Breast and colorectal cancer screening among low-income women with psychiatric disorders

This study investigated breast and colorectal cancer screening among 196 low-income women being treated for psychiatric illnesses. Main outcome measures included breast self-examination (BSE), clinical breast examination (CBE), mammography, digital rectal examination (DRE), and fecal occult blood test (FOBT). Results indicated that 49% and 66% of women 40 years of age or older had obtained mammograms and CBEs, respectively, in the preceding year. Forty-four per cent of women 20 years of age or older reported monthly BSE. Forty-six per cent and 35% of women 50 years of age or older reported having digital rectal exams (DRE) or fecal occult blood tests (FOBT), respectively, in the preceding year. Multivariate analyses showed that physician recommendation of screening was the strongest predictor of having obtained a mammogram, CBE, DRE or FOBT in the preceding year. Physician recommendation and self-confidence in performing BSE were the strongest predictors of monthly BSE. These results highlight the importance of physician recommendation of adherence to screening guidelines for breast and colorectal cancer. Because psychiatrists frequently treat psychiatric patients on a regular basis, they are in a unique position to encourage cancer screening and to monitor compliance with their recommendations.     

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.     

Early breast cancer detection behaviors among ethnically diverse low-income women

We examined factors associated with early breast cancer detection behaviors among 301 ethnically diverse low-income women participating in a breast cancer educational outreach program. Multivariate analyses showed that women who had a mammogram in the past year were more likely to be more knowledgeable about breast cancer than women who did not have a mammogram in the past year. Women who had received a mammogram at any time in the past and who had a clinical breast examination during the preceding year were more likely to have received encouragement to obtain mammography than those who had never received a mammogram and did not get a CBE during the preceding year. For women between the ages of 20 and 39, recommendation of mammography and breast cancer knowledge were related positively to ever having a mammogram. Recommendation of breast self-examination (BSE) and number of barriers to BSE were related to monthly BSE practice. Results suggests that health care providers play an important role in motivating low-income minority women to comply with breast cancer screening recommendations.     

Psychological distress and surveillance behaviors of women with a family history of breast cancer.

Women with a family history of breast cancer are at increased risk for developing the disease. This study investigated the beliefs of women at high risk for breast cancer (one or more first-degree relatives with breast cancer) about their breast cancer risk and the impact of this information on their surveillance behaviors and psychological distress. The Health Belief Model and the Fear Arousing Communications Theory were used in this study. Two hundred and seventeen women, enrolled in a breast protection program, completed a questionnaire regarding health beliefs and behaviors, social support, and psychological distress. While 94% came in for regularly scheduled mammograms, only 69% came in for regular clinical breast examinations. A discriminant function analysis revealed that increased cancer anxiety decreased regular clinical examinations (coefficient = -.65). Only 40% performed breast self-examination monthly, 10% never performed breast self-examination, and 50% did not perform breast self-examination regularly. High breast self-examination performance prior to coming to the program was the best predictor of current breast self-examination, and high anxiety predicted poor adherence to monthly breast self-examination (multiple R = .61). More than 27% of the women at high risk were defined as having a level of psychological distress consistent with the need for counseling. Women reporting more barriers to screening, fewer social supports, and low social desirability had more psychological distress (multiple R = .75). Higher anxiety was directly related to poor attendance at a clinical breast examination and poor adherence to monthly breast self-examination.(ABSTRACT TRUNCATED AT 250 WORDS)     

Psychosocial Predictors of Breast Self-Examination among Female Students in Malaysia: A Study to Assess the Roles of Body Image,Self-efficacy and Perceived Barriers

