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Breast Cancer Knowledge and Screening Behavior among Female School Teachers in Gaza City

  • Abu-Shammala, Bissan Ismail;Abed, Yehia
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7707-7711
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    • 2015
  • A cross-sectional survey of 370 female teachers working at Governmental schools in Gaza city was conducted. Twenty four schools were selected randomly of all female schools of the city that included primary, preparatory and secondary. In each school all-female teachers aged 35-45 year were invited to fill out a self-administered questionnaire to investigate knowledge and behavior toward breast cancer screening. The survey revealed that more than 75% of women had never undergone clinical breast examination and 60% had never undergone mammography, whereas 62% performed breast self-examination (BSE). Women who performed BSE had significantly higher knowledge about breast cancer screening (P=0.001). Women attending CBE and mammography screening also had significantly higher knowledge (P=0.001). There were significant associations between the practices and presence of positive breast cancer family history (P=0.002) and the level of education of husbands (P=0.024). The oldest women demonstrated higher performance rates of screening methods than the youngest (P=0.001). Lack of breast screening knowledge was identified among more than one third of the women, and 24.6% of women did not know any screening method. About a half of women harboured misconceptions about breast cancer screening, including the belief that breast cancer not treatable. Women residing in Gaza city (P=0.00) and with husbands less educated were more likely to have a high level of misconceptions (P=0.01).

Related Factors to Screening or Repeat Screening for Cervical and Breast Cancer among Women (자궁경부암과 유방암 선별검사 수검 및 반복수검 관련요인 조사)

  • Jeong, Ihn-Sook;Ju, Hyeon-Ok;Bae, Eun-Sook
    • Korean Journal of Women Health Nursing
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    • v.10 no.2
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    • pp.150-161
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    • 2004
  • The importance of screening or repeat screening for cervical and breast cancer is well known to decrease the chance of death from cancer. Few data is avaliable regarding factors associated with participation in cervical and breast cancer screening and repeat screening examinations. This study was to investigate the associations of demographic factors, health status and cancer risk recognition, attitude to cancer screening, health behaviors, and inhibiting or facilitating factors to cervical and breast cancer screening with participation in the screening tests. Data was collected with self-administrated questionnaires from 342 women, aged 40 to 69 years. The cancer screenings were classified into have had or never groups and repeat or not repeated groups. In the case of cervical and breast cancer screening, the have had group was 90 (26.3%), and 82 (24.0%) and the repeat group was 17 (5.0%), and 13 (3.8%) respectively. According to logistic regression analysis, age (<60 vs ${\geq}60$ : OR=3.25, 95% CI=1.27-8.26), breast cancer screening (Do vs Don't : OR=14.49, 95% CI=7.46-27.78) and other person's cancer (Yes vs No : OR=4.27, 95% CI=1.01-18.05) were statistically significantly associated with participation in screening for cervical cancer. Regular exercise (Do vs Don't : OR=2.76, 95% CI=1.30-5.88) and cervical cancer screening (Do vs Don't : OR=13.70, 95% CI=7.09-26.32) were statistically significantly related to participation in screening for breast cancer.

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Knowledge, Barriers and Attitudes Towards Breast Cancer Mammography Screening in Jordan

  • Abu-Helalah, Munir Ahmad;Alshraideh, Hussam Ahmad;Al-Serhan, Ala-Aldeen Ahmad;Kawaleet, Mariana;Nesheiwat, Adel Issa
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3981-3990
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    • 2015
  • Background: Breast cancer is the most common type of cancer in Jordan. Current efforts are focused on annual campaigns aimed at increasing awareness about breast cancer and encouraging women to conduct mammogram screening. In the absence of regular systematic screening for breast cancer in Jordan, there is a need to evaluate current mammography screening uptake and its predictors, assess women's knowledge and attitudes towards breast cancer and screening mammograms and to identify barriers to this preventive service. Materials and Methods: This cross-sectional study was conducted in six governorates in Jordan through face-to-face interviews on a random sample of women aged 40 to 69 years. Results: A total of 507 participants with mean age of $46.8{\pm}7.8$ years were interviewed. There was low participation rate in early detection of breast cancer practices. Breast self-examination, doctor examination and periodic mammography screening were reported by 34.9%, 16.8% and 8.6% of study participants, respectively. Additionally 3.8% underwent breast cancer screening at least once but not periodically, while 87.6% had never undergone mammography screening. Reported reasons for conducting the screening were: perceived benefit (50%); family history of breast cancer (23.1%); perceived severity (21.2%); and advice from friend or family member (5.8%). City residents have shown higher probability of undergoing mammogram than those who live in towns or villages. Results revealed negative perceptions and limited knowledge of study participants on breast cancer and breast cancer screening. The most commonly reported barriers for women who never underwent screening were: fear of results (63.8%); no support from surrounding environment (59.7); cost of the test (53.4%); and religious belief, i.e. Qadaa Wa Qadar (51.1%). Conclusions: In the absence of regular systematic screening for breast cancer in Jordan, the uptake of this preventive service is very low. It is essential for the country of Jordan to work on applying regular systematic mammography screening for breast cancer. Additionally, there is a need for improvement in the current health promotion programmes targeting breast cancer screening. Other areas that could be targeted in future initiatives in this field include access to screening in rural areas and removal of current barriers.

