Mammography examination among women aged 40 years or older in Ghana: evidence from wave 2 of the World Health Organization’s study on global AGEing and adult health multicountry longitudinal study

• Published in: Public health (London) Vol. 181; pp. 40 - 45
• Main Authors: Calys-Tagoe, B.N.L., Aheto, J.M.K., Mensah, G., Biritwum, R.B., Yawson, A.E.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.04.2020; Elsevier Science Ltd
• Subjects: Aging; Belonging; Breast cancer; Breast cancer screening; Cancer screening; Confidence intervals; Correlation analysis; Developing countries; Ethnic groups; Ethnicity; Ghanaian women; Health behavior; Health services utilization; Health status; Help seeking behavior; Informal economy; Longitudinal studies; Mammography; Medical screening; Minority & ethnic groups; Older people; Older women; Regression analysis; Regression models; Risk analysis; Risk factors; Self employment; Statistical analysis; Sub-Saharan Africa; Uptake; WHO SAGE study; Womens health; Ghana; Developing countries; Mammography; Ghanaian women; WHO SAGE study; Sub-Saharan Africa; Breast cancer screening
• ISSN: 0033-3506; 1476-5616
• DOI: 10.1016/j.puhe.2019.11.022

To determine the uptake of mammography among Ghanaian women aged 40 years or older and to examine critical risk factors that influence the uptake. A cross-sectional survey. A nationally representative sample of 2787 women and 1948 men aged ≥18 years were surveyed in the Wave 2 (2014-2015) of the World Health Organization's multicountry study on AGEing and adult health in Ghana. Of the 2787 women aged ≥18 years, data on a total of 2301 women aged ≥40 years were included in this study. Univariable and multivariable logistic regression models were applied to examine critical risk factors for mammogram examination. Of the 2301 women sampled, only 83 (3.61%) ever had mammogram. The odds of mammogram examination were lower for women aged ≥70 years (odds ratio [OR] 0.42, 95% confidence interval [CI]: 0.19, 0.93), being self-employed (OR = 0.21, 95% CI: 0.11, 0.42) and being informal sector employee (OR = 0.26, 95% CI: 0.12, 0.57) in the multivariable analyses. Belonging to the Ewe ethnic group (OR=3.41, 95% CI:1.88, 6.16) compared to the Akan group was associated with increased odds of mammogram examination in the multivariable analysis. Women aged ≥70 years, being self-employed, being an informal employee and belonging to the Ewe ethnic group were independently associated with mammography examination. The prevalence of screening for breast cancer using mammography among Ghanaian women aged 40 years and older was 3.6%. Age, type of employer and ethnicity were associated with an older adult woman's likelihood to access mammography screening. Overall, our study provided critical data to encourage and promote good health-seeking behaviour in terms of breast cancer screening among older adult women. Further qualitative studies are warranted to explore why some of these factors influence mammography. •There is paucity of data on mammogram update.•Little is known about critical risk factors influencing mammogram uptake.•Age, type of employer and ethnicity were critical risk factors for mammogram uptake.•Further qualitative studies are needed to know further reasons for the associations.