Barriers and limitations for undergoing mammography screenings among Kuwaiti women (aged 40-69) attending primary health care centers.

Abstract

Breast cancer is the leading cancer among women in Kuwait, yet mammography screening (MS) uptake remains suboptimal despite the Kuwait National Mammography Screening Program (KNMSP). This study identifies barriers to MS adherence among Kuwaiti women aged 40-69, focusing on sociocultural, knowledge-related, and systemic factors. A cross-sectional study was conducted across five primary healthcare centers in Kuwait (June-August 2023) using semi-structured interviews with 201 women. Data were analyzed via SPSS to assess awareness, attitudes, and screening uptake. Only 25.4% of participants underwent MS within the past two years, with 52.2% never screened. Despite 91.5% being aware of screening programs, 84.6% exhibited poor overall awareness. Key barriers included fear of pain (77.6%) and physical discomfort (76.1%). Younger women (40-49 years) and employed individuals had significantly lower uptake (p = 0.001 and p = 0.004, respectively). Women invited to screen were 61.4% more likely to participate (p < 0.001). Trust in screening programs strongly correlated with adherence (p < 0.001), while conflicting medical advice reduced uptake (p = 0.03). Low MS uptake persists due to fear, discomfort, and gaps in targeted education, despite program awareness. Younger and employed women require tailored interventions. Recommendations include culturally resonant campaigns addressing modesty concerns, pre-screening counseling to alleviate pain-related anxiety, and proactive invitation systems via employer partnerships or automated reminders. Future studies should employ population-based sampling and qualitative.