Distance to screening site and non-participation in screening for breast cancer: a population-based study

J Public Health (Oxf). 2014 Jun;36(2):292-9. doi: 10.1093/pubmed/fdt068. Epub 2013 Jul 23.


Background: In population-based breast cancer screening programmes, the geographical distance to the screening site may influence a woman's propensity to participate. The aim of this study was to analyse the effect driving distance to the screening unit had on women's participation in a breast cancer screening programme.

Methods: All women invited to the first round of breast cancer screening in the Central Denmark Region were eligible for inclusion (n = 149,234). Information on participation was collected from a regional administrative database. The shortest road distance between each woman's residence and her affiliated screening site was assessed using Network Analyst, ArcGIS.

Results: The unadjusted association between distance and non-participation formed a J-shape curve. Adjustment for socio-demographic characteristics caused the J-shape to disappear, and the probability of non-attendance rose with longer distance to the screening site but flattened after ~45 km. Women without access to a vehicle had a higher risk of non-participation than women with access to a vehicle.

Conclusions: A long road distance to the screening site was associated with an increased risk of non-participation. Women without access to a vehicle were at higher risk of non-participation than women who had access to a vehicle.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Breast Neoplasms / diagnosis*
  • Denmark
  • Female
  • Humans
  • Mass Screening*
  • Middle Aged
  • Patient Participation*
  • Risk Factors
  • Socioeconomic Factors
  • Travel*