Knowledge of Female Undergraduate Students on Breast Cancer and Breast Self-examination in Klang Valley,Malaysia

Background: In Malaysia, breast cancer is the first cancer among females regardness of race. Aim: The purposeof this study was to identify the knowledge and BSE practice among undergraduate female students at fourpublic universities in Klang Valley, Malaysia. Materials and Methods: This cross-sectional study was conductedamong 820 undergraduate female students using a self-administered questionnaire covering socio-demographicdata, knowledge of breast cancer and BSE practice. Results: The mean age of the respondents was 21.7±1.2years. The majority of them were single (96.8%), Malay (91.9%) and 16.5% of respondents had a family historyof breast cancer. This study showed low level of knowledge on breast cancer and breast self-examination amongparticipants. Only 19.6% participants were performing BSE regularly. Knowledge of breast self-examination wassignificantly associated with BSE practice (p=0.00). Also, there were significant associations between performingBSE with age, marital status and being trained by a doctor for doing BSE (p<0.05). Conclusions: Our findingsshowed that the rate of BSE practice and knowledge of breast cancer is inadequate among young Malaysianfemales. A public health education program is essential to improve breast cancer prevention among this group.     

Predictors of Breast Cancer Screening Uptake: A Pre Intervention Community Survey in Malaysia

Introduction: Despite health education efforts to educate women on breast cancer and breast cancer screeningmodalities, the incidence of breast cancer and presentation at an advanced stage are still a problem in Malaysia.Objectives: To determine factors associated with the uptake of breast cancer screening among women in thegeneral population. Methods: This pre-intervention survey was conducted in a suburban district. All householdswere approached and women aged 20 to 60 years old were interviewed with pre-tested guided questionnaires.Variables collected included socio-demographic characteristics, knowledge on breast cancer and screeningpractice of breast cancer. Univariate and multivariate analysis were performed. Results: 41.5% of a total of381 respondents scored above average; the mean knowledge score on causes and risks factors of breast cancerwas 3.41 out of 5 (SD1.609). 58.5% had ever practiced BSE with half of them performing it at regular monthlyintervals. Uptake of CBE by nurses and by doctors was 40.7% and 37.3%, respectively. Mammogram uptakewas 14.6%. Significant predictors of BSE were good knowledge of breast cancer (OR=2.654, 95% CI: 1.033-6.816), being married (OR=2.213, 95% CI: 1.201-4.076) and attending CBE (OR=1.729, 95% CI: 1.122-2.665).Significant predictors for CBE included being married (OR=2.161, 95% CI: 1.174-3.979), good knowledge ofbreast cancer (OR=2.286, 95% CI: 1.012-5.161), and social support for breast cancer screening (OR=2.312, 95%CI: 1.245-4.293). Women who had CBE were more likely to undergo mammographic screening of the breast(OR=5.744, 95% CI: 2.112-15.623), p<0.005. Conclusion: CBE attendance is a strong factor in promoting BSEand mammography, educating women on the importance of breast cancer screening and on how to conduct BSE.The currently opportunistic conduct of CBE should be extended to active calling of women for CBE.     

Knowledge of Breast Cancer and Breast Self-Examination Practice among Iranian Women in Hamedan,Iran

Background: In Iran, breast cancer is the most prevalent cancer in women and a major public health problem. Methods: A cross sectional study was carried out to determine knowledge on breast cancer and breast selfexamination (BSE) practices of 384 females living in the city of Hamadan, Iran. A purposive sampling method was adopted and data were collected via face-to-face interviews based on a validated questionnaire developed for this study. Results: Among respondents 268 (69.8%) were married and 144 (37.5%) of the respondents reported having a family history of breast cancer. One hundred respondents (26.0%) claimed they practiced BSE. Level of breast cancer knowledge was significantly associated with BSE practice (p=0.000). There was no associationwith demographic details (p<0.05). Conclusion: The findings showed that Iranian women’s knowledge regarding breast cancer and the practice of BSE is inadequate. Targeted education should be implemented to improve early detection of breast cancer.     

