Understanding Breast Cancer Screening Practices in Taiwan: a Country with Universal Health Care

Abstract

While the incidence of breast cancer (BC) has been relatively low in Asian countries, it has been rising rapidlyin Taiwan. Within the last decade, it has replaced cervical cancer as the most diagnosed cancer site for women.Nevertheless, there is a paucity of studies reporting the attitudes and practices of breast cancer screening amongChinese women. The aim of this study is to assess Taiwanese women’s knowledge of and attitudes toward BCscreening and to identify potential factors the may influence screening behavior. The study population consistedof a sample of 434 Taiwanese women aged 40 and older. Despite access to universal health care for Taiwanesewomen and the fact that a majority of the women had heard of the breast cancer screening (mammogram, clinicalbreast exams, etc.), the actual utilization of these screening modalities was relatively low. In the current study, themajority of women had never had mammograms or ultrasound in the past 5 years. The number one most reportedbarriers were “no time,” “forgetfulness,” “too cumbersome,” and “laziness,” followed by the perception of noneed to get screened. In addition, the results revealed several areas of misconceptions or incorrect informationperceived by study participants. Based on the results from the regression analysis, significant predictors ofobtaining repeated screening modalities included age, coverage for screening, barriers, self-efficacy, intention,family/friends diagnosed with breast cancer. The findings from the current study provide the potential to buildevidence-based programs to effectively plan and implement policies in order to raise awareness in breast cancerand promote BC screening in order to optimize health outcomes for women affected by this disease.