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Alkarak S, Badheeb AM, Al-Dowais A, Alhabes H, Almahwiti K, Aman AA, Alhajlan MA, Seada I, Alshamrani SA, Alhussein B. Factors Affecting Breast Cancer Screening Behavior Among Women in Saudi Arabia: A Retrospective Cross-Sectional Study. Cureus 2024; 16:e58324. [PMID: 38752053 PMCID: PMC11095821 DOI: 10.7759/cureus.58324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
Background Early detection of breast cancer is crucial for effective treatment and minimizing mortality, requiring effective screening methods like self-examination, clinical examination, and mammography. However, not all women in Saudi Arabia comply with these examinations, and studies examining its practice and barriers of low uptake are scant. The aim of this study is to investigate factors influencing breast cancer screening behavior among women in Saudi Arabia. Methods This cross-sectional study involving 806 women from October to November 2022 used an online questionnaire for the data collection process, including questions about demographic characteristics, awareness assessment, breast cancer screening behavior, symptoms, risk factors, and screening programs. Factors affecting the screening behavior were analyzed using the logistic regression model with adjusted odds ratio (AOR) and 95% confidence interval (CI). Results Among the 806 women who participated in the study, 479 (59.4%) were under 40 years old, and half of them were urban residents (n = 394, 48.9%). Only 134 subjects (16.6%) had a history of breast screening. Social media (n = 519, 64.5%) was the predominant source of screening information. The primary obstacles to breast cancer screening were the absence of tumor symptoms (n = 333, 41.3%), insufficient knowledge about early detection (n = 249, 31%), lack of time (n = 245, 30%), fear of discovering a tumor (n = 187, 23%), and lack of awareness about screening centers (n = 155, 19%). In regression analysis, predictive factors for breast cancer screening behavior were as follows: age over 40 years old (AOR: 2.56; 95% CI: 1.70-3.87), residents of big cities (AOR: 3.57; 95% CI: 1.02-12.56), positive family history of breast cancer (AOR: 2.53; 95% CI: 1.50-4.28), proximity to the screening center (AOR: 2.56; 95% CI: 1.22-5.39), and using contraceptive pills for more than five years (AOR: 1.78; 95% CI: 1.04-3.04), and were statistically significant (all p-values < 0.05). Conclusions In this study, the most perceived barriers to BSE were the absence of tumor symptoms, followed by insufficient knowledge about early detection, lack of time, fear of discovering a tumor, and lack of awareness about screening centers. Additionally, the predictive factors for breast cancer screening behavior were as follows: age over 40 years old, residents of big cities, positive family history of breast cancer, proximity to the screening center, and using contraceptive pills for more than five years. Given the identified factors affecting breast self-examination behavior in this study, public education initiatives are crucial for raising awareness, facilitating self-examination, and ultimately improving health outcomes and reducing breast cancer treatment costs in society.
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Affiliation(s)
- Samer Alkarak
- General Surgery, King Khalid University Hospital, Najran, SAU
| | - Ahmed M Badheeb
- Oncology, Oncology Center, King Khalid University Hospital, Najran, SAU
| | - Ali Al-Dowais
- E-Health, Eradah Complex Psychiatric & Addiction, King Khalid University Hospital, Najran, SAU
| | - Hessa Alhabes
- Surgery, King Khalid University Hospital, Najran, SAU
| | | | | | - Mana A Alhajlan
- General Surgery, King Khalid University Hospital, Najran, SAU
| | - Islam Seada
- Cardiac Surgery, King Khalid University Hospital, Najran, SAU
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Hibler EA, Fought AJ, Kershaw KN, Molsberry R, Nowakowski V, Lindner D. Novel Interactive Tool for Breast and Ovarian Cancer Risk Assessment (Bright Pink Assess Your Risk): Development and Usability Study. J Med Internet Res 2022; 24:e29124. [PMID: 35200148 PMCID: PMC8914739 DOI: 10.2196/29124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/23/2021] [Accepted: 12/02/2021] [Indexed: 12/04/2022] Open
Abstract
Background The lifetime risk of breast and ovarian cancer is significantly higher among women with genetic susceptibility or a strong family history. However, current risk assessment tools and clinical practices may identify only 10% of asymptomatic carriers of susceptibility genes. Bright Pink developed the Assess Your Risk (AYR) tool to estimate breast and ovarian cancer risk through a user-friendly, informative web-based quiz for risk assessment at the population level. Objective This study aims to present the AYR tool, describe AYR users, and present evidence that AYR works as expected by comparing classification using the AYR tool with gold standard genetic testing guidelines. Methods The AYR is a recently developed population-level risk assessment tool that includes 26 questions based on the National Comprehensive Cancer Network (NCCN) guidelines and factors from other commonly used risk assessment tools. We included all women who completed the AYR between November 2018 and January 2019, with the exception of self-reported cancer or no knowledge of family history. We compared AYR classifications with those that were independently created using NCCN criteria using measures of validity and the McNemar test. Results There were 143,657 AYR completions, and most participants were either at increased or average risk for breast cancer or ovarian cancer (137,315/143,657, 95.59%). Using our estimates of increased and average risk as the gold standard, based on the NCCN guidelines, we estimated the sensitivity and specificity for the AYR algorithm–generated risk categories as 100% and 89.9%, respectively (P<.001). The specificity improved when we considered the additional questions asked by the AYR to define increased risk, which were not examined by the NCCN criteria. By race, ethnicity, and age group; we found that the lowest observed specificity was for the Asian race (85.9%) and the 30 to 39 years age group (87.6%) for the AYR-generated categories compared with the NCCN criteria. Conclusions These results demonstrate that Bright Pink’s AYR is an accurate tool for use by the general population to identify women at increased risk of breast and ovarian cancer. We plan to validate the tool longitudinally in future studies, including the impact of race, ethnicity, and age on breast and ovarian cancer risk assessment.
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Affiliation(s)
- Elizabeth A Hibler
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Angela J Fought
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Rebecca Molsberry
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Virginia Nowakowski
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Cadet T, Burke SL, Naseh M, Grudzien A, Kozak RS, Romeo J, Bullock K, Davis C. Examining the Family Support Role of Older Hispanics, African Americans, and Non-Hispanic Whites and Their Breast Cancer Screening Behaviors. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:38-53. [PMID: 33427579 PMCID: PMC7925380 DOI: 10.1080/19371918.2020.1852993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Disparities in breast cancer mortality rates among older Black and Hispanic women are due in part to low participation in cancer screening. Participation in cancer screening could be affected by an array of factors, including social support. Understanding the complex interplay between social support and breast cancer screening among older female adults, specifically among groups with higher mortality rates, is extremely important for timely and appropriate interventions to increase survival rates. Thus, utilizing the social network theory as the conceptual framework, this study aims to examine effects of social support on receiving a mammogram among a representative sample of older adults, specifically African American and Hispanic populations in the United States. Logistic regression models were conducted using the 2008 and 2012 Health and Retirement Study data. Findings from this study indicate that specific aspects of social support influence breast cancer screening participation among older Hispanic and non-Hispanic White women. However, this was not the case for the older Black women after adjusting for the sociodemographic factors. Given the role that family members play in the care of older adults, it is critical that social workers consider both the possible positive and negative interactions older women may have and how these interactions may affect their cancer screening behaviors. Findings can provide formative data to develop public health and social work interventions to increase positive social support and reduce negative social support by spouses and children to enhance breast cancer screening among older adults.
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Affiliation(s)
- Tamara Cadet
- School of Social Work, Simmons University, Boston, Massachusetts, USA
- Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Shanna L Burke
- Robert Stempel College of Public Health and Social Work, School of Social Work, Florida International University, Miami, Florida, USA
| | - Mitra Naseh
- Robert Stempel College of Public Health and Social Work, School of Social Work, Florida International University, Miami, Florida, USA
| | - Adrienne Grudzien
- Robert Stempel College of Public Health and Social Work, School of Social Work, Florida International University, Miami, Florida, USA
| | | | - Jessica Romeo
- Hope House Addiction Services, Boston, Massachusetts, USA
| | - Karen Bullock
- School of Social Work, North Carolina State University, Raleigh, North Carolina, USA
| | - Cindy Davis
- University of the Sunshine Coast, Sippy Downs, Australia
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Bracke X, Roberts J, McVeigh TP. A systematic review and meta-analysis of telephone vs in-person genetic counseling in BRCA1/BRCA2 genetic testing. J Genet Couns 2020; 30:563-573. [PMID: 33131182 DOI: 10.1002/jgc4.1343] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 11/08/2022]
Abstract
Pathogenic variants in the BRCA1 and BRCA2 genes increase the risk of breast and ovarian cancer. Individuals with identified pathogenic variants in the BRCA1 or BRCA2 gene can benefit from cancer risk-reducing strategies. In the recent years, there has been an increase in the demand of genetic services. In light of the ongoing COVID19 pandemic, alternatives to face-to-face consultations have had to be considered and adopted, including telemedicine. Informed consent is necessary for genetic testing. Studies have suggested that increased levels of cancer-specific distress may impair the patient's ability to retain information, therefore, providing informed consent. This systematic review and meta-analysis aimed to answer if telephone genetic counseling for BRCA1 and BRCA2 genetic testing is non-inferior to in-person genetic counseling for the outcomes of cancer-specific distress and genetic knowledge. Databases of Medline, Embase, PsycINFO, CINAHL, SciELO, Web of Science, CENTRAL, ProQuest Dissertation & Theses Database, Clinicaltrials.gov, EU clinical trials register were accessed to identify any published or unpublished relevant literature. Random-effects models were used for the meta-analysis. Four studies were included in the qualitative synthesis of the results. Three studies were included in the quantitative synthesis of the results. Telephone genetic counseling was non-inferior compared to in-person genetic counseling for the outcomes of cancer-specific distress and genetic knowledge. Sensitivity analysis corroborated the main results. Telephone genetic counseling for BRCA1/BRCA2 genetic testing may be an alternative model of delivering genetic services in front of the increased demand/or when required by social context. However, the paucity of the evidence prevents from drawing strong conclusions regarding the generalizability of these results. Further research is needed to strengthen the conclusions.
