# Sociodemographic, Behavioral, and Psychosocial Factors Associated With Mammography Screening Uptake Among Women in Saudi Arabia: A Cross-Sectional Survey

## TL;DR

This study explores why many Saudi women do not get mammograms, finding that older age, family history, and self-exams increase screening, while fear of cancer diagnosis decreases it.

## Contribution

The study identifies key sociodemographic, behavioral, and psychosocial predictors of mammography screening uptake in Saudi Arabia.

## Key findings

- 34.7% of surveyed women reported having undergone a mammogram.
- Older age, family history of breast cancer, and monthly self-exams were positively associated with screening.
- Fear of cancer diagnosis was linked to lower screening rates.

## Abstract

Background: Breast cancer is a leading cause of morbidity and mortality among women worldwide. Despite free mammography screening availability in Saudi Arabia, participation rates remain low. This study aimed to identify sociodemographic, behavioral, and psychosocial factors associated with mammography screening uptake among women in Saudi Arabia.

Methodology: A cross-sectional survey was conducted from March to April 2025, involving 487 women aged 18 years and older across Saudi Arabia. Participants completed a questionnaire assessing demographics, health behaviors, breast cancer awareness, and barriers to screening. The primary outcome was self-reported mammogram uptake. Statistical analysis included bivariate tests and multivariable logistic regression.

Results: Out of 487 participants, 169 (34.7%) reported having undergone a mammogram. Screening uptake was higher among women aged ≥40 years (142/267; 53.2%) compared to those <40 years (27/220; 12.3%). Women with a family history of breast cancer were more likely to have been screened (74/121; 61.2%) than those without (95/366; 26.0%). Similarly, 58/97 (59.8%) women performing monthly breast self-examinations reported screening, compared to 111/390 (28.5%) who did not. Fear of cancer detection was reported by 154 participants (31.6%) and was associated with lower screening uptake (39/154, 25.3%) versus those without fear (130/333, 39.0%). Multivariable analysis confirmed age ≥40 years (adjusted odds ratio (aOR) 2.61, P < 0.001), family history (aOR 2.23, P < 0.001), and monthly self-examination (aOR 1.79, P = 0.019) as positive predictors, while fear of diagnosis was negatively associated (aOR 0.56, P = 0.014).

Conclusions: Mammography uptake among women in Saudi Arabia remains suboptimal. Older age, family history, and proactive health behaviors increase screening likelihood, while fear of diagnosis reduces it. Targeted interventions addressing emotional and educational barriers are essential to enhance participation.