Determinants of the Use of Breast Cancer Screening Among Women Workers in Urban Mexico

INTRODUCTION: This case-control study aimed to determine critical factors influencing the use of clinical breast examination and mammography among women workers in Monterrey, Mexico. METHODS: We determined case and control status from survey results. Cases were defined in accordance with the guidelines of the Official Mexican Standard as lack of at least one clinical breast examination during the past year by surveyed women. For women older than 40 years, cases were further defined as lack of at least one mammogram in the previous 2 years and, for women older than 50, lack of a mammogram in the previous year. Controls were defined as adherence by surveyed women to these guidelines. Participants (N = 306 clerks aged 18–60) provided information about their practices, knowledge, and perceptions regarding breast cancer screening. Factors identified by odds ratio analysis as significantly different between cases and controls were analyzed by multivariate logistic regression. RESULTS: Survey participants' knowledge about the utility of breast self-examination (odds ratio, 6.0; 95% confidence interval, 1.0–33.9), perception that the health care system has enough equipment and personnel for clinical breast examination (odds ratio, 4.7; 95% confidence interval, 1.7–13.2), and perception that they have enough time to wait for and receive clinical breast examinations (odds ratio, 2.5; 95% confidence interval, 1.1–5.8) significantly predisposed women to use screening services independent of years of formal education, number of pregnancies, number of living children, hours worked per week, and monthly family income. CONCLUSION: Perception of organizational and structural factors played a significant role in screening use. Our findings have implications for the general population, provider practices, community interventions, and future development of strategies to increase use of screening services in similar locales.