Background: Early detection is a critical part of reducing the burden of breast cancer and breast selfexamination (BSE) has been found to be an especially important early detection strategy in low and middle income countries such as Malaysia. Although reports indicate that Malaysian women report an increase in BSE activity in recent years, additional research is needed to explore factors that may help to increase this behavior among Southeastern Asian women. Objective: This study is the first of its kind to explore how the predicting variables of self-efficacy, perceived barriers, and body image factors correlate with self-reports of past BSE, and intention to conduct future breast self-exams among female students in Malaysia. Materials and Methods: Through the analysis of data collected from a prior study of female students from nine Malaysian universities (n=842), this study found that self-efficacy, perceived barriers and specific body image sub-constructs (MBSRQ-Appearance Scales) were correlated with, and at times predicted, both the likelihood of past BSE and the intention to conduct breast self-exams in the future. Results: Self-efficacy (SE) positively predicted the likelihood of past self-exam behavior, and intention to conduct future breast self-exams. Perceived barriers (BR) negatively predicted past behavior and future intention of breast self-exams. The body image sub-constructs of appearance evaluation (AE) and overweight preoccupation (OWP) predicted the likelihood of past behavior but did not predict intention for future behavior. Appearance orientation (AO) had a somewhat opposite effect: AO did not correlate with or predict past behavior but did correlate with intention to conduct breast self-exams in the future. The body image sub-constructs of body area satisfaction (BASS) and self-classified weight (SCW) showed no correlation with the subjects' past breast self-exam behavior nor with their intention to conduct breast self-exams in the future. Conclusions: Findings from this study indicate that both self-efficacy and perceived barriers to BSE are significant psychosocial factors that influence BSE behavior. These results suggest that health promotion interventions that help enhance self-efficacy and reduce perceived barriers have the potential to increase the intentions of Malaysian women to perform breast self-exams, which can promote early detection of breast cancers. Future research should evaluate targeted communication interventions for addressing self-efficacy and perceived barriers to breast self-exams with at-risk Malaysian women. and further explore the relationship between BSE and body image.     

Breast cancer screening among females in Iran and recommendations for improved practice: a review

Breast cancer is the second most common cancer amongst women, in Iran comprising 21.4% of female cancers. There are several screening modalities for breast cancer including breast self-examination, clinical breast examination and mammography. This research reviews the literature surrounding the implementation of these screening approaches in the Islamic Republic of Iran. After initial results produced approximately 208 articles, a total of 96 articles were included because they specifically addressed epidemiological characteristics of breast cancer, culture, religion, health seeking behavior, screening programs and the health system in Iran. Literature showed that breast self-examination and clinical breast examination were most common as there is no population-based mammography screening program in Iran. Additionally, most women appear to obtain information through the mass media. Results also indicate that Islamic beliefs and preventative medicine are very much aligned and can be used to promote breast cancer screening in Iran. These results highlight that there is a need for aggressive preventative measures focusing on breast self examination and gradually moving towards national mammography programs in Iran ideally disseminated through the media with government support.     

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

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 selfadministered 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).     

Breast cancer screening and family history among rural women in Wisconsin.

This study examines the relationship between family history of breast cancer and current compliance with mammography screening guidelines. A random telephone survey of women age 40 or older living in rural Wisconsin (N = 2398) was conducted to determine mammography screening knowledge, family history of breast cancer, attitudes, intentions, physician recommendation, and compliance with screening guidelines. Compared with women without a family history of breast cancer, women with a family history were significantly more likely to demonstrate correct knowledge (p = 0. 01); express intentions in compliance with recommended screening guidelines (p < 0.001); report having been advised by a physician to obtain a mammogram (p < 0.001); and be in current compliance with mammography screening guidelines (p < 0.001). Results of simultaneous and individual logistic regression suggest that the effects of family history on compliance with screening guidelines are directly mediated through the combination of women's knowledge, women's intentions, and physician recommendation. Thus, programs to increase compliance with mammography screening guidelines should address both women and providers.     