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Affiliation(s)
- Xavier Bracke
- Institute of Continuing Education, University of Cambridge, Cambridge, UK.,Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Jonathan Roberts
- Institute of Continuing Education, University of Cambridge, Cambridge, UK
| | - Terri P McVeigh
- Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, UK
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Ouk M, Edwards JD, Colby-Milley J, Kiss A, Swardfager W, Law M. Psychiatric morbidity and cervical cancer screening: a retrospective population-based case-cohort study. CMAJ Open 2020; 8:E134-E141. [PMID: 32161045 PMCID: PMC7065560 DOI: 10.9778/cmajo.20190184] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cervical cancer screening reduces disease-specific mortality. This study aimed to estimate whether bipolar disorder or schizophrenia is associated with disparities in cervical cancer screening rates. METHODS This was a retrospective population-based matched case-cohort study of community-dwelling women aged 19-69 in Ontario using linked health administrative databases. We used odds ratios (ORs), hazards ratios and rate ratios (RRs) adjusted for demographic characteristics and relevant comorbidities to compare cervical cancer screening outcomes between women with a diagnosis of bipolar disorder or schizophrenia to women without that history matched on key demographic characteristics, between 2003 and 2015. RESULTS In total, 1 245 457 women were identified for inclusion in the analyses, 119 948 with a diagnosis of bipolar disorder or schizophrenia, and 1 125 509 without. Over a median follow-up duration of 12.5 years, women with the exposure were 36% less likely to be screened (OR 0.64, 95% confidence interval [CI] 0.64-0.65) than those without, and they took longer to undergo screening (median 18.98 mo v. 16.63 mo; χ2 = 3718.2, p < 0.001). They were also screened less frequently (median 6.16 yr v. 4.69 yr per screen; RR 0.85, 95% CI 0.84-0.85). These effects were consistent after we excluded the 86 475 women (6.9%) with suspected major depressive disorder, and they were larger for the 59 141 women (4.7%) not attached to a family physician. INTERPRETATION Women with bipolar disorder or schizophrenia were less likely to undergo cervical cancer screening, their screening was delayed, and they were screened at a lower rate compared to women without this psychiatric history. This practice gap suggests a need to further address barriers to screening, including access to a family physician, among women with bipolar disorder or schizophrenia.
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Affiliation(s)
- Michael Ouk
- Hurvitz Brain Sciences Program (Ouk, Colby-Milley, Swardfager), Sunnybrook Research Institute, University of Toronto; Departments of Pharmacology & Toxicology (Ouk, Swardfager) and Family & Community Medicine (Law), University of Toronto, Toronto, Ont.; University of Ottawa Heart Institute (Edwards); School of Epidemiology and Public Health (Edwards), University of Ottawa, Ottawa, Ont.; ICES (Kiss), Toronto, Ont
| | - Jodi D Edwards
- Hurvitz Brain Sciences Program (Ouk, Colby-Milley, Swardfager), Sunnybrook Research Institute, University of Toronto; Departments of Pharmacology & Toxicology (Ouk, Swardfager) and Family & Community Medicine (Law), University of Toronto, Toronto, Ont.; University of Ottawa Heart Institute (Edwards); School of Epidemiology and Public Health (Edwards), University of Ottawa, Ottawa, Ont.; ICES (Kiss), Toronto, Ont
| | - Jessica Colby-Milley
- Hurvitz Brain Sciences Program (Ouk, Colby-Milley, Swardfager), Sunnybrook Research Institute, University of Toronto; Departments of Pharmacology & Toxicology (Ouk, Swardfager) and Family & Community Medicine (Law), University of Toronto, Toronto, Ont.; University of Ottawa Heart Institute (Edwards); School of Epidemiology and Public Health (Edwards), University of Ottawa, Ottawa, Ont.; ICES (Kiss), Toronto, Ont
| | - Alexander Kiss
- Hurvitz Brain Sciences Program (Ouk, Colby-Milley, Swardfager), Sunnybrook Research Institute, University of Toronto; Departments of Pharmacology & Toxicology (Ouk, Swardfager) and Family & Community Medicine (Law), University of Toronto, Toronto, Ont.; University of Ottawa Heart Institute (Edwards); School of Epidemiology and Public Health (Edwards), University of Ottawa, Ottawa, Ont.; ICES (Kiss), Toronto, Ont
| | - Walter Swardfager
- Hurvitz Brain Sciences Program (Ouk, Colby-Milley, Swardfager), Sunnybrook Research Institute, University of Toronto; Departments of Pharmacology & Toxicology (Ouk, Swardfager) and Family & Community Medicine (Law), University of Toronto, Toronto, Ont.; University of Ottawa Heart Institute (Edwards); School of Epidemiology and Public Health (Edwards), University of Ottawa, Ottawa, Ont.; ICES (Kiss), Toronto, Ont.
| | - Marcus Law
- Hurvitz Brain Sciences Program (Ouk, Colby-Milley, Swardfager), Sunnybrook Research Institute, University of Toronto; Departments of Pharmacology & Toxicology (Ouk, Swardfager) and Family & Community Medicine (Law), University of Toronto, Toronto, Ont.; University of Ottawa Heart Institute (Edwards); School of Epidemiology and Public Health (Edwards), University of Ottawa, Ottawa, Ont.; ICES (Kiss), Toronto, Ont
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Patel K, Gishe J, Liu J, Heaston A, Manis E, Moharreri B, Hargreaves M. Factors Influencing Recommended Cancer Screening in Low-Income African American Women in Tennessee. J Racial Ethn Health Disparities 2019; 7:129-136. [PMID: 31664677 DOI: 10.1007/s40615-019-00642-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/11/2019] [Accepted: 09/20/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVE This study examined the factors that predict recommended screening compliance to cervical, breast, and colorectal cancers in low-income African American women. It also examined obstacles to screenings by geographic region and screening status. METHODS As a part of the Meharry Community Networks Program (CNP) needs assessment, a 123-item community survey was administered to assess demographic characteristics, health care access and utilization, and screening practices for various cancers in low-income African Americans. For this study, only African American women 40 years and older (n = 308) were selected from the Meharry CNP community survey database. RESULTS There were several predictors to recommended screening such as being employed and having health insurance (P < 0.05). Additionally, the obstacles to screening posed a similar level of difficulty for participants from different geographic areas. DISCUSSION Sociodemographic differences and obstacles of screening need to be addressed in educational interventions aimed at improving cancer screenings.
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Affiliation(s)
- Kushal Patel
- Department of Public Health, Health Administration and Health Sciences, Tennessee State University, 330 10th Avenue North, Suite D-411, Nashville, TN, 37203, USA.
