Prospective study on the determinants of repeat attendance and attendance patterns in breast cancer screening using the theory of planned behaviour

This prospective study, using the Theory of Planned Behaviour (TPB) as a theoretical framework, was carried out to identify the determinants of repeat attendance and attendance patterns in organised breast screening. A group of 2657 women filled out a baseline questionnaire, approximately 8 weeks after having been invited for an initial screening in the Dutch Breast Cancer Screening Programme. Data on actual attendance in second and third screening round were subsequently collected. Personal variables such as family history of breast cancer, breast cancer in someone close and fear of breast cancer were not related to repeat attendance. The TPB variables could explain approximately 17% of the variance in attendance in the second and third round. Maintenance behaviour (consistent attendance vs. dropout) was related to the TPB variables, but the amount of variance explained was only 6%. Initiation of behaviour (consistent refusal vs. delayed attendance) also was related to TPB variables, with a substantially higher amount of explained variance than with maintenance behaviour. Results indicate that the TPB variables are more related to the initiation of screening behaviour than to the maintenance of screening behaviour. Implications of these findings for breast cancer screening are discussed.