Determinants of Participation in a Breast Cancer Screening Trial in Trivandrum District, India

  • 발행 : 2013.12.31


Background: Conspicuous differences in participation rates for breast self-examination (BSE), clinical breast examination (CBE), and referral for further investigations have been observed indicating involvement of a number of different factors. This study analysed determinants for participation in different levels of the breast cancer screening process in Indian females. Materials and Methods: An intervention group of 52,011 women was interviewed in a breast cancer screening trial in Trivandrum district, India. In order to assess demographic, socio-economic, reproductive, and cancer-related determinants of participation in BSE, CBE, and referral, uni- and multi-variate logistic regression was employed. Results: Of the interviewed women, 23.2% reported practicing BSE, 96.8% had attended CBE, and 49.1% of 2,880 screen-positives attended referral. Results showed an influence of various determinants on participation; women who were currently not married or who had no family history of cancer were significantly less likely to attend the screening process at any level. Conclusions: Increasing awareness about breast cancer, early detection methods, and the advantages of early diagnoses among women, and their families, as well as health care workers offering social support, could help to increase participation over the entire screening process in India.


  1. Al-Naggar RA, Al-Naggar DH, Bobryshev YV, et al (2011). Practice and barriers toward breast self-examination among young Malaysian women. Asian Pac J Cancer Prev, 12, 1173-8.
  2. Ali R, Mathew A, Rajan B (2008). Effects of socio-economic and demographic factors in delayed reporting and late-stage presentation among patients with breast cancer in a major cancer hospital in South India. Asian Pac J Cancer Prev, 9, 703-7.
  3. Anyanwu SN, Egwuonwu OA, Ihekwoaba EC (2011). Acceptance and adherence to treatment among breast cancer patients in Eastern Nigeria. Breast, 20, 51-3.
  4. Basu P, Sarkar S, Mukherjee S, et al (2006). Women's perceptions and social barriers determine compliance to cervical screening: results from a population based study in India. Cancer Detect Prev, 30, 369-74.
  5. Cohen M (2006). Breast cancer early detection, health beliefs, and cancer worries in randomly selected women with and without a family history of breast cancer. Psychooncol, 15, 873-83.
  6. Corbex M, Burton R, Sancho-Garnier H (2012). Breast cancer early detection methods for low and middle income countries, a review of the evidence. Breast, 21, 428-34.
  7. Dahlui M, Gan DE, Taib NA, et al (2012). Breast screening and health issues among rural females in Malaysia: How much do they know and practice? Prev Med.
  8. Dinshaw K, Mishra G, Shastri S, et al (2007a). Determinants of compliance in a cluster randomised controlled trial on screening of breast and cervix cancer in Mumbai, India. 1. Compliance to screening. Oncol, 73, 145-53.
  9. Dinshaw K, Mishra G, Shastri S, et al (2007b). Determinants of compliance in a cluster randomised controlled trial on screening of breast and cervix cancer in mumbai, India. 2. Compliance to referral and treatment. Oncol, 73, 154-61.
  10. Dunn RA, Tan A, Samad I (2010). Does performance of breast self-exams increase the probability of using mammography: evidence from Malaysia. Asian Pac J Cancer Prev, 11, 417-21.
  11. Ferlay J, Shin HR, Bray F, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-917.
  12. Gamarra CJ, Paz EP, Griep RH (2009). Social support and cervical and breast cancer screening in Argentinean women from a rural population. Public Health Nurs, 26, 269-76.
  13. Garg P, Bansal M, Garg M, et al (2010). Creating awareness about the painless nature of early breast cancer lump is important in low-income countries. Breast J, 16, 101-2.
  14. Gupta SK (2009). Impact of a health education intervention program regarding breast self examination by women in a semi-urban area of Madhya Pradesh, India. Asian Pac J Cancer Prev, 10, 1113-7.
  15. Khokher S, Qureshi W, Mahmood S, et al (2011). Knowledge, attitude and preventive practices of women for breast cancer in the educational institutions of Lahore, Pakistan. Asian Pac J Cancer Prev, 12, 2419-24.
