Research Article| Volume 135, P27-33, May 2020

Reduction from 2011 to 2017 in adherence to breast cancer screening and non-improvement in the uptake of cervical cancer screening among women living in Spain


      • The adherence rate for mammography was below the recommended 70 % in 2017.
      • This percentage adherence rate for mammography had decreased from 2011.
      • The figures for cervical cancer screening were over 70 % and stable over time.
      • Negative factors predicting adherence to screening included non-healthy lifestyle behaviors.
      • Immigrant women had a lower uptake of both tests than did Spanish-born women.



      To analyze the uptake of breast and cervical cancer screening according to the 2017 Spanish National Health Survey (SNHS), to compare uptake rates with those obtained in the previous SNHS 2011 and to identify predictors for the uptake for these two screening tests.

      Study design

      Cross-sectional study.

      Main outcome measures

      Uptake rates of breast cancer and cervical cancer screening were analyzed for women aged 40–69 and aged 25–65 years, respectively. Independent variables included sociodemographic characteristics and factors related to health status and lifestyle.


      We found that 66.8 % of women aged 40–69 years had undergone mammography in the previous two years. Positive predictors for mammography uptake were age (50–69 years); marital status (married); Spanish nationality; university education; one or more chronic diseases; no alcohol consumption; physical activity; body mass index <30 kg/m2; and not smoking. We observed that 73.0 % of women aged 25–65 years had undergone cervical cytology screening in the previous three years. Positive predictors for uptake were age (25–52 years); marital status (married); Spanish nationality; middle-high educational level; no chronic diseases; no alcohol consumption; physical activity; body mass index <30 kg/m2; and not smoking. There was a significant decrease in the uptake rate for breast cancer screening from the previous SNHS 2011 (OR 0.89; 95 % CI 0.83–0.94).


      The adherence rate for mammography in Spain in 2017 was below the recommended 70 % and was significantly lower than in 2011. The figures for cervical cancer screening were over 70 % and stable over time.


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