Determinants and barriers to mammography screening uptake among Bahraini women: a cross-sectional study in primary healthcare settings

Breast cancer is the most common cancer among women worldwide, and mammography is essential for early detection and improved outcomes. This study assessed attitudes toward mammography screening among Bahraini women aged 40–74 years and identified factors influencing screening uptake. This descriptive analytical cross-sectional study was conducted among 302 randomly selected Bahraini women aged 40–74 years attending primary healthcare centres across Bahrain’s four governorates. Participants were selected using multistage and systematic sampling. Data were collected through face-to-face interviews using a structured questionnaire. Among the 302 participants, 181 (59.9%) had undergone mammography at least once, but only 59 (19.6%) had been screened within the recommended interval. The main barriers were believing mammography was unnecessary (67.9%), lack of physician recommendation (64.4%), insufficient information (42.4%), fear of pain or cancer diagnosis (30.9% each), fear of treatment or mastectomy (27.6%), being asymptomatic (23.4%), embarrassment (23.0%), concerns about radiation (15.6%), and lack of time (10.0%). Screening was significantly associated with age, family history of breast cancer, previous breast-related problems, and receiving a screening invitation from a healthcare provider. In multivariable analysis, receiving a formal screening invitation within the previous two years was strongly associated with higher screening uptake (aOR = 5.23, 95% CI: 2.55–10.72). Women aged ≥50 years, those with a family history of breast cancer, and those with previous breast-related problems were also more likely to undergo screening. Mammography uptake among Bahraini women remains low, particularly regular screening. Culturally tailored health education, systematic screening invitations, and proactive physician recommendations may improve participation. Future research should assess technology- and AI-supported outreach strategies, especially for younger, asymptomatic, and under-screened women.