A Study on the Knowledge, Perception, and Use of Breast Cancer Screening Methods and Quality of Care Among Women from Central Mexico

Knowledge, Attitudes, Behavior, and Practices of Self-Breast Examination in Jalisco, Mexico

The importance of self-breast examination to identify early signs of breast cancer has been widely discussed in scientific literature. We conducted a cross-sectional survey of women aged 18 years and over (n = 547) living in urban and rural areas in the State of Jalisco, Mexico. Survey questions included measures on knowledge, attitudes, behaviors, and practices related to self-breast examination. We compared these measures between women living in urban and rural areas and women aged 18-39 years and 40+ years. Using t-test, we tested the significance of these differentials. Our results indicate that there is no significant difference in knowledge, attitudes, behavior, and practices regarding self-breast examination between women living in urban and in rural areas of Jalisco. However, we found some difference in these measures between women in 18-39 years and 40+ years. While the State of Jalisco has taken significant steps toward promoting significance of cancer prevention, further attention to women in the older cohort is recommended.

Awareness levels of breast cancer among female university and medical college students in Sylhet city of Bangladesh

BACKGROUND

Breast cancer has become a concerning health problem worldwide due to its increasing incidence rate. Women from developing countries are dying off due to the lack of knowledge on breast cancer and its different early detection programs.

AIMS

This study explores the level of knowledge about breast cancer risk factors, early warning signs, screening, and therapeutic approaches and their influential determinants among university and medical college students.

METHODS

A cross-sectional study was conducted, including 567 female university-level students (343 female students from 1 university and 224 female students from 1 medical college). This study used a semi-structured questionnaire about four aspects (risk factors, early warning signs, screening, and therapeutic approaches) of breast cancer, latent class analysis (LCA), and latent class regression (LCR) for investigation.

RESULTS

The percent of knowing correct answers of risk factors, early warning signs, screening approaches, and therapeutic methods were 86.3%, 69.8%, 70.2%, and 51.2%, respectively for medical students who had a high level of awareness and those for university students were 73.0%, 66.8%, 35.9%, and 24.7%. On the other hand, only 37.95% of medical students had been practicing Breast self-examination (BSE), while it was 18.37% for university students. The most effective predictors of the high level of awareness were age, advertisements (ad) promoting awareness about breast cancer, programs/campaign related to breast cancer, and personal breast problem history.

CONCLUSIONS

Taken together, the awareness level about four aspects of breast cancer is low among university students and is moderately high among medical students. Therefore, relevant health education programs in every educational institute are urgently needed to improve the awareness levels among female students to improve women's health at home and abroad.

Breast cancer screening behavior and its associated factors in female employees in South Khorasan

BACKGROUND

Breast cancer is a preventable disease, using three secondary preventive methods of mammography, clinical breast examination (CBE), and breast self-examination (BSE) that can lead to early detection of breast cancer. This study was designed to assess breast cancer screening behavior and its associated factors in females employed in South Khorasan.

MATERIALS AND METHODS

In this analytic-descriptive study, 2256 female personnel of governmental organizations were investigated in Birjand city in 2016-2017. The data collection tool was a three-part questionnaire: sociodemographic characteristics, knowledge about breast cancer screening methods plus women's performance, and stage of change regarding screening behaviors of mammography, CBE, and BSE. The data were analyzed by SPSS 16 and one-way analysis variance, Tukey's post hoc, and multiple logistic regression model statistical tests.

RESULTS

The mean ± standard deviation score of knowledge of the women was 3.45 ± 1.5. There was a significant difference of the mean score of knowledge between the single and married (P = 0.03) and age group (P = 0.04). The stage action of mammography, CBE, and BSE was 6.8%, 12.3%, and 16.8%, respectively. Logistic regression model showed that variables such as age and family history of breast cancer were highly significant related to mammography and also CBE. Knowledge was also highly significant in mammography, CBE, and BSE. Education level in CBE, marital status in BSE and mammography, and job in BSE were also significant (P < 0.001).

CONCLUSIONS

This study reveals insufficient knowledge of female workers about breast cancer and the negative influence of low knowledge on the practice of breast cancer screening behavior. Therefore, the establishment and maintenance of regular educational courses for female employees is essential.

