Determining the Awareness of and Compliance with Breast Cancer Screening among Turkish Residential Women

Background: Breast cancer is the leading cause of cancer-related deaths in women. Despite being associatedwith high morbidity and mortality, breast cancer is a disease that can be diagnosed and treated early. Materialsand Methods: In this cross-sectional study of 321 women, data were collected by Questionnaire, Breast CancerRisk Assessment Form and Champion’s Health Belief Model Scale. Mann-Whitney U, Kruskal-Wallis, Chisquaredtests and logistic regression were used in the statistical analysis. Results: It was found that only 2.2%of women have high and very high risk levels of breast cancer risk. There is a positive correlation between earlydiagnosis techniques and Health Belief Model Sub-Dimension scores which are sensibility, health motivation,BSE (Breast self-examination) self-efficient perception and negative correlation between mammography barrierscore and BSE barrier score (p 0.05). When factors for not having BSE were examined, it was determined thatthe women who do not have information about breast cancer and the women who smoke have a higher risk ofnot having BSE. Conclusions: It is important to determine health beliefs and breast cancer risk levels of womento increase the frequency of early diagnosis. Women’s health beliefs are thought to be a good guide for planninghealth education programs for nurses working in this area.     

Beliefs and Behaviors of Breast Cancer Screening in Women Referring to Health Care Centers in Northwest Iran According to the Champion Health Belief Model Scale

Background: Breast cancer is the most common cancer in women. All ages are susceptible and more than90% of the patients can be cured with early diagnosis. Breast self-examination (BSE) and mammography can beuseful for this aim. In this study we examined the components of the Champion health belief model to identifyif they could predict the intentions of women to perform such screening. Materials and Methods: A total of380 women aged 30 and above who had referred to health-care centers were assessed for use of breast cancerscreening over the past year with a modified health belief model questionnaire. Logistic regression was appliedto identify leading independent predictors. Results: In this study 27% of the women performed BSE in thelast year but only 6.8% of them used mammography as a way of screening. There were significant differencesregarding all components of the model except for perceived severity between women that underwent BSE. overthe past year and those that did not. Findings were similar for mammography. Regression analysis revealedthat intentions to perform BSE were predicted by perceived self-efficacy and perceived barriers to BSE whileintentions to perform mammography were predicted by perceived barriers. Conclusions: This study indicatedthat self-efficacy can support performance of BSE while perceived barriers are important for not performingboth BSE and mammography. Thus we must educate women to increase their self-efficacy and decrease theirperceived barriers.     

Beliefs,Attitudes, and Behavior of Turkish Women about Breast Cancer and Breast Self-Examination According to a Turkish Version of the Champion Health Belief Model Scale

Background: Breast cancer (BC) is one of the most common cancer affecting women worldwide. Although agreat deal of progress has been made in the health sciences, early diagnosis, and increasing community awareness,breast cancer remains a life-threatening illness. In order to reduce this threat, breast cancer screening needs tobe implemented in all communities where possible. Objective: The purpose of this study was to examine healthbeliefs, attitudes and behaviors about breast cancer and breast self-examination of Turkish women. Methods:Data were collected from a sample of 656 women, using an adapted Turkish version of Champion’s Health BeliefModel Scale (CHBMS), between January and May 2011, in Ordu province of Turkey. Results: The results showedthat 67.7% of women had knowledge about and 55.8% performed BSE, however 60.6% of those who indicatedthey practiced BSE reported they did so at irregular intervals. CHBMS subscales scores of women accordingto women’s age, education level, occupation, family income and education level of the women’s mothers, familyhistory of breast cancer, friend and an acquaintance with breast cancer, knowledge about breast cancer, BSEand mammography were significantly different. Conclusion: Knowledge of women about the risks and benefitsof early detection of breast cancer positively affect their health beliefs, attitudes, and behaviors. Health careprofessionals can develop effective breast health programs and can help women to gain good health behaviorand to maintain health.     

