Correlation Study of Knowledge and Behavior Regarding Breast Care among Female Undergraduate Students in China

  • Liu, Meng-Xue ;
  • Li, Jian ;
  • Geng, Yun-Long ;
  • Wang, Yan-Chun ;
  • Li, Jie ;
  • Chen, Yu-Juan ;
  • Ali, Gholam ;
  • Tarver, Siobhan L. ;
  • Wen, Yu-Feng ;
  • Sun, Wen-Jie
  • Published : 2015.01.22


Background: This study aimed to understand the relationship between knowledge level and behavior on breast care in Chinese students, so as to provide strategies for improving the health education of breast care and subsequently for aiding in breast cancer prevention. Materials and Methods: A self-designed questionnaire was used to evaluate breast care knowledge level and characterize related behavior. Correlation analysis was conducted for the knowledge level and behavior. The study was carried out using 597 female undergraduate students in medical and non-medical colleges in Wuhu, China. Results: The average score of breast care knowledge was $5.32{\pm}1.68$ ($5.62{\pm}1.68$ and $5.00{\pm}1.68$ for medical and non-medical students, respectively), with a greater score value for sophomores ($5.59{\pm}1.72$) than freshmen ($5.18{\pm}1.65$). The average score of breast care behavior was $2.21{\pm}1.13$, again with a greater value in sophomores ($2.37{\pm}1.15$) than freshmen ($2.21{\pm}1.13$). A significant positive correlation (r=0.231, p<0.01) between knowledge scores and behavior scores was observed. In addition, various factors, including paying attention to breast care information, receiving breast self-examination guidance, TV program and Internet, were found to influence breast care knowledge. Conclusions: In general, female undergraduate students lack of self-awareness of breast care with a low rate of breast self-examination. It is necessary to carry out health education to improve early detection of breast cancer.