Factors associated with breast cancer screening behaviors in a sample of Jamaican women in 2013

In this study authors aimed to investigate the barriers to participation of a sample of Jamaican women in mammography screening. The data were obtained from a previous survey that was conducted in Jamaica from June to August 2013 in the four parishes (Hanover, St. James, Trelawny, and Westmoreland) served by the Western Regional Health Authority (WRHA). WRHA served four hospitals, five non-randomized health centers, and five sites of community events. The sample consisted of women ranging in age between 35 and 83 years, with the mean age of 50.2 (SD = 10.6). The authors used a logistic regression to determine the extent to which variables were associated with breast cancer screening. The level of significace was 0.1 for the bivariate and multivariable analysis. The main factors associated with the lack of breast cancer screening among the women were: being less than 50 years old, single, never thought about breast cancer screening, in need of childcare, and having more than three children. We identified significant barriers to participation in mammography screening experienced by a sample of Jamaican women. Our results suggest that it is necessary to increase the awareness of the importance of breast screening importance among the women who may never have thought about mammography.

Adaptation and Validation of the Health Belief Model Scale for Breast Self-Examination in Mexican Women

OBJECTIVES

In Mexico, breast cancer is often not detected until it is already at an advanced stage. Many women know about breast self-examination (BSE), but few do it correctly. BSE can assist in the early detection of breast cancer, and a valid and reliable instrument to help determine the factors of the Health Belief Model that affect the practice of BSE in Mexican women would thus be advantageous. This study evaluates the psychometric properties of the Spanish version of the Health Belief Model Scale (HBMS) for BSE and identifies the factors that influence its practice.

METHODS

A cross-sectional design was used; 738 Mexican women aged 20 years and older who attended a tertiary public hospital were evaluated. The HBMS of Champion was translated into Spanish. Focus groups of women were consulted, and experts' judgments were gathered to determine content validity.

RESULTS

In the exploratory factor analysis, a structure of 6 factors was obtained, and Cronbach's alpha scales ranged between 0.65 and 0.84. BSE practice was associated with age (odds ratio [OR] 1.05; confidence interval [CI] 1.03-1.07), self-efficacy (OR 1.16; CI 1.12-1.20), barriers (OR 0.953; CI 0.912-0.996), and health motivation (OR 0.907; CI 0.837-0.983).

CONCLUSION

The Spanish version of the HBMS is an adequate, valid, and reliable instrument for the Mexican population that allows us to evaluate their beliefs about breast cancer and BSE, and it should also be applicable to other Spanish-speaking people. Perceived barriers, self-efficacy, and health motivation in particular should be considered in the development of health promotion programs for Mexican women.

Brief report: Impact of healthcare quality on prostate specific antigen screening for the early detection of prostate cancer

With recent guidelines emphasizing patient values, patient preferences and shared decision-making in regards to prostate specific antigen (PSA) screening it is important for primary care providers and urologists to identify factors that influence men's decisions to undergo PSA screening. We sought to evaluate the impact of men's perceptions of healthcare quality on obtaining a screening PSA for the early detection of prostate cancer. A retrospective secondary data analysis was conducted of men ages 55-69 without a history of prostate cancer using 2015 Medical Expenditure Panel Survey (MEPS) data. The relationship between Consumer Assessment of Healthcare Providers and Systems (CAHPS) questions captured in MEPS and PSA screening in the last two years were assessed using multiple logistic regression. The analysis was carried out in October 2018 at Dartmouth-Hitchcock Medical Center. The final survey sample consisted of 1249 men that equated to 15,313,605.5 once weighted; 69.5% underwent PSA screening. Men who were offered help with filling out forms in the office (OR: 1.86, 95% CI: 1.14-3.01) or rated the quality of healthcare from their doctors ≥7 (OR: 1.63, 95% CI: 1.10-2.44) on a scale from 0 (worst healthcare) to 10 (best health care) had significantly greater adjusted odds of undergoing PSA screening. Men who rated the quality of healthcare delivered to them as high had significantly greater odds of undergoing PSA screening compared to those who rated it lower. Our results may suggest that improvements in healthcare quality and patient experience of care have the potential to positively influence PSA screening.

