Non-participation in breast screening in Denmark: Sociodemographic determinants

Background Internationally, non-participation in breast screening increased with decreasing level of education indicating importance of information campaigns to enhance awareness of screening. However, in Denmark in the 1990s the association between education and non-participation was U-shaped. We therefore analyzed recent Danish data. Methods Data derived from the Capital Region of Denmark, biennial, organized breast screening program 2008–2020, where women aged 50–69 were personally invited to screening. Non-participation was measured as number of women with no participation out of women eligible for at least three invitations. Sociodemographic determinants were identified by linkage to public registers. Results were reported as mutually adjusted odds ratios (OR) of non-participation including 95% confidence intervals (CI). Results Among 196,085 women, 86% participated. Using women with low education as baseline, the OR for professional bachelors was 0.78; and for academics 0.88. The strongest determinants of non-participation were being non-married OR 1.95; born outside Denmark OR 1.53; being self-employed OR 1.69; retired OR 2.40; on public support OR 2.90; or having co-morbidity OR 1.25. Conclusion The U-shaped association between education and non-participation in breast screening prevailed but with small differences. Other recent data support a diminishing impact of education on screening participation in well-educated populations with organized programs.