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Behavioral SciencesBehavioral Sciences
  • Article
  • Open Access

14 February 2025

A Population Survey on Barriers and Facilitators to Breast Cancer Screening Based on the Theoretical Domains Framework

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1
Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
2
Breast Surgery Unit, The Royal Marsden NHS Foundation Trust, Downs Rd, Sutton SM2 5PT, UK
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This article belongs to the Special Issue The Role of Behavioural Science in Improving Public Health

Abstract

Background: In the UK, breast cancer affects 1 in 8 women, accounting for 31% of cancers and 15% of cancer-related deaths in women. In 2023, London’s breast screening coverage was 56%, falling below the NHS target of 70%. This survey assesses psychological and behavioural factors impacting screening attendance. Methods: Using the Theoretical Domains Framework, an online survey including 15 behavioural factors was distributed through a market research company to women eligible for breast screening (aged 47–73) across London and Southeast and West England. Logistic regression was used to predict the impact of behavioural variables on history of attendance and intention to attend future screening opportunities. Results: Of the 922 respondents who returned the full survey, 88.6% intended to attend future screenings, and 88.1% reported previously attending screenings regularly. ‘Behavioural regulation’ had the strongest influence on past attendance (OR = 1.92, p < 0.001) and future intent (OR = 1.56, p = 0.003). Not intending to attend was linked to emotional consequences (OR = 0.68, p = 0.003) and environmental barriers (OR = 0.66, p < 0.001), where OR—Odds Ratio. Conclusions: This survey identifies behavioural factors influencing breast screening participation and screening intention, providing insights that may help design interventions to increase attendance rates.

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