The Effect of Breast Cancer Health Education on The Knowledge,Attitudes, and Practice: A Community Health Center Catchment Area

Studies indicate that women in China are not frequently carrying out breast cancer prevention practices. This is assumed to be due to lack of knowledge and/or lack of personalized instruction. This study was to explore the effect of breast cancer health education on women’s knowledge and attitudes on breast cancer and breast self-examination, behavior related to breast self-examination among women living in the catchment area of a community health center. A pretest and posttest assessment of a 1-h health education session was conducted with 38 participants. A telephone reminder and questionnaires were administered at 1 and 3 months after the education. Three instruments were administered at each contact to assess the knowledge and attitudes on breast cancer and behavior related to breast self-examination and accuracy of breast self-examination before education, 1- and 3-month follow-ups after education. The findings showed the incidence of self-examination, and scores on the accuracy of breast self-examination practice were significantly increased immediately following the intervention and at 1- and 3-month follow-ups. Furthermore, the scores of the health belief regarding perceived benefits, perceived competency, and perceived seriousness significantly improved. The current findings imply community-based intervention could be used to teach women about the general knowledge of breast cancer and how to perform breast self-examination correctly, especially for women who are lack of such information.     

The cancer screening practices of adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study

BACKGROUND: The current study characterized the self-reported cancer screening practices of adult survivors of childhood cancer. METHODS: A cohort of 9434 long-term survivors of childhood cancer and a comparison group of 2667 siblings completed a 289-item survey that included items regarding cancer-screening practices. RESULTS: Overall, 27.3% of female respondents reported performing breast self-examination (BSE) regularly, 78.2% reported undergoing a Papanicolaou smear within the previous 3 years, 62.4% underwent a clinical breast examination (CBE) within the last year, and 20.9% had gotten a mammogram at least once in their lifetime. Approximately 17.4% of male respondents reported performing regular testicular self-examination (TSE). Women age > or =30 years who had been exposed to chest or mantle radiation therapy were more likely to report undergoing CBE (odds ratio [OR], 1.59; 95% confidence interval [95% CI], 1.32-1.92) and mammography (OR, 1.92; 95% CI, 1.47-2.56). Compared with the sibling comparison group, survivors demonstrated an increased likelihood of performing TSE (OR, 1.52; 95% CI, 1.22-1.85) or BSE (OR, 1.30; 95% CI, 1.10-1.52), of having undergone a CBE within the last year (OR, 1.18; 95% CI, 1.02-1.35), and of ever having undergone a mammogram (OR, 1.82; 95% CI, 1.52-2.17). CONCLUSIONS: The results of the current study demonstrate that the cancer screening practices among survivors of childhood cancer are below optimal levels. Primary care physicians who include childhood cancer survivors among their patients could benefit these individuals by informing them about future cancer risks and recommending appropriate evidence-based screening.     

Cultural values and secondary prevention of breast cancer in african american women.

BACKGROUND: Improving mammography initiation and maintenance among African American women has been suggested as a strategy for reducing breast cancer mortality in this population. METHODS: We examined cultural values in relation to self-reported breast cancer screening among 572 low-income, urban, African American women. Cultural values examined included time orientation, family authority, employment aspirations, value of past vs modern life, and reliance on medical professionals. Also, implications for continued development of culturally tailored health interventions and opportunities for the consideration of cultural values in health communication are discussed. RESULTS: Bivariate analyses showed that more traditional values were associated with worse screening histories and lower intentions for future screening. In multivariate analyses, two interactions were observed between cultural values and age: for younger women, more traditional values were associated with lower odds of having ever received a mammogram, and for older women, more traditional values were associated with lower odds of intentions to receive a mammogram in the next 2 years. CONCLUSIONS: This study adds to the evidence that cultural constructs, such as values, are associated with secondary prevention of breast cancer and supports the consideration of cultural constructs as important in increasing mammography and reducing breast cancer disparities for African American women.     

Identification and screening of women at high risk of breast cancer

First- and second-order female relatives of newly treated breast cancer patients who received their care by private practice surgeons were contacted to determine the feasibility of identifying an at-risk population, to ascertain screening practices, and to promote breast cancer screening. Utilizing the breast cancer patient as the primary contact, 42% of relatives participated. Only 32% of relatives reported ever having had a mammogram (40% of those 50 years of age and over), and 52% practiced monthly breast self-examination (BSE). Screening practices correlated with race, with having been taught BSE, and with income; 73% of relatives planned to be screened subsequent to contact. The results of this study indicate a low use of established screening modalities such as BSE and mammography.     