Factors Affecting Breast Cancer Screening Behavior in Japan - Assessment using the Health Belief Model and Conjoint Analysis

  • Tsunematsu, Miwako;Kawasaki, Hiromi;Masuoka, Yuko;Kakehashi, Masayuki
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.6041-6048
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    • 2013
  • Background: Japanese women in their 40s or older have been encouraged to attend breast cancer screening. However, the breast cancer screening rate in Japan is not as high as in Europe and the United States. The aim of this study was to identify psychological and personal characteristics of women concerning their participation in breast cancer screening using the Health Belief Model (HBM). In addition, the attributes of screening more easily accepted by participants were analyzed by conjoint analysis. Materials and Methods: In this cross sectional study of 3,200 age 20-69 women, data were collected by an anonymous questionnaire. Questions were based on HBM and personal characteristics, and included attitudes on hypothetical screening attributes. Data of women aged 40-69 were analyzed by logistic regression and conjoint analysis to clarify the factors affecting their participation in breast cancer screening. Results: Among responses collected from 1,280 women of age 20-69, the replies of 993 women of age 40-69 were used in the analysis. Regarding the psychological characteristics based on HBM, the odds ratios were significantly higher in "importance of cancer screening" (95%CI: 1.21-2.47) and "benefits of cancer screening" (95%CI: 1.09-2.49), whereas the odds ratio was significantly lower in "barriers to participation before cancer screening" (95%CI: 0.27-0.51). Conjoint analysis revealed that the respondents, overall, preferred screening to be low cost and by female staff members. Furthermore, it was also clarified that attributes of screening dominant in decision-making were influenced by the employment status and the type of medical insurance of the women. Conclusions: In order to increase participation in breast cancer screening, it is necessary to disseminate accurate knowledge on cancer screening and to reduce barriers to participation. In addition, the attributes of screening more easily accepted were inexpensive, provided by female staff, executed in a hospital and finished in a short time.

Analysis on Cognitive and Behavioral Factors Associated with the Stage of Change on Breast Cancer Screening Behavior among Women in a Community (일부 중년여성의 유방암 수검행동 변화단계와 인지-행동적 요인간의 관련성 분석)

  • Kim Young-Bok
    • Korean Journal of Health Education and Promotion
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    • v.23 no.2
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    • pp.77-89
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    • 2006
  • Objectives: Recent studies have shown that tailoring to women's individual beliefs and stage of cancer screening adoption increase the probability that cancer screening will ensue. To identify variables associated with cancer screening behavior, many studies for cancer screening have used the Transtheoretical Model(TTM). This study was carried out to identity the cognitive and behavioral factors associated with breast cancer screening by stages of change among women, forties aged. Methods: Building on the TTM constructs, we collected the data to test the association with cognitive and behavioral factors for breast cancer screening by stage of change among women, forties aged (N=232), using the self-reported questionnaire. The stages of change were grouped according to screening participation and intention for breast cancer as precontemplation, contemplation, preparation, action, and maintenance. We found out the association between breast cancer screening and cognitive and behavioral factors, and testified the difference between stages of change by chi-square test, one-way ANOVA, and multiple comparison analysis(Duncan test). Results: Analyses of 232 women showed that participation on mammography was 68.1% within lifetime and 46.1% within last 2 years, and we found out the association with breast cancer screening participation, intention and cognitive-behavioral factors. The stages of change based on participation and intention were different from the decisional balance, the screening attitude, and the self-efficacy(p<0.01). The decisional balance was differ from stages of change because the difference on opinions about pros(positives) and cons(negative) were likely to significant by stages of change(p<0.05, p<0.01). Conclusion: To increase the screening rate for breast cancer, it should be developed the tailored message and recommend guideline. And the tailored message should be designed to increase the pros of breast cancer screening(mammography) and to decrease the cons, and considered the woman's stage of adoption.