China;undergraduate students;breast care;knowledge;behavior


  1. Alwan NA, Al-Attar WM, Eliessa RA, et al (2012). Knowledge, attitude and practice regarding breast cancer and breast self-examination among a sample of the educated population in Iraq. East Mediterr Health J, 18, 337-45.
  2. Anders CK, Hsu DS, Broadwater G, et al (2008). Young age at diagnosis correlates with worse prognosis and defines a subset of breast cancers with shared patterns of gene expression. J Clin Oncol, 2008, 26, 3324-30.
  3. Avci IA (2008). Factors associated with breast self-examination practices and beliefs in female workers at a Muslim community. Eur J Oncol Nurs, 12, 127-33.
  4. Babu GR, Samari G, Cohen SP, et al (2001). Breast cancer screening among females in iran and recommendations for improved practice: a review. Asian Pac J Cancer Prev, 12, 1647-55.
  5. Baxter N (2001). Canadian Task Force on Preventive Health Care. Preventive health care, 2001 update: should women be routinely taught breast self-examination to screen for breast cancer? Can Med Assoc J, 164, 1837-46.
  6. Boulos DN, Ghali RR (2013). Awareness of breast cancer among female students at Ain Shams University, Egypt. Glob J Health Sci, 6, 154-61.
  7. Brennan SF, Cantwell MM, Cardwell CR, et al (2010). Dietary patterns and breast cancer risk: a systematic review and meta-analysis. Am J Clin Nutr, 91, 1294-302.
  8. Celik S, Tasdemir N, Sancak H, et al (2014). Breast cancer awareness among Turkish nursing students. Asian Pac J Cancer Prev, 15, 8941-6.
  9. Dupont WD, Parl FF, Hartmann WH, et al (1993). Breast cancer risk associated with proliferative breast disease and atypical hyperplasia. Cancer, 71, 1258-65.<1258::AID-CNCR2820710415>3.0.CO;2-I
  10. Echavarria MI, Anderson BO, Duggan C, et al (2014). Global uptake of BHGI guidelines for breast cancer. Lancet Oncol, 13, 1421-3.
  11. Erblich J, Bovbjerg DH, Valdimarsdottir HB (2000). Psychological distress, health beliefs, and frequency of breast self-examination. J Behav Med, 23, 277-92.
  12. Gao CM, Ding JH, Li SP, et al (2013). Active and passive smoking, and alcohol drinking and breast cancer risk in Chinese women. Asian Pac J Cancer Prev, 14, 993-6.
  13. Gou YJ, Xie DX, Yang KH, et al (2013). Alcohol consumption and breast cancer survival: a meta- analysis of cohort studies. Asian Pac J Cancer Prev, 14, 4785-90.
  14. Key J, Hodgson S, Omar RZ, et al (2006). Meta-analysis of studies of alcohol and breast cancer with consideration of the methodological issues. Cancer Causes Control, 17, 759-70.
  15. Khakbazan Z, Roudsari RL, Taghipour A, et al (2014), Appraisal of breast cancer symptoms by Iranian women: entangled cognitive, emotional and socio-cultural responses. Asian Pac J Cancer Prev, 15, 8135-42.
  16. Leslie NS, Deiriggi P, Gross S, et al (2003). Knowledge, attitudes, and practices surrounding breast cancer screening in educated Appalachian women. Oncol Nurs Forum, 30, 659-67.
  17. Llic M, Vlajinac H, Marinkovic J, (2013). Cigarette smoking and breast cancer: a case-control study in Serbia. Asian Pac J Cancer Prev, 11, 6643-7.
  18. London SJ, Connolly JL, Schnitt SJ, et al (1992). A prospective study of benign breast disease and the risk of breast cancer. JAMA, 267, 941-4.
  19. Ludwick R, Gaczkowski T (2001). Breast self-exams by teenagers: outcome of a teaching program. Cancer Nurs, 24, 315-9.
  20. Memon ZA, Shaikh AN, Rizwan S, et al (2013). Reasons for patient's delay in diagnosis of breast carcinoma in Pakistan. Asian Pac J Cancer Prev, 14, 7409-14.
  21. Mobarakeh ZS, Mirzaei K, Hatmi N, et al (2014). Dietary habits contributing to breast cancer risk among Iranian women. Asian Pac J Cancer Prev, 15, 9543-7.
  22. Parsa P, Kandiah M, Mohd Zulkefli NA, et al (2008). Knowledge and behavior regarding breast cancer screening among female teachers in Selangor, Malaysia. Asian Pac J Cancer Prev, 9, 221-7.
  23. Samah AA, Ahmadian M, (2014). Relationship between body image and breast self-examination intentions and behavior among female university students in Malaysia. Asian Pac J Cancer Prev, 15, 9499-503.
  24. Sangrajrang S, Chaiwerawattana A , Ploysawang P, et al (2013). Obesity, diet and physical inactivity and risk of breast cancer in Thai women. Asian Pac J Cancer Prev, 11, 7023-7.
  25. Shalini, Varghese D, Nayak M (2011). Awareness and impact of eeducation on breast self examination among college going girls. Indian J Palliative Care, 17, 150-4.
  26. Shen Q, Zhang XJ, Yu YL, et al (2009). Study on a breast-disease screening program and related factors among rural married women at reproductive age in anhui province. Zhonghua Liu Xing Bing Xue Za Zhi, 30, 895-8.
  27. Sundstrom IM, Bixo M, Bjorn I, et al (2001). Prevalence of psychiatric disorders in gynecologic outpatients. Am J Obstet Gynecol, 184, 8-13.
  28. Tazhibi M, Feizi A (2014). Awareness levels about breast cancer risk factors, early warning signs, and screening and therapeutic approaches among Iranian adult women: a large population based study using latent class analysis. Biomed Res Int (in press).
  29. Vithana PV, Hemachandra NN, Ariyaratne Y, et al (2013). Qualitative assessment of breast cancer early detection services provided through well woman clinics in the district of Gampaha in Sri Lanka. Asian Pac J Cancer Prev, 14, 7639-44.
  30. Yoo KB, Kwon JA, Cho E, et al (2013). Is mammography for breast cancer screening cost-effective in both Western and Asian countries?: results of a systematic review. Asian Pac J Cancer Prev, 14, 4141-9.
  31. Zeng H, Zheng R, Zhang S, et al (2014). Female breast cancer statistics of 2010 in China: estimates based on data from 145 population-based cancer registries. J Thorac Dis, 6, 466-70.

Cited by

  1. Association Assessment among Risk Factors and Breast Cancer in a Low Income Country: Bangladesh vol.16, pp.17, 2015,