudes toward the procedure, and screening behaviors.

The study received ethical approval from the Atatürk University Faculty of Medicine Clinical Research Ethics Committee (Approval No: TDK-2023-10251). All participants provided written informed consent. Data analysis was performed using SPSS version 25.0, utilizing descriptive statistics, chi-square tests to examine relationships between variables, and logistic regression analysis to identify significant predictors of mammography uptake.

Key Results
The study population had a mean age of 48.7 ± 6.2 years. The majority of participants were married (82.0%) and held primary or secondary education degrees (58.3%). Key findings regarding knowledge and behavior include:

Knowledge Gaps: Only 36.7% of participants were aware of the recommended frequency for mammography screening.
Attitudes: While 70% agreed that mammography is necessary even without symptoms, significant anxiety was reported, with 53.3% feeling anxious about the procedure and 41.7% considering it painful.
Screening History: 60% of women had undergone at least one mammogram. However, adherence to complementary screening methods was lower, with only 30% reporting a clinical breast examination in the past year and 45% performing regular self-examinations.
Information Sources: Healthcare professionals (40.0%) and television/media (31.7%) were the primary sources of information.
Barriers: Among those not undergoing screening, the most cited reasons were fear of results (30.0%) and lack of time (23.3%).

Statistical analysis revealed significant relationships between mammography behavior and age group ( $p=0.015$ ) and education level ( $p=0.034$ ). Logistic regression identified three significant predictors for mammography uptake:

Age over 50 (OR: 1.85, $p=0.021$ ).
Higher education level (OR: 1.43, $p=0.038$ ).
Previous clinical breast examination (OR: 2.56, $p=0.001$ ).

Additionally, the abstract notes that positive attitudes were associated with physician recommendations (OR: 2.57) and family history of breast cancer (OR: 1.89).

Significance and Claims
The authors position this study as a contribution to understanding the specific barriers and motivators within the Turkish context, particularly in Eastern Turkey. The paper claims that its findings reinforce existing literature indicating that sociodemographic variables—specifically education, family history, and physician recommendations—are crucial determinants of screening engagement.

The study highlights that despite free screening services, participation is hindered by fear of diagnosis, misconceptions, and logistical barriers. The authors assert that their results support the strengthening of primary care roles, specifically through:

Targeted awareness campaigns that emphasize physician encouragement.
Educational interventions tailored to women with lower education levels.
Strategies to address the anxiety and pain associated with the procedure.
Integration of digital health tools (e.g., SMS reminders) to support adherence.

The paper concludes modestly, acknowledging that as a hospital-based study using convenience sampling, its results may not be fully generalizable to rural or underserved populations. It calls for future large-scale, multi-center, and longitudinal studies to validate these findings and guide national policy, rather than proposing immediate new experimental interventions.