Breast Screening in North India: A Cost-Effective Cancer Prevention Strategy

  • Pandey, Saumya;Chandravati, Chandravati
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.853-857
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    • 2013
  • Objectives: Breast cancer is a leading cause of morbidity and mortality in women worldwide. Breast screening in normal and/or asymptomatic women is essential to reduce the burden of breast malignancies. Our study aimed to identify possible risk- and/or co-factors associated with breast screening in North Indian women. Methods: A public health research survey was conducted among 100 women of North Indian ethnicity during clinic visits in a 6-month timeline (April-October 2012). Demographic and clinical data, including mammography screening, were recorded in the questionnaire-based proforma after conducting a 10 minute interview. Written informed consent was taken from all the participants. Results: The mean age of the participants was $32.2{\pm}9.9$ years. Out of 100 women, 6% had family history of breast disease. Breast-related complaints/malignancy, including galactorrhoea, mastitis, axillary lump, fibrocystic disease, fibroadenosis and adenocarcinoma were observed in 41% participants; age stratification revealed that 82.9% of this group (n=41) were <30 years, while 9.7% and 7.3% were >30 years and 30 years of age, respectively. 32% participants underwent mammography screening and 8% had breast ultrasound imaging. Age stratification in the mammography screening group demonstrated that 24 women were <40 years, while 7 women were >40 years. Conclusions: Our pilot study identified possible co-factors affecting breast screening in North Indian women. These findings may be beneficial in early detection of breast abnormalities, including malignancies in women susceptible to breast cancer, and thus aid in future design of cost-effective screening strategies to reduce the increasing burden of breast carcinoma in women worldwide.

Women's Knowledge, Attitudes, and Practices about Breast Cancer in a Rural District of Central India

  • Gangane, Nitin;Ng, Nawi;Sebastian, Miguel San
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.6863-6870
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    • 2015
  • Background: Breast cancer accounted for almost 25% of all cancers in women globally in 2012. Although breast cancer is the most prevalent cancer in India, there is no organised national breast cancer screening programme. Local studies on the burden of breast cancer are essential to develop effective context-specific strategies for an early detection breast cancer programme, considering the cultural and ethnic heterogeneity in India. This study examined the knowledge, attitudes, and practices about breast cancer in rural women in Central India. Materials and Methods: This community-based cross sectional study was conducted in Wardha district, located in Maharashtra state in Central India in 2013. The sample included 1000 women (609 rural, 391 urban) aged 13-50 years, selected as representative from each of the eight development blocks in the district, using stratified cluster sampling. Trained social workers interviewed women and collected demographic and socio-economic data. The instrument also assessed respondents' knowledge about breast cancer and its symptoms, risks, methods of screening, diagnosis and treatment, as well as their attitudes towards breast cancer and selfreported practices of breast cancer screening. Chi-square and t-test were applied to assess differences in the levels of knowledge, attitude, and practice (the outcome variables) between urban and rural respondents. Multivariable linear regression was conducted to analyse the relationship between socio-demographic factors and the outcome variables. Results: While about two-thirds of rural and urban women were aware of breast cancer, less than 7% in rural and urban areas had heard about breast self-examination. Knowledge about breast cancer, its symptoms, risk factors, diagnostic modalities, and treatment was similarly poor in both rural and urban women. Urban women demonstrated more positive attitudes towards breast cancer screening practices than their rural counterparts. Better knowledge of breast cancer symptoms, risk factors, diagnosis, and treatment correlated significantly with older age, higher levels of education, and being office workers or in business. Conclusions: Women in rural Central India have poor knowledge about breast cancer, its symptoms and risk factors. Breast self-examination is hardly practiced, though the willingness to learn is high. Positive attitudes towards screening provide an opportunity to promote breast self-examination.

The National Cancer Screening Program for Breast Cancer in the Republic of Korea: Is it Cost-Effective?

