%0 Journal Article
%T Wich women do not follow the medical guidelines for breast cancer screening with mammography? Results in the E3N cohort
%A Flamant C
%A Gauthier E
%A Clavel-Chapelon F
%J Revue M¨¦dicale de l'Assurance Maladie
%D 2005
%I 
%X Aims: Sufficient evidence has accumulated to recommend that women over 50 years old be screened for breast cancer with mammography. However, available evidence does not suggest that screening with mammography should also be used in women younger than 50. We need more information on the factors which determine whether or not women follow the screening guidelines in order to more specifically target future public health messages and to help interpret epidemiological data in which some breast cancers have been detected through screening while others have not. Method: We analyzed these determining factors in the E3Ncohort study by calculating the odds ratios of the frequency of non-compliance with the guidelines in the two age groups: younger and older than 50 years. Results: In general, women over 50 years old who did not follow the guidelines had less access to medical care (visited their doctor less often, had fewer tests performed), were less likely to take vitamin supplements and were less health-conscious in general (had a higher BMI and a poorer diet) than women who followed the guidelines, even after adjusting for age and educational level. Women who had a personal or family history of a breast disorder were more likely to follow the guidelines. Not surprisingly, women under 50 who had undergone screening in spite of the guidelines demonstrated the opposite characteristics (greater access to medical care and were more health-conscious in general). Conclusion: Public health messages should be specifically targeted to women who do not follow the guidelines for breast cancer screening. In addition, the factors associated with screening should be considered when interpreting epidemiological studies where some cases may be over-screened and others not.
%K screening
%K mammography
%K risk factor
%K compliance.
%U http://www.ameli.fr/fileadmin/user_upload/documents/Depistage_du_cancer_du_sein.pdf