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Reza S, Dewan SMR, Islam MS, Shahriar M. Response of Bangladesh to the World Health Organization call to eliminate cervical cancer as a public health issue: An observational report. Health Sci Rep 2024; 7:e2178. [PMID: 38915360 PMCID: PMC11194611 DOI: 10.1002/hsr2.2178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 04/01/2024] [Accepted: 05/17/2024] [Indexed: 06/26/2024] Open
Abstract
Background Despite being preventable, cervical cancer remains a leading cause of mortality among Bangladeshi women. This article addresses the trends in Bangladesh's response to the World Health Organization's (WHO) request for the eradication of cervical cancer within the nation. Discussion When it comes to cervical cancer, healthcare institutions need to be concerned in terms of protocols for diagnosis and treatment, staff education, and available resources. More than a quarter of all female cancers in Bangladesh are caused by cervical cancer, which can be prevented through better healthcare infrastructure, earlier diagnosis, more qualified healthcare professionals, improved urban and rural hospital infrastructure, community-based clinics, expanded affordable vaccinations, school-based delivery systems, adoption of single-dose vaccine schedules, raising awareness, and compiling a registry of previously affected results. WHO applauds Bangladesh's Ministry of Health and Family Welfare for its efforts to develop the National Strategy for cervical cancer prevention and control, which will guide and strengthen the country's activities to prevent and treat cervical cancer. Conclusion The endeavor to eradicate this global disease burden should not be limited to Bangladesh; all nations should participate collectively to prevent the malignancy from returning and threatening human civilization.
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Affiliation(s)
- Sejuti Reza
- Department of Pharmacy, School of MedicineUniversity of Asia PacificDhakaBangladesh
| | | | | | - Mohammad Shahriar
- Department of Pharmacy, School of MedicineUniversity of Asia PacificDhakaBangladesh
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Hoq MI, Jahan S, Mahmud MH, Hasan MMU, Jakaria M. Breast cancer screening awareness, practice, and perceived barriers: A community-based cross-sectional study among women in south-eastern Bangladesh. Health Sci Rep 2024; 7:e1799. [PMID: 38204752 PMCID: PMC10777436 DOI: 10.1002/hsr2.1799] [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: 08/10/2023] [Revised: 09/30/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024] Open
Abstract
Background and Aims Breast cancer is a leading cause of mortality in Bangladesh. An early-stage screening is the best way to reduce both the morbidity and mortality burden of breast cancer. The study evaluated awareness, practice, and perceived barriers toward breast cancer screening in Bangladesh. Methods A community-based cross-sectional study was conducted from October 2021 to December 2022 in Chattogram, Bangladesh, where 869 women (18 years or above) were randomly selected in this study. Results Among 869 participants, 47.3% of women were recruited from urban areas and 52.7% participated from rural areas. Only 32.68% of respondents (urban vs. rural: 44.28% vs. 22.27%) were aware of breast self-examination (BSE) and 52.47% of respondents (urban vs. rural: 63.75% vs. 42.36%) had ever heard Clinical Breast Examination (CBE), respectively. Among the respondents, 27.73% (urban vs. rural: 40.15% vs. 16.59%) performed their BSE, and only 14.61% of respondents (urban vs. rural: 21.90% vs. 8.08%) had ever visited for CBE. Women residing in rural areas were approximately three times (AOR: 0.36 [95% CI: 0.25-0.52], AOR: 0.37 [95% CI: 0.23-0.58]) less likely to perform BSE and CBE, respectively, than urban dwellers. We found that higher-educated women tend to do more BSE and CBE than women with low levels of education. Perceptions of having "no symptoms" and being "risk-free" are leading barriers to breast screening among women. Conclusion Poor awareness and practice were observed in screening among the urban and rural women in Bangladesh. Urban area dwellers had comparatively better understanding and practice than rural dwellers. We think extending health education and health promotion activities toward breast cancer screening is essential in this region.
