***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective To evaluate the effectiveness of contemporary mammography screening using individual information about screening history and breast cancer mortality from public screening programmes . Design Prospect i ve cohort study of Norwegian women who were followed between 1986 and 2009 . Within that period ( 1995 - 2005 ) , a national mammography screening programme was gradually implemented , with biennial invitations sent to women aged 50 - 69 years . Participants All Norwegian women aged 50 - 79 between 1986 and 2009 . Main outcome measures Multiple Poisson regression analysis was used to estimate breast cancer mortality rate ratios comparing women who were invited to screening ( intention to screen ) with women who were not invited , with a clear distinction between cases of breast cancer diagnosed before ( without potential for screening effect ) and after ( with potential for screening effect ) the first invitation for screening . We took competing causes of death into account by censoring women from further follow-up who died from other causes . Based on the observed mortality reduction combined with the all cause and breast cancer specific mortality in Norway in 2009 , we used the CISNET ( Cancer Intervention and Surveillance Modeling Network ) Stanford simulation model to estimate how many women would need to be invited to biennial mammography screening in the age group 50 - 69 years to prevent one breast cancer death during their lifetime . Results During 15 193 034 person years of observation ( 1986 - 2009 ) , deaths from breast cancer occurred in 1175 women with a diagnosis after being invited to screening and 8996 women who had not been invited before diagnosis . After adjustment for age , birth cohort , county of residence , and national trends in deaths from breast cancer , the mortality rate ratio associated with being invited to mammography screening was 0.72 ( 95 % confidence interval 0.64 to 0.79 ) . To prevent one death from breast cancer , 368 ( 95 % confidence interval 266 to 508 ) women would need to be invited to screening . Conclusion Invitation to modern mammography screening may reduce deaths from breast cancer by about 28 % Background . Few prospect i ve studies have examined associations between breast cancer worry and screening behaviours in women with elevated breast cancer risks based on family history . Methods . This study included 901 high familial risk women , aged 23–71 years , from the Ontario site of the Breast Cancer Family Registry .  Self-reported breast screening behaviours at year-one followup were compared between women at low ( N = 305 ) , medium ( N = 433 ) , and high ( N = 163 ) levels of baseline breast cancer worry using logistic regression . Nonlinear relationships were assessed using likelihood ratio tests . Results . A significant non-linear inverted “ U ” relationship was observed between breast cancer worry and mammography screening  ( P = 0.034 ) for all women , where women at either low or high worry levels were less likely than those at medium to have a screening mammogram . A similar significant non-linear inverted “ U ” relationship was also found among all women and women at low familial risk for worry and screening clinical breast examinations ( CBEs ) . Conclusions . Medium levels of cancer worries predicted higher rates of screening mammography and CBE among high-risk women Breast cancer is the most common cancer among women globally . This study was conducted to compare the awareness of breast cancer and the practice of breast self-examination ( BSE ) , clinical breast examination ( CBE ) and mammography screening among rural females in Pahang and Perak . A cross-sectional study was carried out in five selected rural districts of Pahang and Perak . Two hundred and fifty households were r and omly selected and interviewed face to face using a semi-structured question naire . The majority of residents from both states were Malay , aged between 50 and 60 years and had a secondary level of education . Malay women aged 40 - 49 years and women with a higher level of education were significantly more aware of breast cancer ( p<0.05 ) . About half of these women practice d  BSE  ( 60.7 % ) and  CBE  ( 56.1 % ) , and 7 % had underwent mammography screening . The results of this study suggest that women in Pahang and Perak have good awareness of breast cancer and that more than half practice  BSE and CBE .  The women 's level of education appears to contribute to their level of knowledge and health behaviour . However , more effort is needed to encourage all women in rural areas to acquire further knowledge on breast cancer Background Breast cancer screening can reduce morbidity and mortality and improve the survival rate for this malignancy . Low participation in screening programs has been attributable to many factors including lack of knowledge . The aim of this study was to assess breast cancer screening knowledge , attitudes and practice s among women of screening age ( ≥40 years old ) in the city of Al Ain , United Arab Emirates ( UAE ) . Methods A cross-sectional survey was conducted in 2013 using the Breast Cancer Awareness Measure  ( CAM ) . Four out of twelve cultural and religious community centers in Al Ain city were r