Predisposing, Enabling and Reinforcing Factors Associated with the Use of Reproductive Cancer Screening among Peruvian Women

Abstract

Breast cancer is a major cause of death for women in Peru, and may soon surpass cervical cancer as the number one cause of cancer mortality among Peruvian women. Yet little is known about the determinants of reproductive cancer screening utilization in low and middle income countries. Data from a survey of risk factors for non-communicable diseases (FRENT), undertaken by the Ministry of Health in four Peruvian cities, was used to investigate variables representing three conceptual categories of barriers to obtaining mammograms, clinical breast exams, and pap smears based on a PRECEDE/PROCEED conceptual framework and previous qualitative work. Regression models revealed stress (predisposing), physician access and insurance (enabling), and marital status and previous child abuse (reinforcing) to be factors associated with screening, with some differences found across outcome and by age. Results provide evidence to direct interventions for increasing reproductive cancer screening in Peru.