| | - Jemal Gishe
- Department of Public Health, Health Administration and Health Sciences, Tennessee State University, 330 10th Avenue North, Suite D-410, Nashville, TN, 37203, USA
| | - Jianguo Liu
- Department of Internal Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd, Nashville, TN, 37208, USA
| | - Alexis Heaston
- Department of Public Health, Health Administration and Health Sciences, Tennessee State University, 330 10th Avenue North, Suite D-416, Nashville, TN, 37203, USA
| | - Elizabeth Manis
- Department of Public Health, Health Administration and Health Sciences, Tennessee State University, 330 10th Avenue North, Suite D-419, Nashville, TN, 37203, USA
| | - Bella Moharreri
- Department of Public Health, Health Administration and Health Sciences, Tennessee State University, 330 10th Avenue North, Suite D-419, Nashville, TN, 37203, USA
| | - Margaret Hargreaves
- Department of Internal Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd, Nashville, TN, 37208, USA
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Lee Y, Aurshina A, Lee AJ, Ackerman IM, Chait M, Novak D, Hingorani A, Ascher E, Marks N. Routine colonoscopy, diabetic eye care, mammogram and pap smear screening in vascular surgery patients. Vascular 2017; 26:372-377. [PMID: 29153055 DOI: 10.1177/1708538117742830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective An increasing emphasis on preventive medicine has been supported by the recent reforms in United States health care system. Majority of the patients seen in vascular surgery clinics are elderly with more extensive medical comorbidities compared to the general population. Thus, these patients would be expected at higher risk for common malignant pathologies such as colon, breast and cervical cancer, and nonmalignant diseases such as diabetic retinopathy. This study looked at the screening compliance of vascular patients compared to data provided by Centers for Disease Control on the national and state levels. Methods The office records of 851 consecutive patients seen in Brooklyn and Staten Island vascular clinics were examined. We queried patients regarding their last colonoscopy, diabetic eye exams, recent mammograms, and Pap smears. Our patient screening compliance was compared between the two clinics as well as to the national and New York state data provided by Centers for Disease Control. Compliance with regard to patient's age was also examined. Results Patients referred to the Staten Island office have a better colonoscopy compliance compared to the Brooklyn office ( P = .0001) and the national Centers for Disease Control average ( P = .026). Compliance for mammography and cervical cancer screening was higher in Staten Island office compared to the Brooklyn office ( P = .0001, P < .0001), respectively. Compliance was lower for Pap smear ( P = .0273) in Brooklyn when compared to the national average. Compliance for colonoscopy increased with age for both clinics ( P = .001, P < .001), while Pap smear decreased ( P < .001, P = .004). Conclusion Patients in vascular clinics in an urban setting had better adherence to screening protocol than the national and state average, with the exception of female patients for colonoscopy in our Brooklyn vascular office. There exists variability in both patient populations based on sub-specific locality and demographics including socioeconomic status. Overall, however patients in Staten Island had better compliance and adherence to the screening protocol than Brooklyn vascular clinic.
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Affiliation(s)
- Young Lee
- Vascular Institute of New York, Brooklyn, NY, USA
| | | | - Aaron J Lee
- Vascular Institute of New York, Brooklyn, NY, USA
| | | | | | - Daniel Novak
- Vascular Institute of New York, Brooklyn, NY, USA
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Abstract
BACKGROUND Lung cancer screening is a recent recommendation for long-term smokers. Understanding individual health beliefs about screening is a critical component in future efforts to facilitate patient-provider conversations about screening participation. OBJECTIVE The aim of this study was to describe the development and psychometric testing of 4 new scales to measure lung cancer screening health beliefs (perceived risk, perceived benefits, perceived barriers, self-efficacy). METHODS In phase I, 4 scales were developed from extensive literature review, item modification from existing Breast and Colorectal Cancer Screening Health Belief Scales, focus groups with long-term smokers, and evaluation/feedback from a panel of 10 content experts. In phase II, we conducted a survey of 497 long-term smokers to assess the final scales' reliability and validity. RESULTS Phase I: content validity was established with the content expert panel. Phase II: internal consistency reliability of the scales was supported with Cronbach's α's ranging from .88 to .92. Construct validity was established with confirmatory factor analysis and testing for differences between screeners and nonscreeners in theoretically proposed directions. CONCLUSIONS Initial testing supports the scales are valid and reliable. These new scales can help investigators identify long-term smokers more likely to screen for lung cancer and are useful for the development and testing of behavioral interventions regarding lung cancer screening. IMPLICATIONS FOR PRACTICE Development of effective interventions to enhance shared decision making about lung cancer screening between patients and providers must first identify factors influencing the individual's screening participation. Future efforts facilitating patient-provider conversations are better informed by understanding the perspective of the individual making the decision.
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Yanes T, Meiser B, Young MA, Kaur R, Mitchell G, Barlow-Stewart K, Roscioli T, Halliday J, James P. Psychosocial and behavioral impact of breast cancer risk assessed by testing for common risk variants: protocol of a prospective study. BMC Cancer 2017; 17:491. [PMID: 28720130 PMCID: PMC5516374 DOI: 10.1186/s12885-017-3485-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 07/13/2017] [Indexed: 01/02/2023] Open
Abstract
Background The ‘common variant, common disease’ model predicts that a significant component of hereditary breast cancer unexplained by pathogenic variants in moderate or high-penetrance genes is due to the cumulative effect of common risk variants in DNA (polygenic risk). Assessing a woman’s breast cancer risk by testing for common risk variants can provide useful information for women who would otherwise receive uninformative results by traditional monogenic testing. Despite increasing support for the utility of common risk variants in hereditary breast cancer, research findings have not yet been integrated into clinical practice. Translational research is therefore critical to ensure results are effectively communicated, and that women do not experience undue adverse psychological outcomes. Methods In this prospective study, 400 women with a personal and/or high risk family history of breast cancer will be recruited from six familial cancer centers (FCCs) in Australia. Eligible women will be invited to attend a FCC and receive their personal polygenic risk result for breast cancer. Genetic health professionals participating in the study will receive training on the return of polygenic risk information and a training manual and visual aids will be developed to facilitate patient communication. Participants will complete up to three self-administered questionnaires over a 12-months period to assess the short-and long-term psychological and behavioral outcomes of receiving or not receiving their personal polygenic risk result. Discussion This is the world’s first study to assess the psychological and behavioral impact of offering polygenic risk information to women from families at high risk of breast cancer. Findings from this research will provide the basis for the development of a new service model to provide polygenic risk information in familial cancer clinics. Trial registration The study was retrospectively registered on 27th April 2017 with the Australian and New Zealand Clinical Trials Group (Registration no: ACTRN12617000594325; clinical trial URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372743). Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3485-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tatiane Yanes
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia. .,School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Bettina Meiser
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | | | - Rajneesh Kaur
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Gillian Mitchell
- Familial Cancer Service, Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, 3052, Australia
| | - Kristine Barlow-Stewart
- Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, 2065, Australia
| | - Tony Roscioli
- Department of Medical Genetics, Sydney Children's Hospital, Sydney, Australia
| | - Jane Halliday
- Public Health Genetics, Murdoch Children's Research Institute, Melbourne, VIC, 3052, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, 3052, Australia
| | - Paul James
- Familial Cancer Service, Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
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Abda N, Najdi A, El Fakir S, Tachfouti N, Berraho M, Chami Khazraji Y, Abousselham L, Belakhel L, Bekkali R, Nejjari C. Knowledge, Attitudes, and Preventive Practice Towards Breast Cancer among General Practitioner Health Professionals in Morocco. Asian Pac J Cancer Prev 2017; 18:963-968. [PMID: 28545194 PMCID: PMC5494246 DOI: 10.22034/apjcp.2017.18.4.963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background: Breast cancer is the most common cancer of women in Morocco and its diagnosis is usually made at advanced stages. The aim of this study was to describe the knowledge, practices and attitudes of general practitioners regarding early detection of breast cancer. Methods: A cross-sectional study was carried out during July 2011 on a sample of 140 general practitioners employed in basic health care facilities. Results: The majority (85.7%) of general practitioners were aware of the existence of a ministerial circular which aimed to generalize breast cancer screening. Systematic practice of clinical breast examination was reported by 18.0% of doctors for every woman between 45 and 70 years and a systematic breast self-examination check-up was reported by 59.4% of physicians. Mammography was requested by 54.1% of physicians in the presence of risk factors. Females and physicians practicing in urban areas were less likely to have a knowledge, attitudes and practices score higher than 8 as compared to male physicians and those practicing in rural areas. Discussion and conclusion: Our study showed that the knowledge, attitudes and practices of general practitioners regarding the early detection of breast cancer program were not satisfactory; hence the urgent need for improved implementation of the program in the affected regions.
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Affiliation(s)
- Naima Abda
- Department of Epidemiology and Public Health, Faculty of Medicine and Pharmacy, University Mohammed Premier, Oujda, Morocco.
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Paquet L, Simmonds L, Yang C, Verma S. An exploratory study of patients' views about being at high-risk for breast cancer and risk management beliefs and intentions, before and after risk counselling: Preliminary evidence of the influence of beliefs on post-counselling prevention intentions. PATIENT EDUCATION AND COUNSELING 2017; 100:575-582. [PMID: 27756584 DOI: 10.1016/j.pec.2016.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 09/24/2016] [Accepted: 10/08/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES 1) To describe how women at high-risk for breast cancer (BC) perceive their at-risk status and the options available to manage this risk, before and after risk counselling; 2) to explore the contributions of pre-counselling demographic, clinical, cognitive and emotional factors to post-counselling risk management intentions. METHODS 58 of 173 eligible patients (34%) enrolled and were asked to fill surveys including measures of 1) subjective risk, 2) illness (being at high-risk for BC) and 3) treatment (surveillance, lifestyle modifications, and chemoprevention) cognitions, 4) BC fear and 5) future risk management intentions, prior to and 3 months after risk consultation. RESULTS 48 of 58 participants (83%) completed both surveys. Beliefs and emotions about their condition and its management were stable over time. Surveillance and lifestyle were associated with stronger intentions, higher perceived need, and lower concerns than chemoprevention (all ps <0.001). The strongest predictors of intentions strengths were the women's beliefs about the risk reduction methods, especially for lifestyle and chemoprevention (all ps <0.01). CONCLUSIONS The findings emphasize the importance of patients' beliefs in risk management decisions. PRACTICAL IMPLICATIONS Patients' treatment beliefs appear to influence their choice of BC risk reduction strategies and should be discussed during risk reduction consultations.
