Breast cancer worry, risk level, and knowledge, attitudes, and screening practices among women attending healthy life centers in Türkiye: a cross-sectional study

BACKGROUND: Breast cancer is the most common cancer among women worldwide and a leading cause of cancer-related mortality. Although early detection through screening significantly reduces mortality, participation in screening programs remains suboptimal in many settings, including Türkiye. This study aimed to assess breast cancer worry (BCW), perceived risk, knowledge, attitudes, and screening behaviors among women attending Healthy Life Centers (HLCs), and to identify factors associated with participation in breast cancer screening. METHODS: This cross-sectional study was conducted between May and September 2024 among women aged 18 years and older attending a Healthy Life Center. Of the 802 women approached, 518 agreed to participate (response rate: 64.6%). Data were collected through face-to-face interviews, with responses recorded using a structured questionnaire via Google Forms and included 45 items along with the 6-item Breast Cancer Worry Scale. Descriptive statistics, chi-square tests, Student's t-test, and Mann-Whitney U test were used for bivariate analyses. Multivariate logistic regression analysis was performed to identify independent predictors of mammography participation. RESULTS: A total of 518 women participated (mean age: 35.3 ± 8.7 years), with 66.9% under the age of 40. While 42.9% reported ever performing breast self-examination, only 12.1% practiced it regularly. Clinical breast examination was reported by 24.7% of participants, and 28.1% had undergone mammography. The overall BCW level was low (mean score: 4.1 ± 5.1), with 88.6% of women classified as having low worry. In multivariate analysis, breast cancer worry was identified as an independent predictor of mammography participation (OR: 1.07, 95% CI: 1.02-1.12, p = 0.006), whereas sociodemographic and reproductive factors were not significant after adjustment. CONCLUSIONS: Despite relatively high levels of awareness, participation in breast cancer screening remains limited. Emotional factors, particularly breast cancer worry, appear to play a more prominent role in screening behavior than traditional sociodemographic variables. Interventions should integrate both informational and psychosocial components. Healthy Life Centers may serve as key platforms for improving screening uptake through structured, culturally sensitive, and emotionally supportive approaches.