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Affiliation(s)
- Mohammad Injamul Hoq
- School of Public Health, Epidemiology and Social Medicine at the Institute of Medicine, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Department of Public HealthUniversity of Creative Technology ChittagongChittagongBangladesh
| | - Shamima Jahan
- Department of Pharmaceutical SciencesState University of BangladeshDhakaBangladesh
- Department of PharmacyInternational Islamic University ChittagongKumiraChittagongBangladesh
| | - Md. Hasan Mahmud
- Department of Pharmaceutical SciencesState University of BangladeshDhakaBangladesh
- Department of PharmacyInternational Islamic University ChittagongKumiraChittagongBangladesh
| | - Md. Mayin Uddin Hasan
- Department of PharmacyInternational Islamic University ChittagongKumiraChittagongBangladesh
| | - Md. Jakaria
- The Florey InstituteThe University of MelbourneParkvilleVictoriaAustralia
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Chowdhury MZI, Mubin N, Mohib T, Chowdhury N, Chowdhury TF, Laskar AMH, Sultana S, Raihan M, Turin TC. Cancer screening research in Bangladesh: Insights from a scoping review. Glob Public Health 2024; 19:2351186. [PMID: 38752425 DOI: 10.1080/17441692.2024.2351186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 04/29/2024] [Indexed: 06/14/2024]
Abstract
This scoping review summarises the findings of research conducted on cancer screening in Bangladesh, including the prevalence, awareness, barriers, and evaluation of screening programmes, by performing a comprehensive search of electronic databases and gray literature. 25 studies that met inclusion criteria were included in the final analysis. Most of the studies were about screening for cervical cancer, were quantitative, were cross-sectional, and were conducted in hospital settings. The main challenges to screening uptake were shyness, fear, a lack of knowledge, and an inadequate understanding of the concept of screening. Visual inspection with acetic acid (VIA) was found to be a simple and cost-efficient way to detect early-stage cervical cancer. However, breast self-examination (BSE) was reported to be insufficient. Education was found to have a positive impact on cancer screening knowledge and practice, but more needs to be done to improve screening rates, such as the utilisation of media, particularly in rural areas. The results of this scoping review highlight Bangladesh's low cancer screening prevalence and uptake and suggest that targeted awareness campaigns and enhanced access to screening services are required to increase cancer screening uptake and reduce the cancer burden in Bangladesh.
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Affiliation(s)
- Mohammad Ziaul Islam Chowdhury
- Department of Psychiatry, University of Calgary, Calgary, Canada
- Department of General Educational Development, Daffodil International University, Dhaka, Bangladesh
| | - Nazirum Mubin
- Department of Radiotherapy, Dhaka Medical College Hospital, Dhaka, Bangladesh
| | - Tasmira Mohib
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Nashit Chowdhury
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | | | - Sanchita Sultana
- School of Health Sciences, Central Michigan University, Mount Pleasant, MI, USA
| | - Mohammad Raihan
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Tanvir C Turin
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Jahangirifar M, Fooladi E, Davis SR, Islam RM. Menopause symptoms, sexual dysfunctions and pelvic floor disorders in refugee and asylum seeker women: a scoping review. Climacteric 2023:1-8. [PMID: 36779420 DOI: 10.1080/13697137.2023.2173572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Refugee and asylum seeker women face a variety of health challenges. However, little is known globally about health problems in these women at midlife and beyond, including menopausal symptoms, sexual dysfunctions and pelvic floor disorders. This scoping review aimed to understand these neglected health issues with respect to prevalence and risk factors. Eight databases were searched in August 2022 without the limit of publication year. Data were analyzed narratively. A total of 10 reports from seven studies were included with 945 women living in Australia, Canada, the USA and Pakistan. Three reports were addressing menopause, seven addressed sexual dysfunctions and one addressed pelvic floor disorders. There were no data regarding menopause symptoms; however, perceptions of menopause varied widely across studies. Few studies reported a high prevalence of sexual dysfunctions and pelvic organ prolapses, but none of them used a validated questionnaire. Taboos and cultural factors, lack of knowledge and education, lack of family support, language insufficiency and financial problems were common barriers to not seeking care for these health issues. This review demonstrates lack of evidence of these neglected health issues in refugee and asylum seeker women at midlife, and further studies with validated questionnaires and larger samples are warranted.