Breast conservation versus mastectomy. Is there a difference in psychological adjustment or quality of life in the year after surgery?

Women with a breast cancer diagnosis often are given a choice between breast conservation or mastectomy as the primary treatment for their cancer. Despite the high frequency of this cancer, there is little systemic information about the effect of surgical treatment on the quality of life or psychological adjustment of the patient. In this study, the authors prospectively evaluated quality of life, performance status, and psychological adjustment in 109 women who had primary breast cancer treatment. During the year of follow-up, no statistically significant differences in quality of life, mood disturbance, performance status, or global adjustment were found between the two surgical groups, and both groups of patients improved significantly during the year of observation (P = 0.0001). As was predicted, patients receiving mastectomy reported more difficulties with clothing and body image; however, these results apparently did not affect the assessment of mood or quality of life. The authors conclude that patients receiving breast conservation therapy do not experience significantly better quality of life or mood than patients having mastectomy; however, patients having breast conservation surgery have fewer problems with clothing and body image. Women receiving breast conservation therapy may require more intensive psychosocial intervention in the postoperative period because of the added burden of primary radiation therapy.     

Impact of Cancer Awareness Drive on Generating Understanding and Improving Screening Practices for Breast Cancer: a Study on College Teachers in India

Background: Breast cancer is the most common cancer among women in India and most present at advanced stage. Although early detection is the only way to reduce morbidity and mortality, people have a very low awareness about breast cancer signs and symptoms and screening practices. The purpose of this study was to assess the level of awareness and impact of awareness programs in adoption of safe practices in prevention and early detection. Methods: This assessment was part of a pink chain campaign on cancer awareness. During events from 2011 to 2015 at various women colleges in different parts in India, a pre-test of knowledge related to breast cancer was followed by an awareness program. Post-tests using the same questionnaire were conducted at the end of the interactive sessions, at 6 months and after1 year. Results: A total of 872 out of 985 teachers participated in the study (overall response rate of 88.5 %). Mean age of the study population was 41.6 years (range 28-59 yrs). There was a significant increase in level of knowledge regarding breast cancer at 6 months and this was sustained at 1 year. Adoption of breast self-examination (BSE) was significantly more frequent in comparison to CBE and mammography. Magazines and newspapers were sources for knowledge regarding screening tests for breast cancer for more than 60% of teachers. Regarding post-awareness at 6 months and 1 year, there was a significant change in alcohol and smoking habits. Major reasons came out to be ignorance (83%) at the start of the campaign which was changed to lack of time (37.7%), lethargic attitude (32.2 %) and lack of time (31.5 %) at 6 months and same at 1 year also. Conclusions: With our awareness program there was a significant increase in level of knowledge regarding breast cancer at 6 months and this was sustained at 1 year. Adoption of BSE was significantly greater in comparison to CBE, mammography. To inculcate safe lifestyle practices in people, awareness programmes such as pink chain campaigns should be conducted more widely and frequently.     

Cancer screening practices of adult survivors of retinoblastoma at risk of second cancers

BACKGROUND: The aim of the current study was to investigate the pattern of cancer screening behavior in adult retinoblastoma survivors, who are at high risk of developing second cancers. METHODS: Self-reported cancer screening practices were investigated in a cohort of retinoblastoma survivors to evaluate whether they were receiving adequate screening for specific cancers and compare these rates with those of other adult survivors of childhood cancer and the general population. The prevalence of breast self-examination, clinical breast examination, mammography, Papanicolaou (Pap) test, testicular self-examination, and magnetic resonance imaging (MRI) or computed tomography (CT) scanning was determined from computer-aided telephone interviews with 836 retinoblastoma survivors aged >18 years. RESULTS: Among female survivors, 87% had a Pap test within the past 2 years, and 76% of females age >40 years reported having a mammogram within the past 2 years; 17.4% of male survivors had performed monthly testicular self-examinations. A significantly higher proportion of hereditary compared with nonhereditary survivors reported having undergone an MRI or CT scan in the past 5 years. Higher education, greater contact with the medical care system, and having a second cancer were found to be associated positively with most screening practices. Cancer screening practices reported by retinoblastoma survivors were similar to national screening rates for breast, cervical, and testicular cancer. CONCLUSIONS: To the authors' knowledge, the current study provides the first report of cancer screening practices of retinoblastoma survivors. Survivors of hereditary retinoblastoma should be encouraged to maintain, if not increase, their current screening practices to ensure early detection of second cancers in this high-risk population.     

