Coyle C, Kinnear H, Rosato M, Mairs A, Hall C, O'Reilly D
Registrar in Public Health, Public Health Agency, Belfast.
Post Doctoral Research Fellow, Centre for Public Health, Queen's University Belfast
J Med Screen. 2014 Jun;21(2):98-103. doi: 10.1177/0969141314533677. Epub 2014 May 6.
Analysis of screening uptake usually dichotomizes women into attenders and non-attenders, though many women respond positively to some but not all invitations. This paper studies these intermittent attenders.
A cohort of 8,571 women invited for consecutive breast screens in the Northern Ireland Breast Screening Programme were followed in a study linking screening and census records. Multivariate logistic analysis was used to analyze the characteristics of those who attended both times (consistent), once (intermittent or 'one-time only'), or not at all (non-attenders).
Overall, 15.5% of women attended once and 13.4% were non-attenders. Non-attenders were characteristically disadvantaged (as measured by social renting, car access, and employment status), less likely to be married, and more likely to be healthy. One-time attenders were younger, and suffering poor health, though there was no association with either social renting or employment status. Privately rented accommodation and city living was associated with both one-time attendance and non-attendance.
One-time attenders are an important and distinct subgroup of screening invitees in this analysis. Their distinct characteristics suggest that transitory factors, such as change in marital status, ill-health, or addressing difficulties through change of residence are important. These distinct characteristics suggest the need for different approaches to increase attendance, among both intermittent attenders and those not attending at all.
筛查参与情况分析通常将女性分为参与者和非参与者，然而许多女性对部分而非全部邀请做出了积极回应。本文研究这些间歇性参与者。
在一项将筛查记录与人口普查记录相联系的研究中，对北爱尔兰乳腺癌筛查项目中连续接受乳腺癌筛查邀请的8571名女性队列进行了跟踪。采用多变量逻辑分析来分析那些两次都参加（持续参与者）、参加过一次（间歇性参与者或“仅参加过一次”）或根本未参加（非参与者）的女性的特征。
总体而言，15.5%的女性参加过一次筛查，13.4%为非参与者。非参与者的特征是处于不利地位（以社会租赁、是否有车以及就业状况衡量）、结婚可能性较低且更可能健康。仅参加过一次筛查的女性更年轻且健康状况较差，不过与社会租赁或就业状况均无关联。私人租赁住房和城市居住与仅参加过一次筛查以及未参加筛查均有关联。
在本分析中，仅参加过一次筛查的女性是筛查受邀者中一个重要且独特的亚组。她们独特的特征表明，诸如婚姻状况变化、健康不佳或通过改变居住地址解决困难等短暂因素很重要。这些独特特征表明，对于增加间歇性参与者和根本未参与者的参与率，需要采取不同的方法。