Awareness of breast cancer and screening procedures among Malaysian women

Breast cancer is the most frequently occurring cancer in women globally and early detection increases the survival rate of patients. Therefore, this study was done to determine factors which influence the awareness of breast cancer and practice of screening procedures. A cross-sectional study was performed on 125 women aged 19-60 years in urban and rural areas in Malaysia using a validated questionnaire covering knowledge of breast cancer and screening practices. A total of 99.2% respondents knew that breast cancer is the leading cancer with a mean knowledge of 67.3 ± 15.3% for urban and 50.2 ± 14.7% for rural women Mann Whitney U showed rural women had significantly less awareness compared to urban women (p< 0.05). Spearman correlation test showed a significant positive relationship between education and awareness (p< 0.05). Regarding awareness of the screening methods, 92.8%, 50.4% and 47.2% of respondents correctly answered questions on capability of BSE, CBE and mammography, respectively. In conclusion, the study showed awareness of breast cancer and practice of screening procedures increases with higher education and urban living. Therefore, there is an urgent need for an intensive breast cancer awareness campaign and availablity of screening centres prioritized in rural areas.     

Awareness about Breast Cancer and Its Screening among Rural Egyptian Women,Minia District: a Population-Based Study

Background: Recent global cancer statistics indicate rising global incidence of breast cancer and the increase is occurring at a faster rate in developing countries. Training women how to carry out breast self-examination (BSE) can help them to be alert to any abnormalities in their breasts to speedily seek medical consultation. Health behavior may be influenced by level of awareness about breast cancer. Methods: A cross-sectional community- based study aimed to assess the level of knowledge about breast cancer risk factors, early warning signs, screening approaches and related predictors. Also, to determine the extent of practice of breast self- examination (BSE) among rural women, Minia in the period from February to May 2016. A total of 600 women were randomly included in the study. A questionnaire included socio-demographic characteristics and information related to their knowledge about breast cancer. Data analysis was carried out using SPSS version 19. Results: Moderate and high knowledge scores were presented by 46.9 %. Nearly 40% of participants had the knowledge that smoking increased the likelihood of cancer breast and almost 30% of them affirmed that being obese or having a positive family history of cancer breast made them vulnerable to cancer breast. It was found that 28.7% and 18.2% of them knew that aging and nulliparity increased the likelihood of breast cancer. Participants with better knowledge score were 4.8 times more likely to practice BSE. Conclusion: This study revealed poor knowledge among rural women regarding cancer breast. BSE and clinical breast examination were not well practiced. It is recommended to create awareness programs about breast cancer and regular patterns of BSE.     

Beliefs and Behavior of Malaysia Undergraduate Female Students in a Public University Toward Breast Self-examination Practice

Background: Breast cancer is the most common cancer and the second principal cause of cancer deaths amongwomen worldwide, including Malaysia. Methods: A cross-sectional study was carried out among 262 femaleundergraduate students in University Putra Malaysia using a validated questionnaire which was developed forthis study. Results: The mean age of respondents was 22±2.3 years. Most of them were single (83.1%), Malay(42.3%) and 20.7% reported having a family history of breast cancer. Eighty-seven (36.7%) claimed they hadpracticed BSE. Motivation and self-efficacy of the respondents who performed BSE were significantly highercompared with women who did not (p<0.05).There was no association between BSE practice and demographicdetails (p<0.05). Logistic regression analysis indicated that women who perceived greater motivation (OR=1.089,95%CI: 1.016-1.168) and had higher confidence of BSE (OR=1.076, 95%CI: 1.028-1.126) were more likely toperform the screening. Conclusions: The findings show that Malaysian young female’s perception regarding breastcancer and the practice of BSE is low. Targeted education should be implemented to improve early detection ofbreast cancer.     