Stages of Change for Mammography Among Mexican Women and a Decisional Balance Comparison Across Countries

An analysis of the adoption of secondary preventive behaviors is significant in regions with disparities in mammography use and breast cancer survival. Therefore, we determined the cognitive factors and the degree to which they differentiate stages of change in mammography among Mexican women. We also compared the decisional balance performance at Mexico, Switzerland, South Korea, and the USA. A cross-sectional study was designed for women in the stages of precontemplation (n = 240), contemplation (n = 243), action (n = 205), maintenance (n = 311), and relapse (n = 348). We only considered those ≥40 years with no cancer history. We measured the pros, cons, and self-efficacy, among other components. The decisional balance was estimated, and the result was transformed into T-scores. Odds ratios (OR) and 95% confidence intervals (CI) were estimated with multinomial logistic regression using precontemplation as the reference group. The decisional balance distinguished stages partially: in contemplation, the OR was 1.26 (95%CI 1.08, 1.47) and in maintenance, 1.34 (95%CI 1.13, 1.59); in action and relapse, the statistical significance was marginal (p < 0.10). The decisional balance T-score performance registered variations among countries. Additionally, the effect of self-efficacy progressively ascended from contemplation to action and maintenance (OR = 1.29 [95%CI 1.05, 1.58], 1.53 [95%CI 1.20, 1.96], and 2.48 [95%CI 1.82, 3.39], respectively). Furthermore, risk perception and severity did not have an effect on stages of change among Mexican women. Recognition of what provokes action in a population is a key factor in the efficacy of screening programs. Variations among countries highlight the necessity for importance of investigating cognitive determinants for mammography in specific areas.

Knowledge, Beliefs, and Attitudes About Breast Cancer Screening in Latin America and the Caribbean: An In-Depth Narrative Review

Purpose Breast cancer (BCA) is the most common cancer and leading cause of cancer mortality among women in Latin America and the Caribbean (LAC), and the number of deaths from BCA is expected to continue to increase. Although barriers to care include the physical accessibility of screening resources, personal and cultural barriers must be explored to understand necessary next steps to increase access to preventive care. The purpose of this in-depth narrative literature review was to explore empiric literature that surrounds the knowledge, attitudes, and beliefs toward BCA screening practices among women in LAC. To our knowledge, this is the first literature review to include articles from all countries and national languages (Portuguese, English, and Spanish) that pertain to this topic. Methods OVID Medline, CINAHL, and Web of Science/SciELO were used to identify articles. Thirty-five articles were included according to inclusion and exclusion criteria. Results Themes identified in the literature included knowledge about screening procedures and cause of cancer; knowledge sources; catalysts and deterrents for screening, such as family support, family history; social support or taboo, fear, self-neglect, cost, and transportation; and the perception of the screening experience. Conclusion In addition to physical availability of resources and health care personnel, there is a necessity for culturally competent community educational interventions across all aspects of BCA screening and prevention. In light of the barriers to preventive health care, providers such as nurses and community health workers are uniquely qualified to provide culturally appropriate and individualized health education to address cultural and psychological barriers to BCA screening.

Factors associated with insufficient awareness of breast cancer among women in Northern and Eastern China: a case-control study

OBJECTIVES

To investigate the awareness and knowledge level of breast cancer among Chinese participants.

DESIGN

Case-control study.

SETTINGS

This study was based on the database of the minister-affiliated hospital key project of the Ministry of Health of the People's Republic of China that included 21 Chinese hospitals between April 2012 and April 2013.

PARTICIPANTS

Matched study was designed among 2978 participants with Han ethnicity aged between 25 and 70.

PRIMARY AND SECONDARY OUTCOME MEASURES

Student's t-test, Pearson's χ² test, reliability analysis, exploratory factor analysis, and univariate and multivariate logistic regression analyses were performed to know the level of breast cancer knowledge and find the breast cancer awareness-associated factors.

RESULTS

80.0% (2383/2978) of the participants had poor awareness level of breast cancer. In-depth knowledge of breast cancer such as early symptoms and risk factors was poorly found among them. Television broadcast and relatives or friends with breast cancers were the main sources of information about breast cancer. Of all participants, 72.8% (2167/2978) had heard about breast cancer as a frequent cancer affecting women, and 63.3% (1884/2978) knew that family history of breast cancer was a risk factor for breast cancer. Over half of them were aware that a breast lump could be a symptom of breast cancer. Multivariate analysis identified the following variables that predicted awareness of breast cancer: young age (OR=0.843, 95% CI 0.740 to 0.961), occupation (agricultural worker) (OR=12.831, 95% CI 6.998 to 23.523), high household social status (OR=0.644, 95% CI 0.531 to 0.780), breast hyperplasia history (OR=1.684, 95% CI 1.273 to 2.228), high behavioural prevention score (OR=4.407, 95% CI 3.433 to 5.657).

CONCLUSION

Most women were aware of breast cancer as a disease, but their in-depth knowledge of it was poor. More publicity and education programmes to increase breast cancer awareness are necessary and urgent, especially for the ageing women and agricultural workers.