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.     

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.     

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.     

Level of Awareness of Cervical and Breast Cancer Risk Factors and Safe Practices among College Teachers of Different States in India: Do Awareness Programmes Have an Impact on Adoption of Safe Practices?

Background: Breast and cervical cancers are the most common causes of cancer mortality among womenin India, but actually they are largely preventable diseases. Although early detection is the only way to reducemorbidity and mortality, there are limited data on breast and cervical cancer knowledge, safe practices andattitudes of teachers in India. The purpose of this study is to assess the level of awareness and impact ofawareness programs in adoption of safe practices in prevention and early detection. Materials and Methods:This assessment was part of a pink chain campaign on cancer awareness. During cancer awareness events in2011 at various women colleges in different parts in India, a pre-test related to cervical cancer and breast cancerwas followed by an awareness program. Post-tests using the same questionnaire were conducted at the end of theinteractive session, at 6 months and 1 year. Results: A total of 156 out of 182 teachers participated in the study(overall response rate was 85.7 %). Mean age of the study population was 42.4 years (range- 28-59 yrs). Therewas a significant increase in level of knowledge regarding cervical and breast cancer at 6 months and this wassustained at 1 year. Adoption of breast self examination (BSE) was significantly more frequent in comparisonto CBE, mammography and the Pap test. Magazines and newspapers were sources for knowledge regardingscreening tests for breast cancer in more than 60% of teachers where as more than 75% were educated by doctorsregarding the Pap test. Post awareness at 6 months and 1 year, there was a significant change in alcohol andsmoking habits. Major reasons for not doing screening test were found to be ignorance (50%), lethargic attitude(44.8%) and lack of time (34.6%). Conclusions: Level of knowledge of breast cancer risk factors, symptomsand screening methods was high as compared to cervical cancer. There was a significant increase in level ofknowledge regarding cervical and breast cancer at 6 months and this was sustained at 1 year. Adoption of BSEwas significantly greater in comparison to CBE, mammography and the Pap test. To inculcate safe practices inlifestyle of people, awareness programmes such as pink chain campaign should be conducted more widely andfrequently.     

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.     

Practice of Breast Self-Examination Among Women in Malaysia

Objectives: The objective of this study was to examine the practice and associated factors of breast selfexamination(BSE) among Malaysian women. Methods: For this cross-sectional study 250 women were selectedby a simple random sampling technique. The questionnaire was consisted of three parts: socio-demographiccharacteristics, knowledge about BSE, and practice of BSE. Obtained data was analyzed using SPSS version13. T-test and ANOVA test were used to explore the relation between socio-demographic characteristics and thepractice of BSE. Results: About 32% of the participants reported that they have had family history of cancerand about 20% of the participants reported that they have had family history of breast cancer. The majority ofthe participants (88.8%) have heard about breast cancer and 78.4% of the participants have heard about BSE.Race, marital status, residency, regular exercise, awareness about breast cancer, belief that breast cancer can bedetected early, belief that early detection improves the chance of survival, family history of cancer, family historyof breast cancer, awareness about BSE, and belief that BSE is necessary, significantly influenced the practiceof BSE among women. Practice of BSE on monthly basis was found to be 47.2% among the study participants.Conclusion: The socio-demographic characteristics significantly influence the practice of BSA among womenin Malaysia. The findings of this study might not only influence the planning of specific screening interventionsand strategies in Malaysia but might also be important for the relevant international communities, interestedin the peculiarities of BSE incidence in different countries.     

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.     

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.     

Knowledge, attitude and preventive practices of women for breast cancer in the educational institutions of Lahore, Pakistan

Breast cancer incidence rates, pattern of presentation and survival rates vary worldwide. High incidence, advanced stage disease presentation and low survival rates have been reported from Pakistan. Lack of awareness and screening facilities along with poor socioeconomic status are the main causes. A survey based upon multiple choice questionnaires was conducted during an awareness campaign in women educational institutions of Lahore, to assess the baseline knowledge, attitude towards breast self examination (BSE), clinical breast examination (CBE) and source of information used by them. 1155 filled questionnaires were analyzed by SPSS version 12. The majority (83.7%) of the respondents were <30 years old, 60% had >10 and 31.5% had <14 years of education. Only 27% had "good" while 14% had "poor" and 59% had "fair" knowledge scores about breast cancer. Television was the most commonly cited source of information but was associated with lower knowledge score. The knowledge scores and practice of BSE had a positive association with education level. The respondents had better knowledge of life time risk and association of early diagnosis with better chances of cure, but worse knowledge of risk factors as compared to women in educational institutions of other countries. Generally the respondents of present study had low level of knowledge of breast cancer. Properly designed awareness campaign on television and in educational institutions can be effective to raise the knowledge level, the best long term strategy for this purpose.     

