Change in mammography screening attendance after removing the out-of-pocket fee: a population-based study in Sweden (2014-2018).

Content Provider	Europe PMC
Author	Lagerlund, Magdalena Åkesson, Anna Zackrisson, Sophia
Abstract	PurposeTo assess the change in mammography screening attendance in Sweden—overall and in sociodemographic groups at risk of low attendance—after removal of the out-of-pocket fee in 2016.MethodsIndividual-level data on all screening invitations and attendance between 2014 and 2018 were linked to sociodemographic data from Statistics Sweden. Odds ratios and 95% confidence intervals (CIs) for attendance by time period and sociodemographic factor were computed using mixed logistic regression to account for repeated measures within women. The study sample included 1.4 million women, aged 40–75, who had a mammography screening appointment in 2014–2015 and/or 2017–2018 in 14 of Sweden’s 21 health care regions.ResultsOverall screening attendance was 83.8% in 2014–2015 and 84.1% in 2017–2018 (+ 0.3 percentage points, 95% CI 0.2–0.4). The greatest increase in attendance was observed in non-Nordic women with the lowest income, where attendance rose from 62.9 to 65.8% (+ 2.9 points, 95% CI 2.3–3.6), and among women with four or more risk factors for low attendance, where attendance rose from 59.2 to 62.0% (+ 2.8 points, 95% CI 2.2–3.4).ConclusionScreening attendance did not undergo any important increase after implementing free screening, although attendance among some sociodemographic groups increased by almost three percentage points after the policy change.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8492563&blobtype=pdf
ISSN	09575243
Journal	Cancer Causes & Control
Volume Number	32
DOI	10.1007/s10552-021-01476-4
PubMed Central reference number	PMC8492563
Issue Number	11
PubMed reference number	34322823
e-ISSN	15737225
Language	English
Publisher	Springer International Publishing
Publisher Date	2021-07-28
Publisher Place	Gewerbestrasse 11, Cham, Ch 6330, Switzerland
Access Restriction	Open
Rights License	Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2021
Subject Keyword	Mammography Breast cancer screening Women’s health Socioeconomic aspects of health
Content Type	Text
Resource Type	Article
Subject	Cancer Research Oncology