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Affiliation(s)
- M Jahangirifar
- Monash Nursing and Midwifery, Monash University, Melbourne, Australia
| | - E Fooladi
- Monash Nursing and Midwifery, Monash University, Melbourne, Australia
| | - S R Davis
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - R M Islam
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Raisa A, Roberto AJ, Love RR, Steiness HLS, Salim R, Krieger JL. Pot Song as a Novel Cancer Communication Intervention: Lessons Learned from Developing, Implementing, and Evaluating a Culturally Grounded Intervention for Breast Cancer Education in Rural Bangladesh. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:260-273. [PMID: 34850340 PMCID: PMC9852156 DOI: 10.1007/s13187-021-02111-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/24/2021] [Indexed: 06/13/2023]
Abstract
Targeted public education may offer an approach to achieving more effective treatment in countries like Bangladesh, where breast cancer is a leading cause of cancer death in women. Effective cancer education interventions address the target population's cultural and contextual needs. However, there is little published literature to guide the development of educational cancer interventions in a region where lack of resources combined with cultural stigma about cancer contribute to poor breast health outcomes for women. The goal of the current study was to design, test, and evaluate a culturally grounded intervention to promote breast problem care among women in rural Bangladesh. The current manuscript first describes the process of formative evaluation that led to the development of the intervention, including decisions about the audience, message construction, and mode of intervention delivery. Second, we describe the testing process, including process and outcome evaluation. Finally, we describe the lessons learned from the process. We conclude with recommendations related to cultural grounding for message development, questionnaire design, data collection procedures, and analysis.
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Dimovska M, Borota-Popovska M, Topuzovska-Latkovikj M, Pavleska-Kuzmanoska S. Some Aspects of Women’s Health in Republic of Macedonia. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION: Sex and gender "matters" in terms of the health status as well as a result of both biological and gender-related differences.
AIM: To analyze sex and gender-based differences in North Macedonia through analysis of some aspects of mortality, the knowledge and attitudes related to women’s health.
METHODS: Analysis of the general and age-standardized mortality patterns and CAPI (Computer-assisted personal interview) composed on different topics including women's health for the period 2017-2020 were used.
RESULTS: Age-standardized mortality rates (all-causes of death, circulatory and respiratory diseases and neoplasms) are prevalent and higher in the male population in North Macedonia. A significantly higher all-cause mortality trend for both sexes was found in 2020 making this year hardly comparable with the previous years. A decreasing trend of malignant neoplasms rate of female genital organs and an increasing trend of breast cancer mortality is observed.
The majority of the respondents (50.6%) rated their current health status as excellent with a statistically significant difference between the age and ethnical groups. One-third of the respondents reported regular physical activity, mostly on a daily basis. The majority (39.3%) are overweight and 27.5% belongs to the obesity class I without a significant difference in terms of ethnicity.
Respondents (27%), reported that have high blood pressure, 20.2% vaginal infections, 19.9% allergies, heart issues 15.1%, anemia 11.7%, while diabetes and cancer 8.5% and 2.5% respectively. The youngest and oldest age group of Albanian women are the least informed about the early detection procedures of malignant compared to Macedonian women and other ethnic groups.
CONCLUSIONS: Analyzing some aspects of women's health in North Macedonia through the mortality, knowledge and attitudes of Macedonian women, we provide some further evidence for the development and implementation of targeted interventions and policies aimed to reduce the sex and gender-based health inequalities in the country.
