ArticleBMC women's health2025
Mammography attendance in China's national breast cancer screening program: a county-level analysis of the Fujian province.
Article in BMC women's health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMissed mammography attendance among women screened positive is one of the main challenges facing breast cancer screening program. We sought to analyze county-level mammography non-attendance rates and the spatiotemporal differences in Fujian, China, and to explore factors associated with non-attendance.
methodsWe used county-level non-attendance rates calculated from the Fujian Provincial Maternal and Child Health Information System (2021-2023), complemented by information from the Fujian Provincial Statistical Yearbooks. Theil Indices were used to analyze county-level disparities of non-attendance. Multivariable regressions were used to identify variables associated with non-attendance, with spatiotemporal heterogeneity examined using a geographic temporal weighted regression.
resultsThe average county-level mammography non-attendance rate in Fujian decreased from 43.85% in 2021 to 26.89% in 2023. The Theil-T and Theil-L Indices of county-level non-attendance rates over the three years were 0.4 and 0.29, respectively. Per capita GDP was negatively associated with mammography non-attendance in most counties in Fujian, while urbanization rate and in-house mammography capacity showed a positive association in the southwest. Over time, the spatial effects of these factors weakened.
conclusionWhile mammography non-attendance rates declined in recent years in Fujian, persistent geographical disparity shown in this study indicates the importance of addressing service and information gaps. It is likely helpful to integrate the information system and service delivery across counties in breast screening programs to address effects of potentially higher mobility in the western and poverty in the northern parts of Fujian. Considering the geographically varied effects of such factors, we also suggested a classified approach be adopted to improve mammography attendance. These findings underscore the need to incorporate local contextual factors, such as socioeconomic conditions and health resource availability, into both research and policy-making to better understand and reduce spatial disparities in screening adherence.
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