Peer Leaders and Phone Prompts: Implications in the Practice of Breast Care among College Students

Background: Compliance with breast self-examination (BSE) guidelines helps detect breast cancer early whileincreasing physical activity decreases the risk of having breast cancer. Finding ways to early initiate and maintain suchbehavior among youth is therefore important. In this study we aimed to determine the effects of two health promotioneducation interventions on knowledge and attitude to breast care, as well as practice of BSE and physical activity byfemale college students. Materials and Methods: A total of 999 students from ten colleges underwent two kinds ofhealth education strategies for three months, namely the traditional health education program (THEP) and tapping peerleaders using mobile phone prompts (PPHEP). Results: Improvement in knowledge and attitude was shown for bothgroups as compared to the control group. Both interventions equally increased the practice of BSE and maintenance ofthe recommended level of physical activity. Conclusion: There was an increase in the knowledge and positive attitudeto breast care and practice of BSE with an improvement in the level of exercise when THEP and PPHEP interventionswere used. Health education with peers using mobile phone prompts offers an alternative and effective way of promotingBSE and acceptable levels of exercise.     

Health Beliefs and Breast Self-Examination among Undergraduate Female Students in Public Universities in Klang Valley,Malaysia

Background: Breast cancer is the most frequently occurring cancer in women and the most common causeof cancer death worldwide. Materials and Methods: A cross-sectional study was carried out among 792 femaleundergraduate students in public universities in Klang Valley, Malaysia, from January to April 2011. Data werecollected using a validated questionnaire developed for this study. Results: The mean age of respondents was21.7±1.2 years. Most of them were single (96.8%), Malay (91.9%) and 150 (19.6%) claimed they had practicedBSE. There was a significant differences between performers and non-performers correlated to age, maritalstatus, check breast by doctor, and being trained about BSE. Performers had lower mean scores for perceivedbarriers and susceptibility and higher mean score for confidence. Stepwise logistic regression analysis yieldedfour significant predictor variables. Conclusions: Overall our findings indicate that the practice of BSE whileperceived as being important is not frequently practiced among female in Malaysia. Targeted education shouldbe implemented to improve early detection of breast cancer.     

Knowledge of Risk Factors & Early Detection Methods and Practices towards Breast Cancer among Nurses in Indira Gandhi Medical College,Shimla, Himachal Pradesh,India

Background: Breast cancer is an increasing health problem in India. Screening for early detection should leadto a reduction in mortality from the disease. It is known that motivation by nurses influences uptake of screeningmethods by women. This study aimed to investigate knowledge of breast cancer risk factors & early detectionmethods and the practice of screening among nurses in Indira Gandhi Medical College, Shimla, Himachal Pradesh.Materials and Methods: A cross-sectional study was conducted using a self-administered questionnaire to assessthe knowledge of breast cancer risk factors, early detection methods and practice of screening methods among457 nurses working in a Indira Gandhi Medical College, Shimla-H.P. Chi square test, Data was analysed usingSPSS version 16. Test of significance used was chi square test. Results: The response rate of the study was 94.9%.The average knowledge of risk factors about breast cancer of the entire population is 49%. 10.5% of nurses hadpoor knowledge, 25.2% of the nurses had good knowledge, 45% had very good knowledge and 16.3% of thenurses had excellent knowledge about risk factors of breast cancer and early detection methods. The knowledgelevel was significantly higher among BSC nurses than nurses with Diploma. 54% of participants in this studyreportedly practice BSE at least once every year. Less than one-third reported that they had CBE within thepast one year. 7% ever had mammogram before this study. Conclusions: Results from this study suggest thefrequent continuing medical education programmes on breast cancer at institutional level is desirable.     

Socioeconomic Factors Association with Knowledge and Practice of Breast Self-Examination among Iranian Women.

Background: Breast cancer is the leading type of cancer in women and is one of the most frequent cancers among Iranian women. Delay in diagnosis and treatment of breast cancer diminishes a women's chance of survival. Breast self- examination (BSE) may be effective in early detection. The purpose of this study was to identify the relationship between Iranian women's socioeconomic status and their knowledge and practice of BSE. Methods: Data were from a hospital-based case-control study among women diagnosed with breast cancer. Control subjects were matched to patients on age. 303 breast cancer patients and 303 control women were interviewed. Socioeconomic status and information including knowledge and practices of breast self examination and clinical breast examination were recorded and compared. Results: The mean +/- SD age of cases and controls was 48.2 +/- 9.8 and 50.2 +/- 11.1 (range 24-84 years), respectively. The study revealed that there were significant relationships between education level and knowledge and practices of breast self examination in both cases and controls, increase in usage being observed with the level of education (P<0.05). Conclusion: The findings suggest that the knowledge and practices of women toward breast cancer early detection are inadequate in women with a lower level of education. Mass media cancer education should promote widespread access to information about early detection behavior.     