  • Kang, Moon Hae;Park, Eun-Cheol;Choi, Kui Son;Suh, MiNa;Jun, Jae Kwan;Cho, Eun
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2059-2065
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    • 2013
  • This goal of this research was to evaluate the cost-effectiveness of the National Cancer Screening Program (NCSP) for breast cancer in the Republic of Korea from a government expenditure perspective. In 2002-2003 (baseline), a total of 8,724,860 women aged 40 years or over were invited to attend breast cancer screening by the NCSP. Those who attended were identified using the NCSP database, and women were divided into two groups, women who attended screening at baseline (screened group) and those who did not (non-screened group). Breast cancer diagnosis in both groups at baseline, and during 5-year follow-up was identified using the Korean Central Cancer Registry. The effectiveness of the NCSP for breast cancer was estimated by comparing 5-year survival and life years saved (LYS) between the screened and the unscreened groups, measured using mortality data from the Korean National Health Insurance Corporation and the National Health Statistical Office. Direct screening costs, indirect screening costs, and productivity costs were considered in different combinations in the model. When all three of these costs were considered together, the incremental cost to save one life year of a breast cancer patient was 42,305,000 Korean Won (KW) (1 USD=1,088 KW) for the screened group compared to the non-screened group. In sensitivity analyses, reducing the false-positive rate of the screening program by half was the most cost-effective (incremental cost-effectiveness ratio, ICER=30,110,852 KW/LYS) strategy. When the upper age limit for screening was set at 70 years, it became more cost-effective (ICER=39,641,823 KW/LYS) than when no upper age limit was set. The NCSP for breast cancer in Korea seems to be accepted as cost-effective as ICER estimates were around the Gross Domestic Product. However, cost-effectiveness could be further improved by increasing the sensitivity of breast cancer screening and by setting appropriate age limits.

The Results of a Breast Cancer Screening Camp at a District Level in Rural India

  • Reddy, Neha;Ninan, Tilu;Tabar, Laszlo;Bevers, Therese
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6067-6072
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    • 2012
  • Background: Breast cancer in developing countries is on the rise. There are currently no guidelines to screen women at risk in India. Since mammography in the western world is a well-accepted screening tool to prevent late presentation of breast cancer and improve mortality, it is intuitive to adopt mammography as a screening tool of choice. However, it is expensive and fraught with logistical issues in developing countries like India. Materials and Methods: Our breast cancer screening camp was done at a local district hospital in India after approval from the director and administrators. After initial training of local health care workers, a one-day camp was held. Clinical breast examination, mammograms, as well as diagnostic evaluation with ultrasound and fine needle aspiration biopsy were utilized. Results: Out of total 68 women screened only 2 women with previous history of breast cancer were diagnosed with breast cancer recurrence. None of the women in other groups were diagnosed with breast cancer despite suspicious lesions either on clinical exam, mammogram or ultrasound. Most suspicious lesions were fibroadenomas. The average cost of screening women who underwent mammography, ultrasound and fine needle aspiration was $30 dollars, whereas it was $16 in women who had simple clinical breast examination. Conclusions: Local camps act as catalysts for women to seek medical attention or discuss with local health care workers concerns of discovering new lumps or developing breast symptoms. Our camp did diagnose recurrence of breast cancer in two previously treated breast cancer patients, who were promptly referred to a regional cancer hospital. Further studies are needed in countries like India to identify the best screening tool to decrease the presentation of breast cancer in advanced stages and to reduce mortality.

Obesity and Screening Compliance for Breast and Cervical Cancer in Korean Women

  • Park, Jin Kyun;Park, Hyun Ah;Park, Jin Joo;Cho, Young Gyu
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3271-3274
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    • 2012
  • Purpose : This study was performed to assess whether the weight status is associated with screening rates of breast and cervical cancer in Korean women. Methods: Study participants included women aged between 30 and 80 years from the 4th Korea National Health and Nutrition Examination Survey from 2007 to 2009. Body mass index was classified into ${\sim}18.4kg/m^2$ (underweight), $18.5{\sim}22.9kg/m^2$ (normal), $23{\sim}24.9kg/m^2$ (overweight), $25.0{\sim}29.9kg/m^2$ (moderate obesity) and $30.0kg/m^2$~ (severe obesity) according to the Asia Pacific Standards of WHO recommended definition of obesity. Screening rates of breast and cervical cancer were estimated by the recommendation of the National Cancer Screening Program of the National Cancer Center, Korea. Results : The overall screening rates for breast and cervical cancer were 51.3% and 50.1%, respectively. After covariate adjustment, the screening rates for breast cancer (adjusted odds ratio, 0.70; 95% confidence interval, 0.51 to 0.97) and cervical cancer (adjusted odds ratio, 0.71; 95% confidence interval, 0.53 to 0.94) were significantly lower in the women with severe obesity. Conclusion: Obesity is associated with lower compliance with breast and cervical cancer screening guidelines in Korean women.