Association of childhood behavioral inhibition and breast cancer risk perception with breast cancer screening behavior among women aged 20 years and older

BACKGROUND: Breast cancer is the most common cancer among women worldwide, and participation in screening programs plays a key role in reducing breast cancer morbidity and mortality. Psychological factors, including behavioral inhibition and risk perception, may be associated with women's participation in breast cancer screening. This study aimed to examine the association of behavioral inhibition and risk perception with breast cancer screening behavior among women aged over 20 years in Qom, Iran. METHODS: This descriptive-analytical cross-sectional study was conducted among 315 women aged over 20 years selected through multistage cluster sampling. Data were collected using a demographic questionnaire, the Behavioral Inhibition Scale, the Breast Cancer Risk Perception Scale, and the Breast Cancer Screening Behavior Questionnaire. Descriptive statistics, Pearson's correlation coefficient, and binary logistic regression analysis were performed using SPSS version 23. Logistic regression analysis was adjusted for demographic variables, including age, education, income, marital status, and access to health services. Statistical significance was considered at P < 0.05. RESULTS: The mean age of the participants was 34.98 ± 9.41 years. Pearson's correlation analysis showed that breast cancer screening behavior was significantly correlated with behavioral inhibition (r = 0.231, P < 0.001) and risk perception (r = - 0.120, P = 0.030). After adjustment for demographic characteristics, behavioral inhibition remained significantly associated with breast cancer screening behavior (OR = 0.947, 95% CI: 0.910-0.985, P = 0.007). Each one-unit increase in the behavioral inhibition score was associated with a 5.3% decrease in the odds of engaging in breast cancer screening. Age (OR = 1.064, 95% CI: 1.024-1.105, P = 0.001), educational level (OR = 1.349, 95% CI: 1.052-1.730, P = 0.018), and income (OR = 1.649, 95% CI: 1.066-2.549, P = 0.025) were also independently associated with breast cancer screening behavior. In contrast, risk perception was not independently associated with screening behavior after adjustment for the other variables (OR = 1.019, 95% CI: 0.981-1.058, P = 0.334). CONCLUSION: Behavioral inhibition, age, educational level, and income were significantly associated with breast cancer screening behavior among women in this study, whereas risk perception was not independently associated with screening behavior after adjustment for demographic characteristics. These findings suggest that both psychological and socioeconomic factors should be considered when designing interventions to improve breast cancer screening participation. Because of the cross-sectional design, causal inferences cannot be made. Longitudinal and prospective studies are recommended to further examine these associations.