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Affiliation(s)
- Lise Paquet
- Department of Psychology, Carleton University, Ottawa K1S 5B6, Canada.
| | - Lisa Simmonds
- Medical Oncology, The Ottawa Hospital Cancer Centre, Ottawa, Canada
| | - Charles Yang
- Medical Oncology, The Ottawa Hospital Cancer Centre, Ottawa, Canada
| | - Shailendra Verma
- Medical Oncology, The Ottawa Hospital Cancer Centre, Ottawa, Canada
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12
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Cadet TJ, Stewart K, Howard T. Psychosocial correlates of cervical cancer screening among older Hispanic women. SOCIAL WORK IN HEALTH CARE 2017; 56:124-139. [PMID: 27960632 PMCID: PMC5890332 DOI: 10.1080/00981389.2016.1263268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Early detection through screening can reduce mortality rates of cervical cancer, and yet Hispanic women who have incidence rates higher than their non-Hispanic White counterparts are least likely to participate in cancer screening initiatives. This study utilized data from the 2008 wave of the Health and Retirement Study to investigate the psychosocial correlates associated with older Hispanic women's participation in cervical cancer screening services. Logistic regression models were used. Findings indicated that greater life satisfaction and religiosity were associated with a greater likelihood of participating in cervical cancer screening. Despite ongoing national conversations, evidence indicates there is agreement that underserved women need to be screened, particularly the older Hispanic population.
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Affiliation(s)
- Tamara J Cadet
- a School of Social Work, Simmons College , Boston , Massachusetts , USA
| | - Kathleen Stewart
- a School of Social Work, Simmons College , Boston , Massachusetts , USA
| | - Tenial Howard
- a School of Social Work, Simmons College , Boston , Massachusetts , USA
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13
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Farajzadegan Z, Fathollahi-Dehkordi F, Hematti S, Sirous R, Tavakoli N, Rouzbahani R. The transtheoretical model, health belief model, and breast cancer screening among Iranian women with a family history of breast cancer. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2016; 21:122. [PMID: 28331508 PMCID: PMC5348838 DOI: 10.4103/1735-1995.193513] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 07/08/2016] [Accepted: 08/05/2016] [Indexed: 11/10/2022]
Abstract
Background: Participation of Iranian women with a family history of breast cancer in breast cancer screening programs is low. This study evaluates the compliance of women having a family history of breast cancer with clinical breast exam (CBE) according to the stage of transtheoretical model (TTM) and health belief model (HBM). Materials and Methods: In this cross-sectional study, we used Persian version of champion's HBM scale to collect factors associated with TTM stages applied to screening from women over 20 years and older. The obtained data were analyzed by SPSS, using descriptive statistics, Chi-square test, independent t-test, and analysis of covariance. Results: Final sample size was 162 women. Thirty-three percent were in action/maintenance stage. Older women, family history of breast cancer in first-degree relatives, personal history of breast disease, insurance coverage, and a history of breast self-examination were associated with action/maintenance stage. Furthermore, women in action/maintenance stages had significantly fewer perceived barriers in terms of CBE in comparison to women in other stages (P < 0.05). There was no significant difference in other HBM subscales scores between various stages of CBE screening behavior (P > 0.05). Conclusion: The finding indicates that the rate of women in action/maintenance stage of CBE is low. Moreover, results show a strong association between perceived barriers and having a regular CBE. These clarify the necessity of promoting national target programs for breast cancer screening, which should be considered as the first preference for reducing CBE barriers.
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Affiliation(s)
- Ziba Farajzadegan
- Department of Community Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Simin Hematti
- Department of Radiotherapy, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Sirous
- Department of Radiology, University of Mississippi, Mississippi, USA
| | - Neda Tavakoli
- Department of Community Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Rouzbahani
- Department of Community Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Lam RW, McIntosh D, Wang J, Enns MW, Kolivakis T, Michalak EE, Sareen J, Song WY, Kennedy SH, MacQueen GM, Milev RV, Parikh SV, Ravindran AV. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 1. Disease Burden and Principles of Care. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2016; 61:510-23. [PMID: 27486151 PMCID: PMC4994789 DOI: 10.1177/0706743716659416] [Citation(s) in RCA: 175] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals. METHODS Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. This section is the first of six guidelines articles. RESULTS In Canada, the annual and lifetime prevalence of MDD was 4.7% and 11.3%, respectively. MDD represents the second leading cause of global disability, with high occupational and economic impact mainly attributable to indirect costs. DSM-5 criteria for depressive disorders remain relatively unchanged, but other clinical dimensions (sleep, cognition, physical symptoms) may have implications for depression management. e-Mental health is increasingly used to support clinical and self-management of MDD. In the 2-phase (acute and maintenance) treatment model, specific goals address symptom remission, functional recovery, improved quality of life, and prevention of recurrence. CONCLUSIONS The burden attributed to MDD remains high, whether from individual distress, functional and relationship impairment, reduced quality of life, or societal economic cost. Applying core principles of care, including comprehensive assessment, therapeutic alliance, support of self-management, evidence-informed treatment, and measurement-based care, will optimize clinical, quality of life, and functional outcomes in MDD.
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Affiliation(s)
- Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia
| | - Diane McIntosh
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia
| | - JianLi Wang
- Department of Psychiatry, University of Calgary, Calgary, Alberta
| | - Murray W Enns
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba
| | - Theo Kolivakis
- Department of Psychiatry, McGill University, Montréal, Quebec
| | - Erin E Michalak
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia
| | - Jitender Sareen
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba
| | - Wei-Yi Song
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia
| | - Sidney H Kennedy
- Department of Psychiatry, University of Toronto, Toronto, Ontario
| | | | - Roumen V Milev
- Department of Psychiatry, Queen's University, Kingston, Ontario
| | - Sagar V Parikh
- Department of Psychiatry, University of Toronto, Toronto, Ontario Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Arun V Ravindran
- Department of Psychiatry, University of Toronto, Toronto, Ontario
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15
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Zine K, Nani S, Lahmadi IA, Maaroufi A. [Awareness of breast cancer screening among general practitioners in Mohammedia (Morocco)]. Pan Afr Med J 2016; 24:243. [PMID: 27800098 PMCID: PMC5075484 DOI: 10.11604/pamj.2016.24.243.9627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 07/01/2016] [Indexed: 11/18/2022] Open
Abstract
Introduction Le cancer du sein représente un problème de santé publique majeur au Maroc. C'est le premier cancer chez la femme. L'objectif de ce travail était d'évaluer les connaissances des médecins généralistes (MG) en matière de dépistage du cancer du sein dans la préfecture de Mohammedia Maroc. Méthodes Nous avons mené une étude transversale, descriptive, exhaustive incluant les 97 MG exerçant dans les établissements de soins de santé de base du secteur public et privé de la province de Mohammedia. Résultats Le taux de participation était de 87%. L'âge moyen des MG était de 49,6 ± 8,1. Quatre-vingt pour cent (n=55) des MG ont donné une incidence incorrecte, 77,6% (n=85) ont reconnu l'existence d'un plan national de prévention et de contrôle du cancer (PNPCC) au Maroc, et 67,1 des MG ont rapporté l'existence d'un registre du cancer au Maroc. Le secteur d'activité était associé significativement avec les connaissances des MG sur le PNPCC et sur l'existence d'un guide de détection précoce du cancer du sein avec respectivement (p=0,003 et p=0,001). Une association significative entre l'ancienneté et l'existence d'un guide de détection précoce du cancer du sein et d'un registre du cancer du sein a été retrouvée avec (respectivement p=0,005 et p=0.002). Conclusion À la lumière de ces résultats il faudra renforcer les connaissances et les pratiques des MG par la promotion de la formation initiale et continue sur le dépistage.
