Patterns and determinants of mammography screening in Lebanese women
Open accessAbstract
The associations of ever using and/or repeating a mammography test with psychosocial and socio-demographic factors were surveyed in 2014 among Lebanese women ≥ 40. A sample of 2400 women was selected across Lebanon. Variables with significant bivariate associations with various types of behaviors were entered in multivariate analysis. Of the total, 105 women (4·4%) had never heard of mammography as a tool for early breast cancer detection. Among the remaining 2295, 45% had ever used it, of whom 10% had obtained it for the first time within the 12 months preceding the survey. Repeaters were 67% of 926 women who had the time opportunity to do so (median lifetime frequency: 2). Older age, higher socio-economic status (SES) and living within the Greater Beirut (GB) area were significantly associated with ever-use. Within GB, psychosocial factors such as perceived susceptibility and benefits were most strongly associated with ever-use. Outside GB, socio-economic advantage seemed to mostly affect ever-use. Only 4% reported opposition from husbands to their mammography, and husband's support was significant for adherence to mammography guidelines mostly outside GB. Higher education emerged also as a significant socio-demographic determinant for ever-repeating in all regions. Perceived comfort of the previous test strongly affected the likelihood of repeating it. Providing mammography free-of-charge may alleviate some obstacles among women with socio-economic disadvantage. Stressing that good results one year do not make the cancer less likely or repeating the test less important, as well as improving the comfort of mammography testing could ensure test repeating.
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Higher perceived seriousness of the disease is associated with screening attendance.
“Higher perceived susceptibility and seriousness of the disease, and personal vulnerability have been associated with screening attendance [11,17,20,21].”
From Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review (2026) · cites this paper as [20]
The Results section (Lifetime mammography use) reports that higher perceived severity was significantly associated with ever-use in the initial analysis. But the Discussion says there was an absence of effect associated with perceived severity after multivariate modeling, so the unqualified claim overstates the finding. (LLM, conf=0.86)
Experimental — accuracy not yet measuredPerceived benefits such as reassurance of not having cancer or detecting cancer at a treatable stage are positively related to cancer screening.
“Perceived benefits such as reassurance of not having cancer or detecting cancer at a treatable stage have been positively related to cancer screening [8,11,14,17,20].”
From Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review (2026) · cites this paper as [20]
The Results (Lifetime mammography use; page unavailable) report that higher perceived benefits were significantly associated with ever having a mammogram. The Methods (Instrument and variables; page unavailable) define those benefits as perceived test efficacy, but do not identify reassurance of not having cancer or detection at a treatable stage as the benefits measured. (LLM, conf=0.85)
Experimental — accuracy not yet measuredPerceived ease of access may facilitate screening attendance at healthcare facilities.
“Conversely, perceived ease of access may facilitate screening attendance at healthcare facilities [20].”
From Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review (2026) · cites this paper as [20]
The Results (Multivariate modeling of mammography-associated behaviors) associate ease of access with ever-use of mammography among Lebanese women both within and outside Greater Beirut. This supports the claim for mammography screening, but the source does not establish the broader claim about screening attendance at healthcare facilities generally. (LLM, conf=0.83)
Experimental — accuracy not yet measuredHigher perceived susceptibility is associated with screening attendance.
“Higher perceived susceptibility and seriousness of the disease, and personal vulnerability have been associated with screening attendance [11,17,20,21].”
From Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review (2026) · cites this paper as [20]
Personal vulnerability is associated with screening attendance.
“Higher perceived susceptibility and seriousness of the disease, and personal vulnerability have been associated with screening attendance [11,17,20,21].”
From Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review (2026) · cites this paper as [20]
Perceiving the monetary screening cost as acceptable is positively associated with BC screening attendance.
“Perceiving the monetary screening cost as acceptable has been associated positively with BC screening attendance [20].”
From Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review (2026) · cites this paper as [20]
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Cited by
Sorted by citations
Vallone, F., Lemmo, D., Martino, M. L., Donizzetti, A. R., Freda, M. F., Palumbo, F., Lorenzo, E., D’Argenzio, A., & Caso, D. (2022) · Psycho-Oncology · doi:10.1002/pon.5997 · Cited by 65 · see citing works
Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review
Palsola, M., Likki, T., Snijders, V., Corbex, M., Lasierra, L., & Curtis, B. (2026) · Glasnik javnog zdravlja · doi:10.5937/serbjph2601086p
- Authors
- Elias, N., Bou-Orm, I. R., & Adib, S. M.
- Affiliations
- Saint Joseph University (LB)
- American University of Beirut (LB)
- Corresponding author
- Bou-Orm, Ibrahim R.
- Venue
- Preventive Medicine Reports
- Publisher
- Elsevier BV
- Published
- 2017-03
- Volume
- 5
- Pages
- 187-193
- ISSN
- 2211-3355 (ISSN-L)
- PMC
- PMC5219635
- OpenAlex
- W2566133758
- Cited by
- 31
- References
- 0
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1 · 2023: 6 · 2022: 4 · 2021: 5 · 2020: 5 · 2019: 3 · 2018: 3 · 2017: 1
- FWCI
- 1.26
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Preventive Medicine Reports (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Queen Margaret University Publications Repository (Queen Margaret University) (submittedVersion, cc-by-nc-nd)
- Funders
- Roche-International
- Topics
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Digital Radiography and Breast Imaging
- Keywords
- mammography screening, breast cancer screening, screening uptake, screening adherence, repeat screening, perceived susceptibility, perceived benefits, socioeconomic status, husband support, educational attainment, Lebanese women, Greater Beirut
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