Factors influencing the utilization of breast cancer screening services in Korean women using Andersen’s behavioral model


  • Hyejin Park Department of Health Sciences, Dongduk Women’s University, Seoul, Republic of Korea




Predisposing factor, Need factor, KNHANES, Enabling factor, Breast cancer screening, Anderson’s behavioral model


Background: Breast cancer is a major health concern worldwide, and timely screening plays an important role in early detection and improved treatment outcomes. In this study, factors influencing the utilization of breast cancer screening services were examined using Andersen’s behavioral model, which is widely known as a framework for research on health services utilization.

Methods: In this cross-sectional study, data from 2,602 women aged 35 and older were analysed.

Results: The results of this study shown that the utilization of breast cancer screening was significantly related to predisposing factors, including age and marital status. Moreover, enabling factors, such as income, were also found to be related to screening utilization. However, need factors, such as perceived health status and limitation of activity, did not show a significant association with the utilization of breast cancer screening services.

Conclusions: This study identified factors significantly associated with the utilization of breast cancer screening among Korean women. The findings of this study will contribute to better understand the factors influencing the utilization of breast cancer screening and the development of policies for breast cancer prevention.


Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209-49.

Dorri S, Olfatbakhsh A, Asadi F. Informational needs in patients with breast cancer with lymphedema: Is it important? Breast Cancer. 2020;14:1178223420911033.

Rezanejad Gatabi Z, Mirhoseini M, Khajeali N, Rezanezhad Gatabi I, Dabbaghianamiri M, Dorri S. The accuracy of electrical impedance tomography for breast cancer detection: a systematic review and meta-analysis. Breast J. 2022;2022:8565490.

Jeong JR, Choe YR. Health-promoting behaviors among middle-aged breast cancer survivors compared with matched non-cancer controls: a KNHANES VI-VII (2013-2018) study. Medicine. 2023;102:e34065.

Guillaume E, Launay L, Dejardin O, Bouvier V, Guittet L, Déan P, et al. Could mobile mammography reduce social and geographic inequalities in breast cancer screening participation? Prev Med. 2017;100:84-8.

Ouanhnon L, Rougé Bugat ME, Lamy S, Druel V, Delpierre C, Grosclaude P. Social and territorial inequalities in breast and cervical cancers screening uptake: a cross-sectional study in France. BMJ Open. 2022;12:e055363.

Rollet Q, Guillaume É, Launay L, Launoy G. Socio-territorial inequities in the French National Breast Cancer Screening Programme- a cross-sectional multilevel study. Cancers. 2021;13:4374.

Ghaedamini Harouni G, Sajjadi H, Rafiey H, Mirabzadeh A, Vaez-Mahdavi M, Mohaqeqi Kamal SH. Current status of health index in Tehran: a multidimensional approach. Med J Islam Repub Iran. 2017;31:29.

Fernandez-Olano C, Hidalgo JD, Cerda-Diaz R, Requena-Gallego M, Sanchez-Castano C, Urbistondo-Cascales L, et al. Factors associated with health care utilization by the elderly in a public health care system. Health Polic. 2006;75:131-9.

Jahangir E, Irazola V, Rubinstein A. Need, enabling, predisposing, and behavioral determinants of access to preventative care in Argentina: analysis of the national survey of risk factors. PLoS One. 2012;7:e45053.

SoleimanvandiAzar N, Mohaqeqi Kamal SH, Sajjadi H, Ghaedamini Harouni G, Karimi SE, Djalalinia S, et al. Determinants of outpatient health service utilization according to Andersen’s behavioral model: a systematic scoping review. Iran J Med Sci. 2020;45:405-24.

Organization for Economic Co-operation and Development. What are equivalence scales? OECD; 2009. Available at: https://www.oecd.org/els/ soc/OECD-Note-EquivalenceScales.pdf. Accessed on 10 January 2023.

Economou A, Nikolaou A, Theodossiou I. Socioeconomic status and health-care utilization: a study of the effects of low income, unemployment and hours of work on the demand for health care in the European Union. Health Serv Manage Res. 2008;21:40-59.

Lemstra M, Mackenbach J, Neudorf C, Nannapaneni U. High health care utilization and costs associated with lower socio-economic status: results from a linked dataset. Can J Public Health. 2009;100:180-3.

Kim K, Casado BL. Preventive health services utilization among Korean Americans. Soc Work Public Health. 2016;31:431-8.

Narcisse MR, Shah SK, Hallgren E, Felix HC, Schootman M, McElfish PA. Factors associated with breast cancer screening services use among women in the United States: An application of the Andersen’s Behavioral Model of Health Services Use. Prev Med. 2023;173:107545.

Kim Y, Alhassan M. Analyzing factors enabling prostate cancer screening behaviors among African American males in the south region using the Andersen’s Behavioral Model of Healthcare Services Utilization. J Prev. 2023;44:253-66.

Vikum E, Krokstad S, Westin S. Socioeconomic inequalities in health care utilisation in Norway: the population-based HUNT3 survey. Int J Equit Health. 2012;11:48.

Zhang X, Wu Q, Shao Y, Fu W, Liu G, Coyte PC. Socioeconomic inequities in health care utilization in China. Asia Pac J Public Health. 2015;27:429-38.

Bazie GW, Adimassie MT. Modern health services utilization and associated factors in North East Ethiopia. PLoS One. 2017;12:e0185381.

Ferrat E, Le Breton J, Djassibel M, Veerabudun K, Brixi Z, Attali C, et al. Understanding barriers to organized breast cancer screening in France: women’s perceptions, attitudes, and knowledge. Fam Pract. 2013;30:445-51.

Rollet Q, Exarchakou A, Launoy G, Merville O, Rubio FJ, Belot A. Functional forms of socio-territorial inequities in breast cancer screening- a French cross-sectional study using hierarchical generalised additive models. Prev Med. 2023;173:107587.




How to Cite

Park, H. (2024). Factors influencing the utilization of breast cancer screening services in Korean women using Andersen’s behavioral model. International Journal Of Community Medicine And Public Health, 11(2), 738–742. https://doi.org/10.18203/2394-6040.ijcmph20240262



Original Research Articles