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Affiliation(s)
- Karima Zine
- Laboratoire d'Epidémiolgie, Faculté de Médecine et de Pharmacie de Casablanca, Maroc
| | - Samira Nani
- Laboratoire d'Epidémiolgie, Faculté de Médecine et de Pharmacie de Casablanca, Maroc
| | - Imad Ait Lahmadi
- Centre Hospitalier Universitaire, Ibn Rochd de Casablanca, Maroc
| | - Abderrahmane Maaroufi
- Laboratoire d'Epidémiolgie, Faculté de Médecine et de Pharmacie de Casablanca, Maroc
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Terry MB, Phillips KA, Daly MB, John EM, Andrulis IL, Buys SS, Goldgar DE, Knight JA, Whittemore AS, Chung WK, Apicella C, Hopper JL. Cohort Profile: The Breast Cancer Prospective Family Study Cohort (ProF-SC). Int J Epidemiol 2016; 45:683-92. [PMID: 26174520 PMCID: PMC5005937 DOI: 10.1093/ije/dyv118] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Mary Beth Terry
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA, Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA,
| | - Kelly-Anne Phillips
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, School of Population and Global Health, St Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Mary B Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Esther M John
- Cancer Prevention Institute of California, Fremont, CA, USA, Department of Health Research & Policy, Stanford University School of Medicine, Stanford, CA, USA
| | - Irene L Andrulis
- Lunenfeld-Tanenbaum Research Institute, University of Toronto, Toronto, ON, Canada
| | | | - David E Goldgar
- Department of Dermatology, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Julia A Knight
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada and
| | - Alice S Whittemore
- Department of Health Research & Policy, Stanford University School of Medicine, Stanford, CA, USA
| | - Wendy K Chung
- Departments of Pediatrics and Medicine, Columbia University, New York, NY, USA
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17
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Jensen LF, Pedersen AF, Bech BH, Andersen B, Vedsted P. Psychiatric morbidity and non-participation in breast cancer screening. Breast 2016; 25:38-44. [DOI: 10.1016/j.breast.2015.10.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 09/18/2015] [Accepted: 10/05/2015] [Indexed: 01/17/2023] Open
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18
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Jensen LF, Pedersen AF, Andersen B, Vedsted P. Self-assessed health, perceived stress and non-participation in breast cancer screening: A Danish cohort study. Prev Med 2015; 81:392-8. [PMID: 26494608 DOI: 10.1016/j.ypmed.2015.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/11/2015] [Accepted: 10/12/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Population-based cancer screening is offered in many countries to detect early stages of cancer and reduce mortality. Screening efficiency and equality is susceptible due to a group of non-participants. We investigated associations between self-assessed health, perceived stress and subsequent non-participation in breast cancer screening. METHODS This population-based cohort study included 4512 women who had participated in a Health Survey in 2006 and who were also the target group (aged 50-69 years) for the first organised breast cancer screening programme -3 years later in the Central Denmark Region in 2008-2009. RESULTS A U-shaped association was observed for physical health assessment as women with the highest (PR=1.28, 95% CI: 1.06-1.55), and the lowest (PR=1.41, 95% CI: 1.18-1.68) physical health scores were less likely to participate in the programme than women with physical health scores in the middle range. Women with low mental health assessment were more likely not to participate than women with mental health scores in the middle range (PR=1.44, 95% CI: 1.22-1.69). Higher non-participation propensity was also observed for women with the highest perceived stress scores (PR=1.27, 95% CI: 1.07-1.51) compared with women scoring in the middle range. CONCLUSIONS Women with highest and lowest self-assessed physical health, with lowest mental health or highest perceived stress were significantly more likely not to participate in breast cancer screening 2-3 years later than women who reported average health. Interventions targeting these groups may promote equal participation in future breast cancer screening programmes.
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Affiliation(s)
- Line Flytkjær Jensen
- Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark; Section for General Medical Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark; Research Centre for Cancer Diagnosis in Primary Care (CaP), Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark; Department for Public Health Programs, Randers Regional Hospital, Central Denmark Region, Skovlyvej 1, Randers, NE 8930, Denmark.
| | - Anette Fischer Pedersen
- Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark; Research Centre for Cancer Diagnosis in Primary Care (CaP), Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark
| | - Berit Andersen
- Department for Public Health Programs, Randers Regional Hospital, Central Denmark Region, Skovlyvej 1, Randers, NE 8930, Denmark
| | - Peter Vedsted
- Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark; Research Centre for Cancer Diagnosis in Primary Care (CaP), Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark
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Towne SD, Anderson KE, Smith ML, Dahlke DV, Kellstedt D, Purcell NP, Ory MG. Changing organizational culture: using the CEO cancer gold standard policy initiatives to promote health and wellness at a school of public health. BMC Public Health 2015; 15:853. [PMID: 26334296 PMCID: PMC4559178 DOI: 10.1186/s12889-015-2186-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 08/25/2015] [Indexed: 11/22/2022] Open
Abstract
Background Worksite wellness initiatives for health promotion and health education have demonstrated effectiveness in improving employee health and wellness. We examined the effects of a multifaceted health promotion campaign on organizational capacity to meet requirements to become CEO Cancer Gold Standard Accredited. Methods We conducted an online survey to assess perceived organizational values and support for the five CEO Cancer Gold Standard Pillars for cancer prevention: tobacco cessation; physical activity; nutrition; cancer screening and early detection; and accessing information on cancer clinical trials. Baseline and follow-up surveys were sent 6-months apart to faculty, staff, and students at a school of public health to test the impact of a multifaceted health promotion campaign on perceived organizational change. Descriptive analyses were used to characterize percent improvement. Multivariate logistic regression analyses were used to control for participants’ university status. Results The current organizational culture highly supported tobacco cessation at both time points. Significant improvements (p < .05) from baseline to follow-up were observed for questions measuring organizational values for ‘prevention, screening, and early detection of cancer’ and ‘accessing cancer treatment and clinical trials’. Conclusions Health promotion and education efforts using multiple approaches were effective to improve perceived organizational values and support for cancer prevention and early detection, and increase access to information about cancer clinical trials. Future studies are needed to examine broader impacts of implementing worksite health promotion initiatives.
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20
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McGregor BA, Dolan ED, Murphy KM, Sannes TS, Highland KB, Albano DL, Ward AA, Charbonneau AM, Redman MW, Ceballos RM. Cognitive Behavioral Stress Management for Healthy Women at Risk for Breast Cancer: a Novel Application of a Proven Intervention. Ann Behav Med 2015; 49:873-84. [PMID: 26290001 PMCID: PMC4739817 DOI: 10.1007/s12160-015-9726-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Women at risk for breast cancer report elevated psychological distress, which has been adversely associated with cancer-relevant behaviors and biology. PURPOSE The present study sought to examine the effects of a 10-week cognitive behavioral stress management (CBSM) group intervention on distress among women with a family history of breast cancer. METHODS Participants were randomly assigned to CBSM (N = 82) or a wait-list comparison group (N = 76). Baseline to postintervention effects of CBSM on depressive symptoms and perceived stress were examined using hierarchical regression. RESULTS CBSM participants reported significantly lower posttreatment depressive symptoms (β = -0.17, p < 0.05) and perceived stress (β = -0.23, p < 0.05) than wait-list comparison participants. Additionally, greater relaxation practice predicted lower distress. CONCLUSIONS Group-based CBSM intervention is feasible and can reduce psychological distress among women with a family history of breast cancer. The present findings represent an encouraging avenue for the future application of CBSM. ( Clinicaltrials.gov number NCT00121160).
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Affiliation(s)
- Bonnie A McGregor
- Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, M3-B232, Seattle, WA, 98109, USA.
- Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA.
| | - Emily D Dolan
- Shelter Research and Development, American Society for the Prevention of Cruelty to Animals, New York, NY, USA
| | - Karly M Murphy
- Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, M3-B232, Seattle, WA, 98109, USA
| | - Timothy S Sannes
- Anschutz Medical Campus, University of Colorado Denver, Denver, CO, USA
| | | | - Denise L Albano
- Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, M3-B232, Seattle, WA, 98109, USA
| | - Alison A Ward
- Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, M3-B232, Seattle, WA, 98109, USA
| | - Anna M Charbonneau
- Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, M3-B232, Seattle, WA, 98109, USA
| | - Mary W Redman
- Clinical Research, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, M3-B232, Seattle, WA, 98109, USA
| | - Rachel M Ceballos
- Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, M3-B232, Seattle, WA, 98109, USA
- Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA
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21
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Breast Self-examination Education for BRCA Mutation Carriers by Clinical Nurse Specialists. CLIN NURSE SPEC 2015; 29:E1-7. [DOI: 10.1097/nur.0000000000000118] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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22
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Jensen LF, Pedersen AF, Andersen B, Vedsted P. Social support and non-participation in breast cancer screening: a Danish cohort study. J Public Health (Oxf) 2015; 38:335-42. [DOI: 10.1093/pubmed/fdv051] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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23
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Heiniger L, Butow PN, Charles M, Price MA. Intuition versus cognition: a qualitative exploration of how women understand and manage their increased breast cancer risk. J Behav Med 2015; 38:727-39. [PMID: 25820809 DOI: 10.1007/s10865-015-9632-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 03/18/2015] [Indexed: 01/05/2023]
Abstract
Risk comprehension in individuals at increased familial risk of cancer is suboptimal and little is known about how risk is understood and managed by at-risk individuals who do not undergo genetic testing. We qualitatively studied these issues in 36 unaffected women from high-risk breast cancer families, including both women who had and had not undergone genetic testing. Data were collected through semi-structured interviews and data analysis was guided by Grounded Theory. Risk comprehension and risk management were largely influenced by the individual's experience of coming from a high-risk family, with both tested and untested women relying heavily on their intuition. Although women's cognitive understanding of their risk appeared generally accurate, this objective risk information was considered of secondary value. The findings could be used to guide the development and delivery of information about risk and risk management to genetically tested and untested individuals at increased risk of hereditary cancer.