Poor Knowledge and Practice Towards Breast Cancer among Women in Baghdad City,Iraq

Background: Breast cancer is one of the most common cancers among females worldwide. The aim of thisstudy was to assess the knowledge and practice about breast cancer and its related factors among women inBaghdad city, Iraq. Materials and Methods: A cross-sectional study was conducted among 508 women aged18 to 55 years from four non-governmental organizations (NGO) in Baghdad city, Iraq. A self-administeredquestionnaire on breast cancer knowledge and practice was distributed to participants during weekly activityof the NGO. Results: A total of 61.2% of the respondents had poor knowledge, only 30.3% performed breastself-examination (BSE) and 41.8% said that they did not know the technique to perform BSE. Associationsbetween knowledge and marital status and age were significant. For practice, working status, education, ageand family income were significant. After controlling for cofounders, the most important contributing factorsfor poor knowledge among respondents were marital status and not performing BSE, with adjusted odds ratioof 1.6 and 1.8 respectively. Conclusions: Breast cancer knowledge and practice of BSE are poor among womenin Baghdad city, Iraq. More promotion regarding breast cancer signs and symptoms and also how to performBSE should be conducted using media such as television and internet as these constituted the main sources ofinformation for most women in our study.     

Exploration of barriers to breast-self examination among urban women in Shah Alam, Malaysia: a cross sectional study

Background: Breast cancer is the most common cancer among women in Malaysia. Barriers for practicingbreast self examination (BSE) await exploration. Objective: To assess the practice of BSE and its correlatedfactors and particularly barriers amongst urban women in Malaysia. Methods: This cross-sectional study wasconducted with 222 Malaysian women using a self-administered questionnaire. Results: The mean (SD) agewas 28.5 (±9.2) years, 59.0% were university graduates. Of the total, 81.1% were aware of breast cancer and55% practiced BSE. Amongst 45% of respondents who did not practice BSE, 79.8% did not know how to doit, 60.6% feared being diagnosed with breast cancer, 59.6% were worried about detecting breast cancer, 22%reported that they should not touch their bodies, 44% and 28% reported BSE is embarrassing or unpleasant,29% time consuming, 22% thought they would never have breast cancer or it is ineffective and finally 20%perceived BSE as unimportant. Logistic regression modeling showed that respondents aged ≥45 years, beingMalay, married and having a high education level were more likely to practice BSE (p<0.05). Conclusion: Inthis study sample, a significant proportion of respondents was aware of breast cancer but did not practice BSE.Knowledge, psychological, cultural, perception and environmental factors were identified as barriers. BSEpractice was associated significantly with socio-demographic factors and socioeconomic status.     

Epidemiological Study on Breast Cancer Associated Risk Factors and Screening Practices among Women in the Holy City of Varanasi,Uttar Pradesh,India

Background: Breast cancer is the second most cause of death (1.38 million, 10.9% of all cancer) worldwide after lung cancer. In present study, we assess the knowledge, level of awareness of risk factors and screening practices especially breast self examination (BSE) among women, considering the non-feasibility of diagnostic tools such as mammography for breast screening techniques of breast cancer in the holy city Varanasi, Uttar Pradesh, India. Materials and Methods: A cross-sectional population based survey was conducted. The investigation tool adopted was self administrated questionnaire format. Data were analysed using SPSS 20 version and Chi square test to determine significant association between various education groups with awareness and knowledge, analysis of variance was applied in order to establish significance. Results: The attitude of participants in this study, among 560 women 500 (89%) responded (age group 18-65 years), 53.8% were married. The knowledge about BSE was very low (16%) and out of them 15.6% were practised BSE only once in life time. study shown that prominent age at which women achieve their parity was 20 yrs, among 500 participants 224 women have achieved their parity from age 18 to 30 yrs. Very well known awareness about risk factors of breast cancer were alcohol (64.6%), smoking (64%) and least known awareness risk factors were early menarche (17.2%) and use of red meat (23%). The recovery factors of breast cancer cases were doctors support (95%) and family support (94.5%) as most familiar responses of the holy city Varanasi. Conclusions: The study revealed that the awareness about risk factors and practised of BSE among women in Varanasi is extremely low in comparison with other cities and countries as well (Delhi, Mumbai, Himachal Pradesh, Turkey and Nigeria). However, doctors and health workers may promote the early diagnosis of breast cancer.     

