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Worldwide, there has been an increase in the breast cancer mortality rate, with disproportionately high rates in low and middle-income countries. Addressing breast cancer starts with early detection through screening services. In Tanzania, despite being among countries with high rates of breast cancer, screening services uptake has remained low. This study aimed to explore the drivers for breast cancer screening among women accessing health care services at a specialized cancer treatment hospital in Dar es Salaam, Tanzania. We adopted an exploratory case study employing qualitative techniques to analyze the drivers for breast cancer screening among women in Dar es Salaam. We interviewed four groups of respondents: women with breast cancer attending cancer treatment clinics, young women and old women without breast cancer attending cancer screening units, and older women who do not show up for breast cancer screening. From analysis of the in-depth interviews and focus group discussions we found that the drivers for breast cancer screening operate at different levels; individual as a centre of making the decision to be screened, family as an attribute to decide uptake of screening, the society drivers, the healthcare providers related drivers and health facility related drivers. These attributes were found to influence women’s decisions to screen, and the possibility of uptake of breast cancer screening was dependent on family and social motivation. In most instances, women were driven to utilize breast cancer screening when the services were readily available at their neighbouring health facilities. The findings from this study have enlightened that people’s decision about utilizing breast cancer screening services is based not only on perceptions of their risk but also on fellow community members who have survived the disease, the experiences of breast cancer screening services from their networks and the performance of healthcare institutions in delivery of such services. The use of breast cancer survivors’ support groups to promote breast cancer screening services is advocated from the findings of our study.

全球范围内，乳腺癌死亡率呈上升趋势，其中中低收入国家的死亡率畸高。乳腺癌防控始于通过筛查服务实现早期检出。坦桑尼亚虽是乳腺癌高发国家之一，但其筛查服务的普及率仍偏低。本研究旨在探究坦桑尼亚达累斯萨拉姆某专科肿瘤医院就医女性的乳腺癌筛查驱动因素。我们采用探索性案例研究设计，运用定性研究方法分析达累斯萨拉姆女性的乳腺癌筛查驱动因素。访谈共纳入四类受访者：就诊于肿瘤治疗门诊的乳腺癌患者、前往癌症筛查单元就诊的未患乳腺癌的年轻与老年女性，以及未参与乳腺癌筛查的老年女性。通过对深度访谈与焦点小组讨论的资料分析，我们发现乳腺癌筛查的驱动因素可划分为多个层级：以个体作为筛查决策主体的个体层面、影响筛查决策的家庭层面、社会层面驱动因素、与医疗服务提供者相关的驱动因素，以及与医疗机构相关的驱动因素。上述因素均会对女性的筛查决策产生影响，而乳腺癌筛查的参与可能性则取决于家庭与社会的正向激励。多数情况下，当周边医疗机构可便捷提供乳腺癌筛查服务时，女性会更倾向于使用该服务。本研究结果表明，人群对乳腺癌筛查服务的选择不仅基于自身的患病风险认知，还受到社区内乳腺癌康复者、社交网络中他人的筛查体验，以及医疗机构提供此类服务的服务质量的影响。基于本研究结果，我们建议通过乳腺癌康复者支持团体推广乳腺癌筛查服务。