Access to and participation in breast cancer screening: a review of recent literature

Abstract

Recently, attention has been focused on the incentives for access to and participation in breast cancer screening programs. The Healthy People 2000 health goals for the nation calls for 60% of women aged 50 years and older to have had mammograms and clinical breast exams within the preceding 2 years. To achieve this objective, the incentives for access to and participation in breast cancer screening programs must be identified. The present review examines incentive-based hypotheses dealing with lower socioeconomic status, lack of insurance coverage, physician referral, and self-referral. Policy-oriented solutions that have attempted to correct the disincentives associated with low access and participation were analyzed. The sophistication of screening technology is of primary importance; however, this review provides additional information that can be used to ensure the implementation of quality mammography screening programs.