Impact of a Health Education Intervention Program Regarding Breast Self Examination by Women in a Semi-Urban Area of Madhya Pradesh,India

Background: Breast cancer is the most common carcinoma in the world and the second most prevalent inIndian females. Over 0.7 million new cases of carcinoma breast are detected every year globally, with nearly 0.3million deaths, affecting 28 per 100,000 females in the age group of 35 to 60 years. Breast self examination(BSE) can detect 40% of breast lesions. The present study aimed to assess the impact of a health educationintervention program about breast self examination (BSE) among women in a semi-urban area in MadhyaPradesh, India. Methodology: The study was carried out in three phases; pre-intervention phase, interventionphase, and post-intervention phase. A total of 1000 women were included. Interventional health education inthe form of a lecture, pamphlets, flip charts and demonstration of the five step method of breast self examinationusing audio-visual aids was administrated. Results: There was a significant improvement in knowledge regardingall aspects of breast self examination of the intervention group from pre- to post-test. After the interventionprogram, 590 (59%) women had good knowledge and among them 90.7% practiced (BSE) compared to 0%pre-test. An overall increase in the awareness of 43% and 53% of BSE practice was observed in the study groupafter intervention. Seven cases of breast disease were detected in which two were breast carcinoma and fivewere fibroadenomas. Conclusion: The knowledge and practices of women toward breast self examination forearly detection were observed to be inadequate in respondents but there was a significant improvement afterthe intervention. Health education programs through various channels to increase the awareness and knowledgeabout BSE are the need of the hour. Mass media cancer education should promote widespread access toinformation about early detection behavior.     

Is Health Locus of Control a Modifying Factor in the Health Belief Model for Prediction of Breast Self-Examination?

Background: Breast cancer is one of the most common cancers among women in the world. Early detection is necessary to improve outcomes and decrease related costs. The aim of this study was to assess the predictive power of health locus of control as a modifying factor in the Health Belief Model (HBM) for prediction of breast self-examination. Materials and Methods: In this cross- sectional study, 400 women selected through the convenience sampling from health centers. Data were collected using part of the Champion's HBM scale (CHBMS), the Health Locus of Control Scale and a self administered questionnaire. For data analysis by SPSS the independent T test, Chi square test, logistic and linear regression modes were appliedl. Results: The results showed that 10.9% of the participants reported performing BSE regularly. Health locus of control did not act as a predictor of BSE as a modifying factor. In this study, perceived self-efficacy was the strongest predictor of BSE performance (Exp (B) =1.863) with direct effect, while awareness had direct and indirect influence. Conclusions: For increasing BSE, improvement of self-efficacy especially in young women and increasing knowledge about cancer is necessary.     

Breast cancer early detection, health beliefs, and cancer worries in randomly selected women with and without a family history of breast cancer

BACKGROUND: Early detection practices (EDP) consist of clinical breast examination (CBE) and mammography. Breast self-examination (BSE) is no longer generally recommended, but many women still perform it. AIMS: To compare EDP, health beliefs, and cancer worries in women with and without a family history of breast cancer in a population-based sample. METHODS: 489 women aged 21-60 were randomly sampled from the entire Jewish female population of Israel; 61 (12.5%) had a family history of breast cancer. Participants answered questionnaires by phone, including demographic details, EDP performance, health beliefs, and cancer worries. RESULTS: Rates of CBE were similar in women with and without a family history (p>0.05). For women over 40, rates of undergoing mammography screening were similar (p>0.05), but regular attendance was reported more by women with a family history (p<0.05). More women under 40 with a family history of breast cancer attended mammography (p<0.05), but only about 14% had ever undertaken mammography screening and 27% had ever undertaken CBE. More than 50% of the women had performed BSE, while significantly more women with a family history reported its over-performance (p<0.01). Women with a family history reported higher perceived susceptibility (p<0.01), higher cancer worries (p<0.05), and fewer barriers to mammography (p<0.05). According to logistic regression analysis, higher odds of EDP were significantly related to perceiving fewer barriers and having higher cancer worries. A positive family history was related to higher odds of women undergoing mammography. Perceived susceptibility was significantly related to higher odds of BSE only. Over-performance of BSE was significantly related to having a positive family history, higher susceptibility, and higher cancer worries. CONCLUSIONS: (1) A high rate of women did not undergo CBE or mammography screening. Women under 40 with a family history of breast cancer who have never undergone CBE or mammography merit special attention. (2) The change in guidelines on BSE necessitates further study of its over-performance in relation to cancer worries. (3) Interventions are needed to promote attendance for CBE and mammography in younger women with a positive family history.     