  16. Kumar YS, Mishra G, Gupta S, et al (2011). Level of cancer awareness among women of low socioeconomic status in Mumbai slums. Asian Pac J Cancer Prev, 12, 1295-8.
  17. Liao MN, Chen PL, Chen MF, et al (2010). Effect of supportive care on the anxiety of women with suspected breast cancer. J Adv Nurs, 66, 49-59.
  18. Luszczynska A, Durawa AB, Scholz U, et al (2012). Empowerment beliefs and intention to uptake cervical cancer screening: three psychosocial mediating mechanisms. Women Health, 52, 162-81.
  19. Meechan GT, Collins JP, Moss-Morris RE, et al (2005). Who is not reassured following benign diagnosis of breast symptoms? Psychooncol, 14, 239-46.
  20. Mittra I (2011). Breast cancer screening in developing countries. Prev Med, 53, 121-2.
  21. Mittra I, Mishra GA, Singh S, et al (2010). A cluster randomized, controlled trial of breast and cervix cancer screening in Mumbai, India: methodology and interim results after three rounds of screening. Int J Cancer, 126, 976-84.
  22. Nene B, Jayant K, Arrossi S, et al (2007). Determinants of womens participation in cervical cancer screening trial, Maharashtra, India. Bull World Health Organ, 85, 264-72.
  23. Pandey M, Thomas BC, Ramdas K, et al (2006). Factors influencing distress in Indian cancer patients. Psychooncol, 15, 547-50.
  24. Panieri E (2012). Breast cancer screening in developing countries. Best Pract Res Clin Obstet Gynaecol, 26, 283-90.
  25. Pisani P, Parkin DM, Ngelangel C, et al (2006). Outcome of screening by clinical examination of the breast in a trial in the Philippines. Int J Cancer, 118, 149-54.
  26. Rasu RS, Rianon NJ, Shahidullah SM, et al (2011). Effect of educational level on knowledge and use of breast cancer screening practices in Bangladeshi women. Health Care Women Int, 32, 177-89.
  27. Sankaranarayanan R, Rajkumar R, Arrossi S, et al (2003). Determinants of participation of women in a cervical cancer visual screening trial in rural south India. Cancer Detect Prev, 27, 457-65.
  28. Sankaranarayanan R, Ramadas K, Thara S, et al (2011a). Clinical breast examination: preliminary results from a cluster randomized controlled trial in India. J Natl Cancer Inst, 103, 1476-80.
  29. Sankaranarayanan R, Swaminathan R, Jayant K, et al (2011b). An overview of cancer survival in Africa, Asia, the Caribbean and Central America: the case for investment in cancer health services. IARC Sci Publ, 257-291.
  30. Silva IT, Griep RH, Rotenberg L (2009). Social support and cervical and breast cancer screening practices among nurses. Rev Lat Am Enfermagem, 17, 514-21.
  31. Sim HL, Seah M, Tan SM (2009). Breast cancer knowledge and screening practices: a survey of 1,000 Asian women. Singapore Med J, 50, 132-8.
  32. Taha H, Halabi Y, Berggren V, et al (2010). Educational intervention to improve breast health knowledge among women in Jordan. Asian Pac J Cancer Prev, 11, 1167-73.
  33. Woodward V, Webb C (2001). Women's anxieties surrounding breast disorders: a systematic review of the literature. J Adv Nurs, 33, 29-41.
  34. Yavari P, Pourhoseingholi MA (2007). Socioeconomic factors association with knowledge and practice of breast selfexamination among Iranian women. Asian Pac J Cancer Prev, 8, 618-22.
  35. Yeole BB, Kumar AV, Kurkure A, et al (2004). Population-based survival from cancers of breast, cervix and ovary in women in Mumbai, India. Asian Pac J Cancer Prev, 5, 308-15.

피인용 문헌

  1. Cancer screening and prevention in low-resource settings vol.14, pp.12, 2014,
  2. What is the Most Effective Strategy for Improving the Cancer Screening Rate in Japan? vol.15, pp.6, 2014,
  3. Effect of Perceived Social Support on Psychosocial Adjustment of Turkish Patients with Breast Cancer vol.15, pp.8, 2014,
  4. Descriptive Epidemiology of Common Female Cancers in the North East India - a Hospital Based Study vol.15, pp.24, 2015,
  5. Breast Cancer Awareness at the Community Level among Women in Delhi, India vol.16, pp.13, 2015,
  6. Breast Cancer Awareness among Middle Class Urban Women - a Community-Based Study from Mumbai, India vol.16, pp.15, 2015,
  7. Predictors affecting breast self-examination practice among undergraduate female students in Klang Valley, Malaysia vol.41, pp.12, 2015,
  8. Should low-income countries invest in breast cancer screening? vol.27, pp.11, 2016,