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.     

First degree relatives of breast cancer patients: screening practices and provision of risk information.

Little is known about breast cancer screening knowledge and behaviors among women with a family history of breast cancer. Data gathered from 125 first-degree relatives of breast cancer patients indicated that only 63.3% of women over age 35 "ever" had a mammogram, 53% of women 40 or older reported a mammogram in the last year, and only 36.8% of all participants reported monthly breast self-exam (BSE). Self-reported BSE competence was generally poor. One hundred five (105) (84%) reported a clinical breast exam over the previous year. Only 71 (56.8%) of the women indicated that they had been asked about their family history of breast cancer by their physician, and minimal information about risk related to family history was provided. Worry about developing breast cancer was positively related to mammography use and BSE competence. Confidence in performing BSE and learning BSE from a physician/nurse were both positively related to competence. Women who believed they had control over finding breast cancer in its early stages reported more frequent BSE. Poor compliance of women with a family history of breast cancer in the practice of BSE and utilization of mammography, and lack of risk information provided by physicians mandate a search for effective intervention.     

Awareness of breast and cervical cancer risk factors and screening behaviours among nurses in rural region of Turkey

Breast and cervical cancer are the most common causes of cancer mortality among women worldwide, but actually they are largely preventable diseases. There is limited data on breast and cervical cancer knowledge, screening practices and attitudes of nurses in Turkey. A self-administered questionnaire was used to investigate the knowledge and attitude of nurses on risk factors of the breast and cervical cancer as well as screening programmes such as breast self-examination (BSE), clinical breast examination, mammography (MMG) and papanicolaou (pap) smear test. In total, 125 out of 160 nurses participated in the study (overall response rate was 80.6%). The risk factors and symptoms of breast cancer was generally well known, except for early menarche (23.2%) and late menopause (28.8%). For cervical cancer, the correct risk factors mostly indicated by the nurses were early age at first sexual intercourse (56%), smoking (76%), multiple sexual partners (71.2%). As for screening methods, it was believed that BSE was a beneficial method to identify the early breast changes (84.8%) and MMG was able to detect the cancer without a palpable mass (57.6%). Little was known about the fact that women should begin cervical cancer screening approximately 3 years after the onset of sexual intercourse (23.2%) and if repeated pap smear test were normal, it could be done every 2–3 years. Most of the nurses considered that MMG decreases the mortality in breast cancer (65.6%) and also believed that pap smear test decreases the mortality in cervical cancer (75.2%). Despite high level of knowledge of breast cancer risk factors, symptoms and screening methods, inadequate knowledge of cervical cancer screening method were found among nurses.     

Awareness of Breast Cancer Warning Signs and Screening Methods among Female Residents of Pokhara Valley,Nepal

Background: Breast cancer is the second most common cancer in the world and by far the most frequentcancer among women. Objective: The present study was undertaken to assess the awareness of breast cancerwarning signs and screening methods among the women of Pokhara valley, Nepal. Materials and Methods: Across-sectional questionnaire survey was carried out in a community setting with the female population. Thequestionnaire was administered in face-to-face interviews by trained research assistants. Results: Nepalesewomen demonstrated poor awareness of warning signs like a breast lump, lump under the armpit, bleedingor discharge from the nipple, pulling of the nipple, changes in the position of the nipple, nipple rash, rednessof the breast skin, changes in the size of the breast or nipple, changes in the shape of the breast or nipple, painin the breast or armpit, and dimpling of the breast skin. While 100% of nurses were aware about breast selfexamination(BSE), mammography and warning signs of breast cancer. Levels of knowledge were significantlypoorer in women with other occupations. Graduates were more aware about BSE, mammogram and warningsigns of breast cancer compared to those with other educational levels. Conclusions: The findings indicated thatthe level of awareness of breast cancer, including knowledge of warning signs and BSE, is sub-optimal amongNepalese women.     