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Wondie B, Aragaw A, Worku G, Kassie N. Breast self-examination and its associated factors among women who attended anti-retroviral therapy clinic in Bahir Dar city administration, North West Ethiopia. SAGE Open Med 2022; 10:20503121221124948. [PMID: 36161210 PMCID: PMC9500302 DOI: 10.1177/20503121221124948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 08/16/2022] [Indexed: 12/24/2022] Open
Abstract
Objective: Although breast self-examination has been shown to be the least-expensive, less time-consuming, and non-invasive screening method, still there is a gap in practice. Furthermore, the information among more risky population which attends anti-retroviral therapy is too limited. Therefore, the aim of this study is to assess breast self-examination practices and its associated factors among women who attended the anti-retroviral therapy clinic in Bahir Dar city administration, Northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted among 660 women who attended anti-retroviral therapy clinics from March 1 to March 30, 2020. A systematic random sampling technique was used to select study participants. Pre-tested interviewer-administered questionnaires were used to collect data. Data were entered in to EPI data 3.1 and exported to Statistical Package for the Social Sciences version 23.00 software for analysis. A binary logistic regression model was fitted to identify factors associated with self-breast examination. Variables with a p value less than 0.2 in bivariable regression were candidates for multivariable regression. Adjusted odds ratios with a 95% confidence intervals and p values less than 0.05 were used to determine the association between independent and dependent variables. Hosmer–Lemeshow Test was used to determine model fitness. Result: Among 641 study participants, 224 (34.9%) have ever practiced breast self-examination. Women who attended college or above (adjusted odds ratio = 4.04, 95% confidence interval (1.65,9.90)), rich (adjusted odds ratio = 6.64, 95% confidence interval (2.72,16.20)), knowledgeable about signs and symptoms of breast cancer (adjusted odds ratio = 5.13, 95% confidence interval ( 2.55,10.31)), risk factors for breast cancer (adjusted odds ratio = 3.62, 95% confidence interval (1.85,7.07)), positive attitude toward breast self-examination (adjusted odds ratio = 2.76,95% confidence interval (1.41,11.84)), family history of breast cancer (adjusted odds ratio = 3.68,95% confidence interval (1.14,11.84)), and knowledge about breast self-examination technique (adjusted odds ratio = 2.64, 95% confidence interval (1.23,5.66)) had higher odds of breast self-examination practice. Conclusion: The practice of breast self-examination was low. During their regular visits for other issues, education and information dissemination about the benefits and techniques of self-breast examination is recommended.
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Affiliation(s)
- Betelhem Wondie
- School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Amanu Aragaw
- School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Gizachew Worku
- School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Nigus Kassie
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
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8
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Mehejabin F, Rahman MS. Knowledge and perception of breast cancer among women of reproductive age in Chattogram, Bangladesh: A cross-sectional survey. Health Sci Rep 2022; 5:e840. [PMID: 36189418 PMCID: PMC9488900 DOI: 10.1002/hsr2.840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 07/14/2022] [Accepted: 08/31/2022] [Indexed: 12/24/2022] Open
Abstract
Background and Aims Breast cancer is the second leading cause of cancer death in women worldwide. The significantly higher mortality rate has been considered due to poor knowledge of women, delay in diagnosis, and initiation of treatment. Therefore, this hospital-based cross-sectional study aimed to understand the knowledge and perception of women with breast cancer in Bangladesh. Methods Data was collected using a questionnaire-based interview from 357 women aged 15-49 years attending two tertiary care hospitals in Chattogram city of Bangladesh. Results Neighbors (18.6%) and relatives (18.1%) were the leading sources of information on breast cancer. Among the total, 69.5% knew about breast cancer however, only 14% of them knew about screening tests and 61.5% were unaware of risk factors for developing breast cancer. Pain in the breast, painless lump, and nipple discharge were the most recognized clinical symptoms by the participants. Exercise and weight control, the practice of breastfeeding, and taking medicine were the three most known prevention practices. Women perceived wrong conceptions that Breast cancer is only found in older age (42.3%) and women (15.7%) and that it causes losing one's breast (3.1%). A significant correlation was found between the education level of participants and their knowledge of risk factors related to breast cancer. Conclusion Although the majority of the participants have heard about breast cancer, they do not possess enough knowledge regarding the risk factor, symptoms, and preventive methods of breast cancer. We suggest interventions targeting a community-based awareness program.