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Affiliation(s)
- Louise Heiniger
- Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, The University of Sydney, Sydney, NSW, Australia. .,Psycho-Oncology Cooperative Research Group (PoCoG), The University of Sydney, Level 6 North, Chris O'Brien Lifehouse (C39Z), Sydney, NSW, 2006, Australia.
| | - Phyllis N Butow
- Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, The University of Sydney, Sydney, NSW, Australia.,Psycho-Oncology Cooperative Research Group (PoCoG), The University of Sydney, Level 6 North, Chris O'Brien Lifehouse (C39Z), Sydney, NSW, 2006, Australia
| | - Margaret Charles
- Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | | | - Melanie A Price
- Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, The University of Sydney, Sydney, NSW, Australia.,Psycho-Oncology Cooperative Research Group (PoCoG), The University of Sydney, Level 6 North, Chris O'Brien Lifehouse (C39Z), Sydney, NSW, 2006, Australia
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Abstract
OBJECTIVE The research about follow-up patterns of women attending high-risk breast-cancer clinics is sparse. This study sought to profile daughters of breast-cancer patients who are likely to return versus those unlikely to return for follow-up care in a high-risk clinic. METHOD Our investigation included 131 patients attending the UCLA Revlon Breast Center High Risk Clinic. Predictor variables included age, computed breast-cancer risk, participants' perceived personal risk, clinically significant depressive symptomatology (CES-D score ≥ 16), current level of anxiety (State-Trait Anxiety Inventory), and survival status of participants' mothers (survived or passed away from breast cancer). RESULTS A greater likelihood of reattendance was associated with older age (adjusted odds ratio [AOR] = 1.07, p = 0.004), computed breast-cancer risk (AOR = 1.10, p = 0.017), absence of depressive symptomatology (AOR = 0.25, p = 0.009), past psychiatric diagnosis (AOR = 3.14, p = 0.029), and maternal loss to breast cancer (AOR = 2.59, p = 0.034). Also, an interaction was found between mother's survival and perceived risk (p = 0.019), such that reattendance was associated with higher perceived risk among participants whose mothers survived (AOR = 1.04, p = 0.002), but not those whose mothers died (AOR = 0.99, p = 0.685). Furthermore, a nonlinear inverted "U" relationship was observed between state anxiety and reattendance (p = 0.037); participants with moderate anxiety were more likely to reattend than those with low or high anxiety levels. SIGNIFICANCE OF RESULTS Demographic, medical, and psychosocial factors were found to be independently associated with reattendance to a high-risk breast-cancer clinic. Explication of the profiles of women who may or may not reattend may serve to inform the development and implementation of interventions to increase the likelihood of follow-up care.
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25
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Cadet TJ. The relationship between psychosocial factors and breast cancer screening behaviors of older Hispanic women. SOCIAL WORK IN PUBLIC HEALTH 2015; 30:207-223. [PMID: 25611310 DOI: 10.1080/19371918.2014.969857] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Guided by the theory of planned behavior, this study utilized data from the 2008 wave of the Health and Retirement Study to investigate psychosocial factors associated with older Hispanic women's participation in breast cancer screening services. Hierarchical logistic regression models were used to assess the odds of breast cancer screening participation. Findings indicate that satisfaction with aging and constraints were associated with a reduced likelihood of participating in breast cancer screening. These findings suggest the continued importance to assess older women's attitudes when discussing preventive services.
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Affiliation(s)
- Tamara J Cadet
- a School of Social Work, Simmons College , Boston , Massachusetts , USA
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Cloud AJ, Thai A, Liao Y, Terry MB. The impact of cancer prevention guideline adherence on overall mortality in a high-risk cohort of women from the New York site of the Breast Cancer Family Registry. Breast Cancer Res Treat 2015; 149:537-46. [PMID: 25604794 PMCID: PMC4308644 DOI: 10.1007/s10549-014-3234-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 12/05/2014] [Indexed: 12/13/2022]
Abstract
The American Cancer Society (ACS) recommends at least 150 min of moderate intensity physical activity per week, alcohol intake of ≤1 drink per day, and maintaining a body mass index (BMI) of <25 kg/m2 for breast cancer prevention. Adherence to these guidelines has been linked to lower overall mortality in average-risk populations, it is not known if mortality reduction extends to women at higher risk given their family history of breast cancer. We followed 2,905 women from a high-risk Breast Cancer Family Registry in New York, of which 77 % were white non-Hispanic and 23 % were Hispanic. We collected information on BMI, physical activity, and alcohol intake at baseline and prospectively followed our cohort for outcomes based on questionnaires and National Death Index linkage. We used Cox regression to examine the relation between adherence to ACS guidelines and overall mortality and examined effect modification by race, age, and BRCA status. There were 312 deaths after an average of 9.2 ± 4.1 years of follow-up. Adherence to all three ACS recommendations was associated with 44–53 % lower mortality in women unaffected with breast cancer at baseline [Hazard Ratio (HR) 0.56, 95 % CI (0.33–0.93)] and in women affected with breast cancer at baseline [HR 0.47, 95 % CI (0.30–0.74)]. These associations remained after stratification by age, race, and BRCA status {e.g., BRCA1 and/or BRCA2 carriers [HR 0.39, 95 % CI (0.16–0.97)]}. These results support that women at high risk, similar to women at average risk, may also have substantial benefits from maintaining the ACS guidelines.
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Affiliation(s)
- Ann J Cloud
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Rm724A, New York, NY, 10032, USA,
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Does perceived risk predict breast cancer screening use? Findings from a prospective cohort study of female relatives from the Ontario site of the breast cancer family registry. Breast 2014; 23:482-8. [PMID: 24821458 DOI: 10.1016/j.breast.2014.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 04/03/2014] [Accepted: 04/04/2014] [Indexed: 11/21/2022] Open
Abstract
While the relationship between perceived risk and breast cancer screening use has been studied extensively, most studies are cross-sectional. We prospectively examined this relationship among 913 women, aged 25-72 with varying levels of familial breast cancer risk from the Ontario site of the Breast Cancer Family Registry. Associations between perceived lifetime breast cancer risk and subsequent use of mammography, clinical breast examination (CBE) and genetic testing were assessed using logistic regression. Overall, perceived risk did not predict subsequent use of mammography, CBE or genetic testing. Among women at moderate/high familial risk, those reporting a perceived risk greater than 50% were significantly less likely to have a CBE (odds ratio (OR) = 0.52, 95% confidence interval (CI): 0.30-0.91, p = 0.04), and non-significantly less likely to have a mammogram (OR = 0.70, 95% CI: 0.40-1.20, p = 0.70) or genetic test (OR = 0.61, 95% CI: 0.34-1.10, p = 0.09) compared to women reporting a perceived risk of 50%. In contrast, among women at low familial risk, those reporting a perceived risk greater than 50% were non-significantly more likely to have a mammogram (OR = 1.13, 95% CI: 0.59-2.16, p = 0.78), CBE (OR = 1.11, 95% CI: 0.63-1.95, p = 0.74) or genetic test (OR = 1.29, 95% CI: 0.50-3.33, p = 0.35) compared to women reporting a perceived risk of 50%. Perceived risk did not significantly predict screening use overall, however this relationship may be moderated by level of familial risk. Results may inform risk education and management strategies for women with varying levels of familial breast cancer risk.
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Silberbogen AK, Busby AK, Ulloa EW. Impact of Psychological Distress on Prostate Cancer Screening in U.S. Military Veterans. Am J Mens Health 2013; 8:399-408. [PMID: 24362494 DOI: 10.1177/1557988313516357] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The benefit of routine prostate cancer screening is currently under debate; however, many experts recommend that men with elevated risk for the disease discuss the potential risks and benefits of screening with their health care team. Psychological factors have been negatively associated with preventive health behaviors such as cancer screenings. The purpose of this study was to investigate the impact of depressive and trauma-related symptoms on prostate cancer screening behaviors and relevant health care perceptions among a sample of U.S. military veterans, as veterans are at higher risk for prostate cancer, depression, and posttraumatic stress disorder than the general population. Participants (n = 350) were a national sample of predominantly Caucasian (84.6%) male U.S. military veterans (60.5 years ± 8.9) who completed an online questionnaire regarding past prostate cancer screening engagement, as well as validated measures of depression, posttraumatic stress disorder, and perceived barriers and benefits to prostate cancer screening. Results indicate that greater depressive symptoms, trauma-related symptoms, and perceived barriers were associated with lower rates of past prostate cancer screening among this veteran sample and that greater depressive and trauma-related symptoms were associated with greater perceived barriers to prostate cancer screening. As prostate cancer screening recommendations continue to evolve, it is important for health care providers not only to discuss pros and cons of screening with high risk men but also to consider the impact of psychological distress on the decision-making process.