Breast cancer detection: knowledge, attitudes, and behaviors of women from Pennsylvania

PURPOSE/OBJECTIVES: To assess relationships among breast cancer detection behaviors and selected variables in healthy women. DESIGN: Correlational study. SETTING/SAMPLE: A sample of 1,000 women was selected randomly from the 16,500 members of the General Federation of Women's Clubs of Pennsylvania. Respondents (N = 538; 54% response rate) were predominately white, well educated, lived in urban areas, and had an average age of 60 years. METHODS: Mailed packets with a professionally designed, scannable survey instrument that included questions related to detection behaviors, a risk index, health behaviors, attitudes, and knowledge. MAIN RESEARCH VARIABLES: Breast cancer detection behaviors: mammography, clinical breast examination (CBE), breast self-examination (BSE). Structural/demographic variables: age, education, residence, knowledge of breast cancer and detection methods, teaching history, encouragement, and risk index (family/medical history). Predisposing variables: susceptibility, benefits/barriers, confidence, social norms and influence, and general health motivation. FINDINGS: Women reported moderate/high adherence to recommendations for early detection of breast cancer. Mammography behavior was predicted by older age, being encouraged by a doctor or nurse, and greater risk. CBE predictors were greater knowledge and risk along with greater benefits, social norms, and health motivation. BSE behavior was predicted by having had BSE technique checked, greater knowledge, greater risk, decreased barriers to BSE, and higher health motivation. CONCLUSIONS: Common predictors of breast screening behaviors include risk (family/medical history), knowledge, and general health motivation. IMPLICATIONS FOR NURSING PRACTICE: Educational efforts can be designed specifically to influence variables related to compliance with early breast cancer detection behaviors.     

Awareness and knowledge of breast cancer and mammography among a group of Malaysian women in Shah Alam

Objectives: The aim of this study was to assess awareness and knowledge of breast cancer and mammography among Malaysian women in Shah Alam. Methods: This cross sectional study was conducted among 250 Malaysian women. Data were collected using a self administrated questionnaire which included questions on socio-demographic data, knowledge of breast cancer and awareness of mammography. Results: Mean age of respondents was 28 ± 9.2 with 69.2% aged 18 to 29 years. The majority had heard about breast cancer (81.2%) and indicated books, magazines and brochures as their source of information (55.2%). However, most did not know about signs and symptoms of breast cancer and many of its risk factors. On multivariate analysis, significant predictors of breast cancer knowledge were age, race, marital status, level of education, occupation, family size and family history of other cancers (p<0.05). Fifty percent of women were aware of mammography, significant predictors being age, occupation, marital status and knowledge of breast cancer (p<0.05). Conclusion: Most women were aware of breast cancer. However, the knowledge about signs and symptoms of breast cancer and awareness of mammography were inadequate. It is recommended that the level of knowledge should be raised among Malaysian women, particularly in the young and less educated women.     

Reproductive Risk Factors Differ Among Breast Cancer Patients and Controls in a Public Hospital of Paraiba,Northeast Brazil

The incidence and mortality rates of breast cancer in Northeast Brazil are increasing and little is known aboutprevailing reproductive factors contributing to this increase. A case-control study was conducted in a publichospital of Campina Grande, state of Paraíba, including 81 women with diagnosed invasive breast cancer and 162age matched (±5 years) controls. Binominal logistic regression analysis was applied to estimate odds ratio (OR)and confidence intervals (CI) of risk factors. In this model, age at menarche ≤12 (OR= 2.120; CI: 1.043- 4.308;p=0.038), single parity (OR=3.748; CI: 1.459- 9.627; p=0.06) and reproductive period >10 years (OR=3.042;CI: 1.421- 6.512; p=0.04) were identified as independent variables that significantly increased breast cancerrisk of parous women. Compared to parous women who never practised breastfeeding, total breastfeeding time> 24 months decreased the risk of breast cancer (OR=0.258; CI: 0.084- 0.787; p= 0.017). The results indicatedthat modifiable reproductive factors contribute to breast cancer risk in women included in the present study.Women’s knowledge about factors such as the protective effect of breastfeeding could reduce the risk of breastcancer.