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Affiliation(s)
- Fatema Mehejabin
- Asian University for WomenChattogramBangladesh
- One Health Center for Research and ActionChattogramBangladesh
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Knowledge of breast cancer and breast self-examination practices and its barriers among university female students in Bangladesh: Findings from a cross-sectional study. PLoS One 2022; 17:e0270417. [PMID: 35763525 PMCID: PMC9239455 DOI: 10.1371/journal.pone.0270417] [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: 09/03/2021] [Accepted: 06/10/2022] [Indexed: 11/21/2022] Open
Abstract
Early diagnosis of breast cancer is the best approach towards its control that may result in alleviating related mortality and morbidity. This study aimed to evaluate knowledge about breast cancer and both practices and perceived barriers to breast self-examination among female university students in Bangladesh. A cross-sectional study was carried out with 400 female students of Jahangirnagar University, Bangladesh. Participants were sampled from female dormitories at the university from January to April 2020. Proportionate stratified random sampling was conducted to calculate the study sample from each dormitory. A validated semi-structured self-reported questionnaire was employed to collect data from participants during the survey periods. The questionnaire consisted of demographic variables, items about knowledge about breast cancer, breast self-examination practices and its barriers. We applied descriptive and inferential statistics and data were analyzed using the Statistical Package for the Social Sciences (SPSS). Participants were aged between 18–26 years and comprised university students of first year (20%), second year (24%), third year (22%), fourth year (21%) and Master’s (14%). 18% of them reported positive family history (mother, aunt, sister/cousin, grandmother) of breast cancer. The overall mean score of total knowledge items was 15 (SD = 3) out of 43, with an overall correct rate of 34%. The mean score of total knowledge items was significantly higher (p<0.001) among Master’s students and students with family members who have had breast cancer. Only one in five students (21%) ever practiced breast self-examination. The mean score of practice of breast self-examination was significantly higher (p<0.001) among participants who reported having family member of breast cancer. Total knowledge score about breast cancer and practice of breast self-examination were significantly correlated with each other (r = 0.54; p<0.001). About 33% participants reported ‘lack of knowledge’ as the main barrier to practicing breast self-examination followed by ‘I do not have the symptoms’ (22%), and ‘shyness/ uncomfortable feelings’ (17%). The study revealed low levels of knowledge about breast cancer and low breast self-examination practices. Our findings highlight the need to develop, implement and promote socially, culturally and demographically appropriate educational interventions programs aimed at breast cancer and breast self-examination awareness and practice in Bangladesh.
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Islam S, Hoque N, Nasrin N, Hossain M, Rizwan F, Biswas K, Asaduzzaman M, Rahman S, Hoskin DW, Sultana S, Lehmann C. Iron Overload and Breast Cancer: Iron Chelation as a Potential Therapeutic Approach. Life (Basel) 2022; 12:963. [PMID: 35888054 PMCID: PMC9317809 DOI: 10.3390/life12070963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 11/18/2022] Open
Abstract
Breast cancer has historically been one of the leading causes of death for women worldwide. As of 2020, breast cancer was reported to have overtaken lung cancer as the most common type of cancer globally, representing an estimated 11.3% of all cancer diagnoses. A multidisciplinary approach is taken for the diagnosis and treatment of breast cancer that includes conventional and targeted treatments. However, current therapeutic approaches to treating breast cancer have limitations, necessitating the search for new treatment options. Cancer cells require adequate iron for their continuous and rapid proliferation. Excess iron saturates the iron-binding capacity of transferrin, resulting in non-transferrin-bound iron (NTBI) that can catalyze free-radical reactions and may lead to oxidant-mediated breast carcinogenesis. Moreover, excess iron and the disruption of iron metabolism by local estrogen in the breast leads to the generation of reactive oxygen species (ROS). Therefore, iron concentration reduction using an iron chelator can be a novel therapeutic strategy for countering breast cancer development and progression. This review focuses on the use of iron chelators to deplete iron levels in tumor cells, specifically in the breast, thereby preventing the generation of free radicals. The inhibition of DNA synthesis and promotion of cancer cell apoptosis are the targets of breast cancer treatment, which can be achieved by restricting the iron environment in the body. We hypothesize that the usage of iron chelators has the therapeutic potential to control intracellular iron levels and inhibit the breast tumor growth. In clinical settings, iron chelators can be used to reduce cancer cell growth and thus reduce the morbidity and mortality in breast cancer patients.