The Effect of Education on the Early Diagnosis of Breast and Cervix Cancer on the Women’s Attitudes and Behaviors Regarding Participating in Screening Programs

The objective of this paper was to define the effect of education on the early diagnosis of breast and cervix cancer on the women?s attitudes and behaviors regarding participating in Cancer Early Diagnosis, Screening and Training Centers-CEDSTC screening programs. This semi-experimental study was completed with 342 women. The data were collected with forms “Champion’s Health Belief Model Scale Breast Cancer-HBMSBC” and “Health Belief Model Scale for Cervical Cancer and the Pap Smear Test-HBMSCCPST.” When the women’s health beliefs before and after 6 months of the education about the early diagnosis of breast and cervical cancers are considered, it is seen that the HBMSBC subscales health motivation, breast self-examination (BSE), and evasion to mammography (MMG) decreased and BSE self-efficacy and MMG benefit attitudes increased and HBMSCCPST subscales pap smear benefit attitudes increased and evasion to pap smear attitude decreased (p < 0.05). Six months after the education, 28.4% of the women had undergone MMG, 69.9% had performed BSE, and 33.6% had undergone a pap smear test. Education regarding early diagnosis of breast and cervix cancer was found to have positive effects on the health behaviors of the women related to BSE, MMG, and pap smear tests. The women require professional education program for increasing their attitudes and behaviors for CEDSTC screening programs. We suggest regularly providing education to increase participation in early screening programs.     

Breast cancer prevention and control programs in Malaysia

Breast cancer is the most common cancer in Malaysian females. The National Cancer Registry in 2003 and 2006 reported that the age standardized incidence of breast cancer was 46.2 and 39.3 per 100,000 populations, respectively. With the cumulative risk at 5.0; a woman in Malaysia had a 1 in 20 chance of developing breast cancer in her lifetime. The incidence of cancer in general, and for breast cancer specifically was highest in the Chinese, followed by Indians and Malays. Most of the patients with breast cancers presented at late stages (stage I: 15.45%, stage II: 46.9%, stage III: 22.2% and stage IV: 15.5%). The Healthy Lifestyles Campaign which started in the early nineties had created awareness on breast cancer and after a decade the effort was enhanced with the Breast Health Awareness program to promote breast self examination (BSE) to all women, to perform annual clinical breast examination (CBE) on women above 40 and mammogram on women above 50. The National Health Morbidity Survey in 2006 showed that the prevalence rate of 70.35% by any of three methods of breast screening; 57.1% by BSE, 51.8% by CBE and 7.6% by mammogram. The current screening policy for breast cancer focuses on CBE whereby all women at the age of 20 years and above must undergo breast examination by trained health care providers every 3 years for age between 20-39 years, and annually for age 40 and above. Several breast cancer preventive programs had been developed by various ministries in Malaysia; among which are the RM50 subsidy for mammogram by the Ministry of Women, Family and Community Development and the SIPPS program (a call-recall system for women to do PAP smear and CBE) by the Ministry of Health. Measures to increase uptake of breast cancer screening and factors as to why women with breast cancer present late should be studied to assist in more development of policy on the prevention of breast cancer in Malaysia.     

Comparison of Three Educational Interventions on Breast Self-Examination Knowledge and Health Beliefs

Background: This study was designed to investigate the effectiveness of various training methods for breastself-examination (BSE) knowledge, practice, and health beliefs. Methods: The quasi-experimental investigationwas carried out in an area where two community health care centers are located, in the city of Trabzon, Turkey.Divided randomly into three groups, 1,342 women were instructed in BSE using individual or group training orby way of pamphlets. Data were gathered in four stages: during the pretraining and one month, six months, andtwelve months after training. Results: All of the training methods used in the study produced a significantincrease in the participants’ BSE knowledge, but individually trained women scored higher than did the others.Regardless of the training method, BSE instruction improved the women’s perceived confidence and benefits,while their perceived barriers declined. The variables influencing BSE practice were found to be BSE practiceat the pretraining period, perceived confidence in and benefits from BSE six months after BSE instruction, andhealth motivation one year after training. No significant difference was found in women’s BSE performancescores one year after training. Conclusion: This study in which three training methods were used enabled us toassess the effectiveness of instruction on BSE performance and competence. In addition, it provided us withvaluable information on how training methods can influence health beliefs related to BSE.     

Do Turkish Nursing and Midwifery Students Teach Breast Self-Examination to Their Relatives ?

