- Volume 15 Issue 5
DOI QR Code
Screening for Breast Cancer in a Low Middle Income Country: Predictors in a Rural Area of Kerala, India
- Sreedevi, Aswathy (Community Medicine Amrita Institute of Medical Sciences, Ponnekkara P.O Amrita Vishwa Vidyapeetham Kochi) ;
- Quereshi, Mariya Amin (Community Medicine Amrita Institute of Medical Sciences, Ponnekkara P.O Amrita Vishwa Vidyapeetham Kochi) ;
- Kurian, Beteena (Community Medicine Amrita Institute of Medical Sciences, Ponnekkara P.O Amrita Vishwa Vidyapeetham Kochi) ;
- Kamalamma, Leelamoni (Community Medicine Amrita Institute of Medical Sciences, Ponnekkara P.O Amrita Vishwa Vidyapeetham Kochi)
- Published : 2014.03.01
Background: In India, breast cancer is the leading malignancy among women in a majority of the cancer registries. Therefore it is important to understand screening practices and its predictors, including in rural areas with high female literacy and good health indices. Materials and Methods: A cross-sectional study with multistage sampling was conducted in Vypin Block, Ernakulam district, Kerala, India. Four Panchayats (self administration units) were randomly chosen and a woman in every second household was invited to participate from the tenth ward of each. Thus a total of 809 women were interviewed. Results: The majority of the repondents (82.1%) were not aware of risk factors and about a third (37.9%) were not aware of symptoms of breast cancer. About half of the population studied (46.6%) had undergone screening. Age (35-50 years), being married, health professionals as source of information and working were significant predictors of screening. Logistic regression showed that older women (35-50 yrs) were more likely to practice screening. Out of the never screened, about a third (35%) were desirous of doing it, but had not for various reasons and 53.5% were not willing to screen. The reasons identified for not screening among those desirous of doing it were grouped into knowledge 66 (43.4%), resources 23 (15.1%) and psychosocial 32(21.1%) factors. Unmarried women were significantly more likely to express factors related to all the three domains. Conclusions: This study showed that in spite of the absence of a population-based screening program, about half of the study population had undergone some type of screening. The older women (35-50 years) in particular were significantly more likely to practice screening. At this critical juncture, a high quality breast cancer awareness and screening initiative can help to consolidate the gains and tackle knowledge, resource and psychosocial barriers.
- Agarwal AK (2008). Social classification:the need to update in present scenario. Indian J Comm Med, 33, 50-1. https://doi.org/10.4103/0970-0218.39245
- Aswathy S, Sumithra S, Valsala LS, et al (2006). Self reported morbidity and awareness regarding common cancers in elderly women. J Commun Dis, 38, 106-11.
- Berner A, Alwash R, Miller CJ, Denic S, Dun EV (2001). Knowledge, attitudes and practices related to breast cancer screening :a survey of Arabic women. J Cancer Educ, 16, 215-20.
- Bevers TB (2009). Breast awareness:A shift in the paradigm of breast self examination. J Natl Cancer Inst, 7, 10.
- Dahlui M, DanielEHG, Nur AT, et al (2012). Predictors of breast cancer screening uptake:A preintervention community survey in Malaysia. Asian Pac J Cancer Prev, 13, 3443-49 https://doi.org/10.7314/APJCP.2012.13.7.3443
- Dinshaw KA, Shastri SS, Patil SS (2005). Cancer control programme in India: challenges for the new Millennium. Health Adm, 17, 10-13.
- Dunbar J, Begg I, Yasko J, Belle S (1991). Patient education and counseling. ???? 18, 223-30. https://doi.org/10.1016/0738-3991(91)90131-N
- Feldman JG, Carter AC, Nicastri AD, Hosat ST (1981). Breast self examination, relationship to stage of breast cancer at diagnosis. Cancer, 47, 2740-45. https://doi.org/10.1002/1097-0142(19810601)47:11<2740::AID-CNCR2820471133>3.0.CO;2-4
- Ferlay J, Shin HR, Bray F, et al (2010). Estimates of world wide burden of cancer in 2008:GLOBOCAN 2008. Int J Cancer, 127, 2893-29 https://doi.org/10.1002/ijc.25516
- Forounzanfar M, Foreman KJ, Delossantos AM, et al (2011) Breast and cervical Cancer in 187 countries between 1980 and 2010: a systematic analysis. Lancet, 378, 1461-84. https://doi.org/10.1016/S0140-6736(11)61351-2
- 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, 1113-17.
- Hackshaw AK, Paul EA (2003). Breast self examination and death from breast cancer:a metaanalysis. Br J Cancer, 88, 1047-53. https://doi.org/10.1038/sj.bjc.6600847
- Indian Council of Medical Research, National cancer registry programme (2009). Time trends in cancer incidence rates:1982-2005, ICMR, 4, 20.
- Indian Council of Medical Research (2010). National Cancer Registry Programme:Three year report of population based cancer registries, 2006-2008.
- Im EO, Park YS, Lee EO, Yun SN (2004). Korean women's attitudes towards breast cancer screening tests. Int J Nursing Studies, 41, 583-9. https://doi.org/10.1016/j.ijnurstu.2004.01.004
- Jatoi I,Anderson WF (2009). Breast cancer screening: overdiagnosis with screening mammography (2014). Arch Int Med, 169, 999-1000.