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Affiliation(s)
- Amy K Silberbogen
- VA Boston Healthcare System, Boston, MA, USA Boston University School of Medicine, Boston, MA
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Hui SKA, Engelman KK, Shireman TI, Ellerbeck EF. Adherence to cancer screening guidelines and predictors of improvement among participants in the Kansas State Employee Wellness Program. Prev Chronic Dis 2013; 10:E115. [PMID: 23845176 PMCID: PMC3711498 DOI: 10.5888/pcd10.120212] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Employee wellness programs (EWPs) have been used to implement worksite-based cancer prevention and control interventions. However, little is known about whether these programs result in improved adherence to cancer screening guidelines or how participants’ characteristics affect subsequent screening. This study was conducted to describe cancer screening behaviors among participants in a state EWP and identify factors associated with screening adherence among those who were initially nonadherent. Methods We identified employees and their dependents who completed health risk assessments (HRAs) as part of the Kansas state EWP in both 2008 and 2009. We examined baseline rates of adherence to cancer screening guidelines in 2008 and factors associated with adherence in 2009 among participants who were initially nonadherent. Results Of 53,095 eligible participants, 13,222 (25%) participated in the EWP in 2008 and 6,205 (12%) participated in both years. Among the multiyear participants, adherence was high at baseline to screening for breast (92.5%), cervical (91.8%), and colorectal cancer (72.7%). Of participants who were initially nonadherent in 2008, 52.4%, 41.3%, and 33.5%, respectively, became adherent in the following year to breast, cervical, and colorectal cancer screening. Suburban/urban residence and more frequent doctor visits predicted adherence to breast and colorectal cancer screening guidelines. Conclusion The effectiveness of EWPs for increasing cancer screening is limited by low HRA participation rates, high rates of adherence to screening at baseline, and failure of nonadherent participants to get screening. Improving overall adherence to cancer screening guidelines among employees will require efforts to increase HRA participation, stronger interventions for nonadherent participants, and better access to screening for rural employees.
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Affiliation(s)
- Siu-kuen Azor Hui
- Fox Chase Cancer Center, Department of Psychosocial and Behavioral Medicine, 333 Cottman Ave, Young Pavilion 4141, Philadelphia, PA 19111, USA.
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Guvenc I, Guvenc G, Tastan S, Akyuz A. Identifying women's knowledge about risk factors of breast cancer and reasons for having mammography. Asian Pac J Cancer Prev 2013; 13:4191-7. [PMID: 23098429 DOI: 10.7314/apjcp.2012.13.8.4191] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The aim of this study was to identify breast cancer risk factors and reasons for having mammography of the women who applied for mammography, as well as to determine their level of knowledge about risk factors and level of risk perception, and anxiety concerning breast cancer. This cross-sectional descriptive study was conducted from June 15, 2010 through September 10, 2010, in a university hospital in Ankara, Turkey. A questionnaire prepared by the researchers was used to collect the data. The mean age of the women was 52.1 ± 9.98 years. Sixteen percent of the women had a family history of breast cancer. The majority of participants had mammograms (75.8%) before and had gained knowledge about breast cancer and its screening (73.7%). The leading source of information about breast cancer was physicians (46.2%). Physician recommendations, having breast-related complaints, and family history of breast cancer were important reasons to obtain mammography. The mean knowledge score about risk factors of breast cancer was 4.15 ± 2.73 and the mean anxiety score was 1.65 ± 1.61. It was found that some socio-demographic and obstetrical characteristics of women, their family history, and risk perceptions about breast cancer affect their knowledge and anxiety scores about breast cancer. In conclusion, the present study identified a number of factors affecting mammography participation for women. The results of this study can be helpful in promoting screening for breast cancer.
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Affiliation(s)
- Inanc Guvenc
- Department of Radiology, Gulhane Military Medical Academy, Etlik, Ankara, Turkey.
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Walker MJ, Chiarelli AM, Knight JA, Mirea L, Glendon G, Ritvo P. Perceived risk and adherence to breast cancer screening guidelines among women with a familial history of breast cancer: a review of the literature. Breast 2013; 22:395-404. [PMID: 23313062 DOI: 10.1016/j.breast.2012.12.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 10/12/2012] [Accepted: 12/17/2012] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES A small positive association has been consistently demonstrated between perceived breast cancer risk and mammography use. Evidence specific to women with familial breast cancer risk has not been previously reviewed. METHODS A literature search was conducted. 186 studies were identified for abstract/full-text review, of which 10 articles were included. Manual searching identified 10 additional articles. Twenty articles examining the association between perceived breast cancer risk and adherence to mammography, clinical breast examination (CBE) or breast self-examination (BSE) guidelines among women with familial breast cancer risk were reviewed. Studies were classified according to screening modality, categorized by finding and ordered by year of publication. Studies assessing mammography were further classified according to the applied method of measuring perceived risk. RESULTS Our review found a weak positive association between higher perceived risk and adherence to mammography guidelines among women with familial breast cancer risk. Consistent associations between perceived risk and adherence to CBE and BSE guidelines were not observed. CONCLUSIONS Our ability to understand the relationship between perceived breast cancer risk and adherence to breast screening guidelines is limited, because most previous research is cross-sectional. Future studies with prospective methodologies that use consistent measurement methods and are adequately powered are warranted.
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Affiliation(s)
- Meghan J Walker
- Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada.
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Adherence to breast and ovarian cancer screening recommendations for female relatives from the Ontario site of the Breast Cancer Family Registry. Eur J Cancer Prev 2012; 20:492-500. [PMID: 21691207 DOI: 10.1097/cej.0b013e3283476217] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This study compares adherence to breast and ovarian cancer screening recommendations among a population cohort of women at familial risk of breast and/or ovarian cancer. This cross-sectional study included 1039 first-degree female relatives without breast cancer identified from the Ontario site of the Breast Cancer Family Registry. We compared breast and ovarian cancer screening behaviors, using a telephone-administered questionnaire among three groups of women defined by their familial risk (high, moderate, and low) of breast and/or ovarian cancer. Associations between screening behaviors and familial risk were assessed using multinomial regression models adjusted by familial clustering. Women, 40-49 years of age, at moderate or high familial risk were significantly more likely to have had a screening mammogram within the past 12 months [odds ratio (OR): 2.80; 95% confidence interval (CI): 1.40-5.58], and women of less than 50 years of age were more likely to have a clinical breast examination (OR: 1.84; 95% CI: 1.02-3.31) compared with women at low familial risk. Compared with women at low or moderate familial risk, women at high familial risk were significantly more likely to have ever had a genetic test for the BRCA 1/2 genes (OR: 2.67; 95% CI: 1.76-4.05). Although the overall level of adherence among high-risk women is suboptimal in the community, women at a higher familial risk are adhering more often to cancer screening recommendations than women at a lower familial risk.
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Ritvo P, Edwards SA, Glendon G, Mirea L, Knight JA, Andrulis IL, Chiarelli AM. Beliefs about optimal age and screening frequency predict breast screening adherence in a prospective study of female relatives from the Ontario site of the Breast Cancer Family Registry. BMC Public Health 2012; 12:518. [PMID: 22788119 PMCID: PMC3432622 DOI: 10.1186/1471-2458-12-518] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 07/12/2012] [Indexed: 11/13/2022] Open
Abstract
Background Although few studies have linked cognitive variables with adherence to mammography screening in women with family histories of breast and/or ovarian cancer, research studies suggest cognitive phenomena can be powerful adherence predictors. Methods This prospective study included 858 women aged 30 to 71 years from the Ontario site of the Breast Cancer Family Registry with at least one first-degree relative diagnosed with breast and/or ovarian cancer. Data on beliefs about breast cancer screening and use of mammography were obtained from annual telephone interviews spanning three consecutive years. Self-reported mammogram dates were confirmed with medical imaging reports. Associations between beliefs about breast cancer screening and adherence with annual mammography were estimated using polytomous logistic regression models corrected for familial correlation. Models compared adherers (N = 329) with late-screeners (N = 382) and never-screeners (N = 147). Results Women who believed mammography screening should occur annually were more likely to adhere to annual screening recommendations than women who believed it should happen less often (OR: 5.02; 95% CI: 2.97-8.49 for adherers versus late-screeners; OR: 6.82; 95% CI: 3.29-14.16 for adherers versus never-screeners). Women who believed mammography screening should start at or before age 50 (rather than after) (OR: 9.72; 95% CI: 3.26-29.02) were significantly more likely to adhere when compared with never-screeners. Conclusions Study results suggest that women with a family history of breast cancer should be strongly communicated recommendations about initial age of screening and screening intervals as related beliefs significantly predict adequate adherence.
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Affiliation(s)
- Paul Ritvo
- Research, Prevention and Cancer Control, Cancer Care Ontario, 620 University Ave, Toronto, ON M5G 2L7, Canada.
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Jensen LF, Mukai TO, Andersen B, Vedsted P. The association between general practitioners' attitudes towards breast cancer screening and women's screening participation. BMC Cancer 2012; 12:254. [PMID: 22708828 PMCID: PMC3413538 DOI: 10.1186/1471-2407-12-254] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 06/18/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer screening in Denmark is organised by the health services in the five regions. Although general practitioners (GPs) are not directly involved in the screening process, they are often the first point of contact to the health care system and thus play an important advisory role. No previous studies, in a health care setting like the Danish system, have investigated the association between GPs' attitudes towards breast cancer screening and women's participation in the screening programme. METHODS Data on women's screening participation was obtained from the regional screening authorities. Data on GPs' attitudes towards breast cancer screening was taken from a previous survey among GPs in the Central Denmark Region. This study included women aged 50-69 years who were registered with a singlehanded GP who had participated in the survey. RESULTS The survey involved 67 singlehanded GPs with a total of 13,288 women on their lists. Five GPs (7%) had a negative attitude towards breast cancer screening. Among registered women, 81% participated in the first screening round. Multivariate analyses revealed that women registered with a GP with a negative attitude towards breast cancer screening were 17% (95% CI: 2-34%) more likely to be non-participants compared with women registered with a GP with a positive attitude towards breast cancer screening. CONCLUSION The GPs' attitudes may influence the participation rate even in a system where GPs are not directly involved in the screening process. However, further studies are needed to investigate this association.