Knowledge and Practices Related to Screening for Breast Cancer among Women in Delhi,India

Background: Breast cancer is a major public health problem globally. The ongoing epidemiological, socio-cultural and demographic transition by accentuating the associated risk factors has disproportionately increased the incidence of breast cancer cases and resulting mortality in developing countries like India. Early diagnosis with rapid initiation of treatment reduces breast cancer mortality. Therefore awareness of breast cancer risk and a willingness to undergo screening are essential. The objective of the present study was to assess the knowledge and practices relating to screening for breast cancer among women in Delhi. Methods: Data were obtained from 222 adult women using a pretested self-administered questionnaire. Results: Rates for knowledge of known risk factors of breast cancer were: family history of breast cancer, 59.5%; smoking, 57.7%; old age, 56.3%; lack of physical exercise, 51.9%; lack of breastfeeding, 48.2%; late menopause, 37.4%; and early menarche, 34.7%. Women who were aged < 30 and those who were unmarried registered significantly higher knowledge scores (p ≤ 0.01). Breast self-examination (BSE) was regularly practiced at-least once a month by 41.4% of the participants. Some 48% knew mammography has a role in the early detection of breast cancer. Since almost three-fourths of the participants believed BSE could help in early diagnosis of breast cancer, which is not supported by evidence, future studies should explore the consequences of promoting BSE at the potential expense of screening mammography. Conclusion: Our findings highlight the need for awareness generation among adult women regarding risk factors and methods for early detection of breast cancer.     

Breast Cancer Awareness of Rural Women in Malaysia: is it the Same as in the Cities?

Breast cancer is the most common cancer among women globally. This study was conducted to compare theawareness of breast cancer and the practice of breast self-examination (BSE), clinical breast examination (CBE)and mammography screening among rural females in Pahang and Perak. A cross-sectional study was carried outin five selected rural districts of Pahang and Perak. Two hundred and fifty households were randomly selectedand interviewed face to face using a semi-structured questionnaire. The majority of residents from both stateswere Malay, aged between 50 and 60 years and had a secondary level of education. Malay women aged 40–49years and women with a higher level of education were significantly more aware of breast cancer (p<0.05). Abouthalf of these women practiced BSE (60.7%) and CBE (56.1%), and 7% had underwent mammography screening.The results of this study suggest that women in Pahang and Perak have good awareness of breast cancer andthat more than half practice BSE and CBE. The women’s level of education appears to contribute to their levelof knowledge and health behaviour. However, more effort is needed to encourage all women in rural areas toacquire further knowledge on breast cancer.     

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.     

Breast Cancer Knowledge and Related Behaviors among Women in Abha City, Southwestern Saudi Arabia

Breast cancer is the most common malignancy among women in Saudi Arabia. A cross-sectional study was conducted on 1,092 women attending urban primary health care centers in Abha City southwestern Saudi Arabia about breast cancer knowledge, attitudes, and related practices. Only 22.0 % heard about mammography, and 41.5 % heard about breast self-examination (BSE). More than half of the women in the study identified changes occurring in case of breast cancer and identified risk factors. Only 8.3 % were examined by clinical breast examination (CBE), 6.2 % were examined by mammography, and 29.7 % performed BSE. The study points to the insufficient knowledge of women and the low practice of BSE, CBE, and mammography. Public awareness should be enhanced by all available means including mass media, schools, social gatherings, and waiting areas in primary health care centers. There is an urgent need for continuing medical education programs for health care workers in the region concerning breast cancer.