and omly selected . Two hundred and forty seven women were interviewed . Chi Square test and regression analysis were used to analyze the data . Results Despite the increase in the uptake of screening modalities in our study group , a lack of knowledge about breast cancer screening is still evident . Almost half ( 44.8 % ) of women who never had a Clinical Breast Exam ( CBE ) and 44.1 % of women who never had a mammography expressed a lack of knowledge about the existence of these screening techniques . Nearly one third of the participants interpreted the presence of a breast lump incorrectly and , moreover , expressed fewer worries about the nature of the lump than would normally be expected . Conclusions The National screening program needs to be improved and directed towards more efficient and targeted utilization of re sources . Healthcare professionals play a major role in alerting women to the importance of periodic screening BACKGROUND Breast cancer is the most common type of cancer in Jordan . Current efforts are focused on annual campaigns aim ed at increasing awareness about breast cancer and encouraging women to conduct mammogram screening . In the absence of regular systematic screening for breast cancer in Jordan , there is a need to evaluate current mammography screening uptake and its predictors , assess women 's knowledge and attitudes towards breast cancer and screening mammograms and to identify barriers to this preventive service . MATERIAL S AND METHODS This cross-sectional study was conducted in six governorates in Jordan through face- to-face interviews on a r and om sample of women aged 40 to 69 years . RESULTS A total of 507 participants with mean age of 46.8±7.8 years were interviewed . There was low participation rate in early detection of breast cancer practice s.  Breast self-examination , doctor examination and periodic mammography screening  were reported by 34.9 % , 16.8 % and 8.6 % of study participants , respectively . Additionally 3.8 % underwent breast cancer screening at least once but not periodically , while 87.6 % had never undergone mammography screening . Reported reasons for conducting the screening were : perceived benefit ( 50 % ) ; family history of breast cancer ( 23.1 % ) ; perceived severity ( 21.2 % ) ; and advice from friend or family member ( 5.8 % ) . City residents have shown higher probability of undergoing mammogram than those who live in towns or villages . Results revealed negative perceptions and limited knowledge of study participants on breast cancer and breast cancer screening . The most commonly reported barriers for women who never underwent screening were : fear of results ( 63.8 % ) ; no support from surrounding environment ( 59.7 ) ; cost of the test ( 53.4 % ) ; and religious belief , i.e. Qadaa Wa Qadar ( 51.1 % ) . CONCLUSIONS In the absence of regular systematic screening for breast cancer in Jordan , the uptake of this preventive service is very low . It is essential for the country of Jordan to work on applying regular systematic mammography screening for breast cancer . Additionally , there is a need for improvement in the current health promotion programmes targeting breast cancer screening . Other areas that could be targeted in future initiatives in this field include access to screening in rural areas and removal of current barriers INTRODUCTION Breast cancer is the leading cancer in women today and the major challenge is late presentation then later contributes to poor outcome and high fatality rate .  Mammography is effective in early detection of breast cancer and consequently significantly improves the breast cancer survival . MATERIAL S AND METHODS This cross-sectional study was used to study the knowledge and awareness towards mammogram amongst women aged 15 years old and above . A systemic r and om sampling was applied and information gathered through guided interview by using a structured question naire . RESULTS Eighty-six respondents were recruited . The mean age of respondents was 40.5 years ( SD : 15.51 ) and more than 80 % had secondary and tertiary level of education . The percentage of respondents ever performed mammogram was 10.5 % ( 95 % CI : 4.0%-17.0 % ) . The rate of correct answers was between 8.1 % and 48.8 % . Most of the respondents do not sure the answer ( 45.3%-61.6 % ) rather than wrongly answer ( 4.7%-43.0 % ) . Only about 8 % truly answer that mammogram should be done once in a life . There are 10.5 % of women cl aim ed that mammogram had no serious side effect and not a painful procedure . Nearly half of respondents ( 48.8 % ) correctly mentioned that Mammogram can detect breast cancer in early stage . CONCLUSION Only a small percentage of women ever performed mammogram and there are seriously unaware and poor knowledge pertaining to mammography screening for breast cancer among women in sub urban area . A massive health education campaign through multiple methods and agencies are needed to enhance the knowledge and awareness on mammogram 
    Output:
    
Barriers to mammogram screening were lack of knowledge , embarrassment , fear of cancer diagnosis , perception that breast screening was unnecessary , lack of coping skills and pain during procedure .
Mammogram screening uptake among women in selected communities were generally low .