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Affiliation(s)
- Line Flytkjær Jensen
- The Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C, Denmark.
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Zheng DD, Christ SL, Lam BL, Arheart KL, Galor A, Lee DJ. Increased mortality risk among the visually impaired: the roles of mental well-being and preventive care practices. Invest Ophthalmol Vis Sci 2012; 53:2685-92. [PMID: 22427599 PMCID: PMC3366723 DOI: 10.1167/iovs.11-8794] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 02/07/2012] [Accepted: 03/12/2012] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Mechanisms by which visual impairment (VI) increases mortality risk are poorly understood. We estimated the direct and indirect effects of self-rated VI on risk of mortality through mental well-being and preventive care practice mechanisms. METHODS Using complete data from 12,987 adult participants of the 2000 Medical Expenditure Panel Survey with mortality linkage through 2006, we undertook structural equation modeling using two latent variables representing mental well-being and poor preventive care to examine multiple effect pathways of self-rated VI on all-cause mortality. Generalized linear structural equation modeling was used to simultaneously estimate pathways including the latent variables and Cox regression model, with adjustment for controls and the complex sample survey design. RESULTS VI increased the risk of mortality directly after adjusting for mental well-being and other covariates (hazard ratio [HR] = 1.25 [95% confidence interval: 1.01, 1.55]). Poor preventive care practices were unrelated to VI and to mortality. Mental well-being decreased mortality risk (HR = 0.68 [0.64, 0.74], P < 0.001). VI adversely affected mental well-being (β = -0.54 [-0.65, -0.43]; P < 0.001). VI also increased mortality risk indirectly through mental well-being (HR = 1.23 [1.16, 1.30]). The total effect of VI on mortality including its influence through mental well-being was HR 1.53 [1.24, 1.90]. Similar but slightly stronger patterns of association were found when examining cardiovascular disease-related mortality, but not cancer-related mortality. CONCLUSIONS VI increases the risk of mortality directly and indirectly through its adverse impact on mental well-being. Prevention of disabling ocular conditions remains a public health priority along with more aggressive diagnosis and treatment of depression and other mental health conditions in those living with VI.
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Affiliation(s)
- D Diane Zheng
- Department of Epidemiology & Public Health, University of Miami School of Medicine, Miami, FL 33136, USA.
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Chien LC, Deshpande AD, Jeffe DB, Schootman M. Influence of primary care physician availability and socioeconomic deprivation on breast cancer from 1988 to 2008: a spatio-temporal analysis. PLoS One 2012; 7:e35737. [PMID: 22536433 PMCID: PMC3335009 DOI: 10.1371/journal.pone.0035737] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Accepted: 03/20/2012] [Indexed: 11/19/2022] Open
Abstract
Background Breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer death among women in the United States. It is unclear how county-level primary care physician (PCP) availability and socioeconomic deprivation affect the spatial and temporal variation of breast cancer incidence and mortality. Methods We used the 1988–2008 public-use county-based data from nine Surveillance, Epidemiology, and End Results (SEER) programs to analyze the temporal and spatial disparity of PCP availability and socioeconomic deprivation on early-stage incidence, advanced-stage incidence and breast cancer mortality. The spatio-temporal analysis was implemented by a novel structural additive modeling approach. Results Greater PCP availability was significantly associated with higher early-stage incidence, advanced-stage incidence and mortality during the entire study period while socioeconomic deprivation was significantly negatively associated with early-stage incidence, advanced-stage incidence, and mortality up to 1992. However, the observed influence of PCP availability and socioeconomic deprivation varied by county. Conclusions We showed important associations of PCP availability and socioeconomic deprivation with the three breast cancer indicators. However, the effect of these associations varied over time and across counties. The association of PCP availability and socioeconomic deprivation was stronger in selected counties.
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Affiliation(s)
- Lung-Chang Chien
- Division of Health Behavior Research, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, United States of America.
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Are videoconferenced consultations as effective as face-to-face consultations for hereditary breast and ovarian cancer genetic counseling? Genet Med 2012; 13:933-41. [PMID: 21799430 DOI: 10.1097/gim.0b013e3182217a19] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Videoconferencing is increasingly used to deliver family cancer services for hereditary breast and ovarian cancer to outreach areas. This study compared the effectiveness and acceptability of genetic counseling for hereditary breast and ovarian cancer through videoconferencing (hereafter referred to as "telegenetics"). METHODS One hundred six women seen by telegenetics and 89 women seen face-to-face completed self-administered questionnaires before, and 1 month after, genetic counseling. Telegenetics consultations involved a genetic clinician via telegenetics in addition to a local genetic counselor present with the patient. RESULTS No significant differences were found between telegenetics and face-to-face genetic counseling in terms of knowledge gained (P = 0.55), satisfaction with the genetic counseling service (P = 0.76), cancer-specific anxiety (P = 0.13), generalized anxiety (P = 0.42), depression (P = 0.96), perceived empathy of the genetic clinician (P = 0.13), and perceived empathy of the genetic counselor (P = 0.12). Telegenetics performed significantly better than face-to-face counseling in meeting patients' expectations (P = 0.009) and promoting perceived personal control (P = 0.031). CONCLUSION Telegenetics seems to be an acceptable and effective method of delivering genetic counseling services for hereditary breast and ovarian cancer to underserved areas.
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Dreyer G. Screening for gynaecologic cancers in genetically predisposed women. Best Pract Res Clin Obstet Gynaecol 2012; 26:267-82. [PMID: 22361688 DOI: 10.1016/j.bpobgyn.2011.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Accepted: 11/09/2011] [Indexed: 12/24/2022]
Abstract
Hereditary breast and ovarian cancer syndrome and hereditary non-polyposis colon cancer syndrome are the two most important syndromes responsible for inherited cancers in gynaecology. Genetic testing is available for both these syndromes. Breast cancer gene testing is affordable and easy in women with ancestry where the mutation patterns are known, whereas other population groups need full gene screening. Hereditary non-polyposis colon cancer syndrome can now be diagnosed more frequently with the use of immunohistochemistry. Ovarian cancer risk is high in hereditary breast and ovarian cancer syndromes, and advanced screening techniques should be used when preventive surgery is not an option. Early detection techniques offer less protection than prophylactic removal, but enable women to retain their reproductive organs. Oophorectomy has the advantage of reducing breast cancer risk. In colorectal cancer syndromes, the risk for endometrial and ovarian cancer is much elevated. These risks should be recognised and addressed as these diseases are easy to prevent.
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Affiliation(s)
- Greta Dreyer
- Gynaecologic Oncology Unit, Department of Obstetrics and Gynaecology, University of Pretoria, 183 Charles Street, Brooklyn 0181, South Africa.
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Miles A, Rainbow S, von Wagner C. Cancer fatalism and poor self-rated health mediate the association between socioeconomic status and uptake of colorectal cancer screening in England. Cancer Epidemiol Biomarkers Prev 2011; 20:2132-40. [PMID: 21953115 PMCID: PMC3199581 DOI: 10.1158/1055-9965.epi-11-0453] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Little is known about the psychological predictors of colorectal screening uptake in England and mediators of associations between uptake and socioeconomic status (SES). This study tested the hypotheses that although higher threat and efficacy beliefs, lower cancer fatalism, lower depression, and better self-rated health would predict higher screening uptake, only efficacy beliefs, fatalism, depression, and self-rated health would mediate associations between uptake and SES. METHODS Data from 529 adults aged 60 to 69 who had completed a postal survey in 2005-2006 were linked with data on fecal occult blood test (FOBt) uptake recorded at the screening "hub" following its introduction in 2007, resulting in a prospective study. RESULTS Screening uptake was 56% and was higher among people with higher SES, better self-rated health, higher self-efficacy beliefs, and lower cancer fatalism in univariate analyses. Path analysis on participants with complete data (n = 515) showed that both better self-rated health and lower cancer fatalism were directly associated with higher uptake of FOBt screening and significantly mediated pathways from SES to uptake. Lower depression only had an indirect effect on uptake through better self-rated health. Efficacy beliefs did not mediate the relationship between SES and uptake. CONCLUSION SES differences in uptake of FOBt in England are partially explained by differences in cancer fatalism, self-rated health, and depression. IMPACT This is one of only a few studies to examine mediators of the relationship between SES and screening uptake, and future research could test the effectiveness of interventions to reduce fatalistic beliefs to increase equality of uptake.
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Affiliation(s)
- Anne Miles
- Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom.
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