- Kosters JP , Gotzsche PC (2008). Regular self examination or clinical examination for early detection of breast Cancer. The Cochrane Collaboration, 4, 1-9.
- Lierman L, Kaspryzk D, Benoliel J (1991). Understanding adherence to breast self examination in older women. Western J Nurs Res, 13, 46-61. https://doi.org/10.1177/019394599101300104
- Moss S (2008). Screening for breast cancer in India-is it an appropriate strategy? J Natl Cancer Inst, 100, 1270-1. https://doi.org/10.1093/jnci/djn303
- NCCN guidelines version1. 2012 accessed on Jan 13, 2013 from www.nccn.org
- Nystrom L (2000). How effective is screening for breast cancer? BMJ, 32, 647-9.
- Okonkwo QL, Draisma G, Kinderen AD, et al (2008). Breast cancer screening policies in developing countries: a cost effectiveness analysis for India. J Natl Cancer Inst, 100, 1290-300. https://doi.org/10.1093/jnci/djn292
- Parsa P, Mirnalini K, Rahman HA, Zulkefli NAM (2006). Barriers for breast cancer screening among Asian women : a mini literature review. Asian Pac J Cancer Prev, 7 509-14.
- Puri S, Mangat C, V Bhatia, et al (2009). Awareness of risk factors and aspects of breast cancer among North Indian women.The Internet J Hlth, 8, 2.
- Rao RS, Nair S, Nair NS, Kamath VG (2005). Acceptability and effectiveness of a breast health awareness programme for rural women in India. Indian J Med Sci, 59, 398-402. https://doi.org/10.4103/0019-5359.16817
- Robert AS, Maira C, Ute-Susan A, et al (2006). Breast cancer in limited resource countries: early detection and access to care. Breast J, 12, 16-26 https://doi.org/10.1111/j.1075-122X.2006.00185.x
- Sankaranarayanan R, Boffeta P (2010). Research on Cancer prevention, detection and management in low -and mediumincome countries, Ann Oncol, 1-9.
- Sankaranarayanan R, Ramadas K, Thara S, et al (2011). Clinical breast examination: preliminary results from a cluster randomized controlled trial in India. J Natl Cancer Inst, 103, 1476-80. https://doi.org/10.1093/jnci/djr304
- Sara IG, Muhammad K, Tooba M, et al (2010). Knowledge, attitude and practice of a Pakistani female cohort towards breast cancer. J Pak Med Assoc, 60, 3.
- Sensiba M, Stewart D (1995). Relationship of perceived barriers to breast self examination in women of varying ages and levels of education. Oncol Nurs Forum, 22, 1265-68.
- Sharon AG (2000). Barriers to breast cancer screening;an integrative review. Health Care Women Int, 21, 53-65. https://doi.org/10.1080/073993300245401
- Silvia CF, Alan AA, Susan L (2012). Global Breast Cancer: The lessons to bring home. Int J Breast Cancer, 2012, 249501.
- Somdutta P, Baridalyne N (2008). Awareness of breast cancer in women of an urresettlement colony. Indian J Cancer, 45, 149-53. https://doi.org/10.4103/0019-509X.44662
- Subramaniam P, Oranye NO, Masri AM, et al (2013). Breast cancer knowledge and screening behavior among women with a positive family history: A cross sectional study. Asian Pac J Cancer Prev, 14, 6783-90. https://doi.org/10.7314/APJCP.2013.14.11.6783
- Tabar L, Fager berg CJ, Gad A, et al (1985). Reduction in mortality from breast cancer after non screening with mammography: Randomized trial from the Breast cancer screening working group of the Swedish National Board of Health and Welfare. Lancet, 1, 829-3
- Takiar R, Vijay CR (2010). An alternative approach to study the changes in the cancer pattern of women in India (1988-2005). Asian Pac J Cancer Prev, 11, 1253-6.2.
- Wu TY, Chung S, Yeh MC, et al (2012). Understanding breast cancer screening practices in Taiwan:a country with Universal health care. Asian pac J Cancer prv, 13, 4289-94. https://doi.org/10.7314/APJCP.2012.13.9.4289
- World Health Organization, Breast cancer: prevention and control, 2013.
- Zahl PH, Maehlen J, Welch HG (2008). The natural history of invasive breast cancers detected by screening mammography. Arch Int Med, 168, 2311-6. https://doi.org/10.1001/archinte.168.21.2311
- Five Year Survival of Women with Breast Cancer in Yazd vol.15, pp.16, 2014, https://doi.org/10.7314/APJCP.2014.15.16.6597
- Breast Cancer Awareness at the Community Level among Women in Delhi, India vol.16, pp.13, 2015, https://doi.org/10.7314/APJCP.2015.16.13.5243
- Breast Cancer Awareness among Middle Class Urban Women - a Community-Based Study from Mumbai, India vol.16, pp.15, 2015, https://doi.org/10.7314/APJCP.2015.16.15.6249
- The Spectrum of Genetic Mutations in Breast Cancer vol.16, pp.6, 2015, https://doi.org/10.7314/APJCP.2015.16.6.2177
- Breast cancer screening among shift workers: a nationwide population-based survey in Korea vol.23, pp.2, 2017, https://doi.org/10.1080/10773525.2018.1425656