Aim: To describe health beliefs and breast self-examination (BSE) practice of Turkish female nursing andmidwifery students and extent of teaching the screening method to their mothers, sisters and relatives. Design:In this definition survey, data were obtained from 113 nursing and midwifery students (n = 113) in third andfourth class and their mothers, sisters and other relatives in Turkey. Methods: Data were collected using apersonal data form, a knowledge evaluation form for BSE (Maurer 1997) and the Champion’s Health BeliefModel Scale. Number percentage, Chi-square test were used in the evaluation of the data. Results: Studentslearned breast cancer and BSE in their lessons one or two years previously. Knowledge level scores of the studentswere 52.3 ± 9.6 (min:25,max: 75). Rate of having regular BSE was 32.7%. When health belief scale assessed; theaverage of susceptibility was 7.52±2.62, seriousness was 21.8±5.30, benefit was 16.7±4.45, barrier was 22.3±6.44,confidence was 40.3±6.67 and medical motivation was 26.6±4.22. The rate of having regular BSE and benefit,barrier scores were compared, they were statistically significant difference(p<0.05). The majority (106, 91.3%)gave BSE training to their mother and sisters, and 42.6% ( 48) to relatives, 6.2% (7) to friends, and 5.4% (6) topatients. Conclusions: Knowledge about breast cancer and BSE repetition training programs should be plannedfor nursing/midwifery students, to increasae their sensitivity, beliefs and attitudes, and medical motivation forBSE.     

Prospective analysis of the long-term effect of teaching breast self-examination and breast awareness

Breast cancer is the most common cancer in women in the industrialized world and a leading cause of death. Breast self-examination (BSE) is one of the methods for an early detection of breast cancer. In the present study the effectiveness of a campaign promoting BSE and breast awareness was analysed. Seminars were conducted in 2003 in Lower Saxony, Germany by a female gynaecologist and a social pedagogue and included a lecture, an individual training in BSE in a separate room and a talk about the importance of regular BSEs. Questionnaires were handed out immediately after the seminar and were sent by post 1 year later. Attendance of the seminar resulted in a significantly higher percentage of monthly BSEs (21.4% before vs. 61.9% after the teaching). Furthermore, 92.1% of the women who did not perform a monthly BSE stated that at least they examined their breasts more frequently after attending the seminar. The data demonstrate that the seminars in BSE had profound effects on the compliance of women in carrying out BSE regularly and correctly, without influence of age or education.     

Knowledge about Risk Factors for Breast Cancer and Having a Close Relative with Cancer Affect the Frequency of Breast Self-Examination Performance

Background: Breast cancer incidence and mortality rates are increasing in North-Eastern Brazil and the patients with the disease often presented at advanced stages. The present study was focused on identifying variables that affect women's frequency of breast self- examination (BSE) performance. Materials and Methods: Data on BSE, socio-economic parameters and risk factors for breast cancer were obtained from 417 women from a community in North-Eastern Brazil by a self-informant method. To identify independent variables that affect frequency of BSE, nominal logistic regression analysis was performed. Results: Of 417 women, 330 (79.3%) reported performing BSE. Compared to high-income women, BSE performance by low-income women every month was 7.69 (OD=0.130; CI 95%: 0.044- 0.0386; p=0.000) times lower. Women who did not live in a stable union performed BSE each month 2.73 (OD=0.366; CI 95%: 0.171-0.782; p=0.010) less often than those living in a stable union. BSE performance every month and every six months or every year by women with poor knowledge about risk factors for breast cancer was 3.195 (OD=0.313; CI 95%: 0.141- 0.695; p=0.004) times and 2.028 (OD=0.493; CI 95%: 0.248- 0.979; p=0.043) times lower, compared to women with good knowledge. Participants who had a close relative with cancer performed BSE every month and every six months or every year 2.132 (OD=0.469; CI 95%: 0.220-0.997; p=0.049) times and 2.337 (OD=0.428; CI 95%: 0.219-0.836; p=0.013) times less often, compared to those women without close relatives with cancer. Conclusions: The results of this study indicated that income, marital status, knowledge about risk factors and having a close relative with breast cancer, affect the frequency of BSE performance. Information about risk factors in public health campaigns could additionally strengthen avoidance behaviour and also motivate BSE performance.