Knowledge, attitude about breast cancer and practice of breast cancer screening among female health care professionals: a study from Turkey

The awareness of health professionals about breast cancer prevention is of vital importance, since their beliefs and behaviors may have a major impact on other women. The aim of this study was to investigate the knowledge, and attitudes regarding risk factors for breast cancer as well as screening such as breast self-examination, clinical breast examination and mammography among different groups of female health professionals. In this cross- sectional study, 444 female health professionals in various health centers located in Corum Province, Turkey, were interviewed using a self-administered questionnaire. The mean age was 33.1 ± 6.1 and most were married (81.3%). The rate of feeling under risk regarding breast cancer among female health personnel was 31.3%. The majority (98.4 %) perceived breast self-examination as a beneficial method for the early detection of breast cancer. Although 81.3 % of the participants stated that they did breast self examination, only 27.3 % reported doing so on a regular basis (performed monthly or once per menstrual cycle). The most common reason for not doing breast self-examination was the belief that it was not necessary (45.8 %). Of the entire group, the rate of having a mammography was 10.1% and the rate of clinical breast examination was 24.8%. Health professionals are a direct source of medical information to the public. The use of breast self-examination and mammography was found lower than expected when considering the fact that participants were health care professionals.     

Factors Influencing Breast Cancer Screening Behavior among Iranian Women

Background: Early detection of breast cancer is of great importance to improve women’s health and to decreasethe cost related to cancer death. Therefore, recognition of variables related to breast cancer screening behaviorsis necessary. Objectives of this study were to identify the rates of breast self-examination (BSE) performance andmammography use in Iranian women, and to characterize the demographic and cognitive factors associated withtheir breast cancer screening behavior. Method: Data were collected from a convenience sample of 388 females,using an adapted version of Champion’s revised Health Belief Model Scale. Results: The results showed that7.5% of the participants performed BSE on a regular monthly basis, and among the women aged 40 and older,14.3% reported having had at least one mammography in their lifetime. Perceived self-efficacy and perceivedbarriers to BSE were significant predictors for BSE performance. For having mammography, health motivationwas the main predictor. Conclusion: Eliminating barriers and increasing perceived self-efficacy with an emphasisto make the women acquainted with BSE performance; as well as increasing health motivation of women andpersuading of physicians for clinical breast examination (CBE) performance with low cost and free access tom ammography, are important to promote BSE and mammography.     

Breast cancer screening behaviors and attitudes in three racial/ethnic groups.

Data from a multiethnic sample of women participating in the American Cancer Society 1987 Texas Breast Screening Project was used to compare attitudes and behaviors related to breast cancer screening for whites, blacks, and Hispanics. In general, similar patterns of association were observed across racial/ethnic groups between a number of demographic and risk factors and prior mammography and recent clinical breast examination (CBE), although the magnitude of the associations varied somewhat across groups. Reasons for not having had prior mammography also were similar across groups, with lack of physician referral and cost cited as the two most important reasons. However, Hispanics were less likely than blacks or whites to report prior breast cancer screening, including mammography, CBE, and breast self-examination (BSE). This study demonstrated that women of different racial/ethnic backgrounds can be successfully recruited to participate in a patient-initiated, community-based program. However, this programmatic approach requires augmentation with other intervention strategies designed to reach low-income women because women with more years of education and higher family income were overrepresented in all three groups.