Mental health, mental fatigue and breast cancer screening examination behavior in adult women

Breast cancer has attracted increasing attention recently, because the number of breast cancer patients has increased, and breast cancer has affected some famous people. In Japan, however, the rate of screening examinations for breast cancer remains low and has shown little increase. Various innovations have been introduced to raise the examination rate, but the existence of some kinds of psychosocial problems in examinees may be one reason for the limited effect of these efforts. Here we report a study on the mental health and mental fatigue level of adult women that could affect their behavior of undergoing examinations.
　Questionnaires on breast cancer screening examination behavior were distributed to 5,321 adult women from March to September 2014, and responses were obtained from 1,752 (32.9%). After excluding women under 40 years old and questionnaires with clearly inadequate responses, the subjects of the investigation were 1,047 women.
　Past experience of undergoing breast cancer screening and levels of mental health and mental fatigue using the WHO subjective well-being inventory (SUBI) were investigated. The SUBI consists of two scales for positive affect and negative affect that make up subjective well-being, with 11 subscales (General Well-Being Positive Affect, Expectation-Achievement Congruence, Confidence in Coping, Transcendence, Family Group Support, Social Support, Primary Group Concern, Inadequate Mental Mastery, Perceived Ill-Health, Deficiency in Social Contacts, and General Well-Being Negative Affect). It is used to assess levels of mental health and mental fatigue.
　802 people (51.6 ± 7.97) had undergone examinations in the past, and 245 (49.3 ± 7.29 years old) had not. The group that had never undergone examinations tended to be significantly younger (P < 0.0001). The score for mental health level was significantly higher in the group that had undergone examinations (P = 0.013), but no significant difference was seen in mental fatigue level (P = 0.847). Subjects with poor mental health (score < 31) were significantly less likely to undergo screening examinations (odds ratio (OR) 1.61, 95% confidence interval (CI) 1.112-2.331, P = 0.012). The results of a multivariate analysis of the 11 subscales showed trends of women being less likely to undergo screening examinations with higher scores for Confidence in Coping (OR 1.175, 95% CI 1.026-1.346, P = 0.019), and more likely to undergo screening examinations with higher scores for Family Group Support (OR 0.872, 95% CI 0.777-0.979, P = 0.020).
　Low mental health level was found to be an impediment to the behavior of undergoing breast cancer screening examinations. Among the mental health items, family support and excessive confidence affected the behavior of undergoing examinations. Thus, approaches that raise mental health with that in mind are thought to be necessary.