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Affiliation(s)
- Sufia Islam
- Department of Pharmacy, East West University, A/2, Jahurul Islam Avenue, Jahurul Islam City, Aftabnagar, Dhaka 1212, Bangladesh; (N.H.); (N.N.); (F.R.); (K.B.)
| | - Nazia Hoque
- Department of Pharmacy, East West University, A/2, Jahurul Islam Avenue, Jahurul Islam City, Aftabnagar, Dhaka 1212, Bangladesh; (N.H.); (N.N.); (F.R.); (K.B.)
| | - Nishat Nasrin
- Department of Pharmacy, East West University, A/2, Jahurul Islam Avenue, Jahurul Islam City, Aftabnagar, Dhaka 1212, Bangladesh; (N.H.); (N.N.); (F.R.); (K.B.)
| | - Mehnaz Hossain
- Department of Political Science and Global Governance, Balsillie School of International Affairs, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Farhana Rizwan
- Department of Pharmacy, East West University, A/2, Jahurul Islam Avenue, Jahurul Islam City, Aftabnagar, Dhaka 1212, Bangladesh; (N.H.); (N.N.); (F.R.); (K.B.)
| | - Kushal Biswas
- Department of Pharmacy, East West University, A/2, Jahurul Islam Avenue, Jahurul Islam City, Aftabnagar, Dhaka 1212, Bangladesh; (N.H.); (N.N.); (F.R.); (K.B.)
| | - Muhammad Asaduzzaman
- Department of Clinical Pharmacy and Pharmacology, University of Dhaka, Dhaka 1000, Bangladesh;
| | - Sabera Rahman
- Department of Pharmacy, City University, Dhaka 1215, Bangladesh;
| | - David W. Hoskin
- Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada;
| | - Saki Sultana
- Department of Anesthesia, Pain Management and Perioperative Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (S.S.); (C.L.)
| | - Christian Lehmann
- Department of Anesthesia, Pain Management and Perioperative Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (S.S.); (C.L.)
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Elshami M, Al-Slaibi I, Ghithan RJ, Alser M, Shurrab NR, Ismail IO, Mahfouz II, Fannon AA, Qawasmi MA, Hawa MR, Giacaman N, Ahmaro M, Okshiya HM, Zaatreh RK, AbuKhalil WA, Usrof FD, Melhim NK, Madbouh RJ, Hziema HJA, Lahlooh RAA, Ubaiat SN, Jaffal NA, Alawna RK, Abed SN, Abuzahra BN, Kwaik AJA, Dodin MH, Taha RO, Alashqar DM, Mobarak RAA, Smerat T, Abu-El-Noor N, Bottcher B. Women's awareness of breast cancer symptoms: a national cross-sectional study from Palestine. BMC Public Health 2022; 22:801. [PMID: 35449048 PMCID: PMC9027340 DOI: 10.1186/s12889-022-13224-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 04/12/2022] [Indexed: 11/26/2022] Open
Abstract
Background Early diagnosis is crucial to reduce the morbidity and mortality associated with breast cancer (BC). Awareness of BC symptoms plays a key role in this. This study aimed to evaluate the Palestinian women’s awareness of BC symptoms and determine factors associated with good awareness. Methods This was a national cross-sectional study conducted from July 2019 to March 2020 in Palestine. Convenience sampling was used to recruit adult women from hospitals, primary healthcare centers, and public spaces located in 11 governorates. A translated-into-Arabic version of the validated BC awareness measure was utilized for data collection. The awareness level was categorized based on the number of symptoms recognized into: poor (0 to 4), fair (5 to 9), and good (10 to 13). Results Of 6269 approached, 5434 participants completed the questionnaire (response rate = 86.7%). A total of 5257 questionnaires were included in the analysis: 2551 from the Gaza Strip and 2706 from the West Bank and Jerusalem (WBJ). Participants living in the WBJ were more likely to be older, have higher monthly income, and suffer from more chronic diseases than participants living in the Gaza Strip. The most frequently identified BC symptom was ‘lump or thickening in the breast’ (n = 4887, 92.9%) followed by ‘lump or thickening under the armpit’ (n = 4394, 83.6%). The least frequently identified symptoms were ‘pulling in of the nipple’ (n = 2665, 50.7%) and ‘change in the position of the nipple’ (n = 2710, 51.6%). A total of 2191 participants (41.7%) demonstrated good awareness of BC symptoms. Participants from the Gaza Strip were more likely than participants from the WBJ to have good awareness (47.0.0% vs. 36.7%). On the multivariable analysis, being ≥ 40 years, completing a post-secondary education, knowing someone with cancer, and visiting hospitals and primary healthcare centers were all associated with an increase in the likelihood of having good awareness. However, living in the WBJ was associated with a decrease in the likelihood of having good awareness. Conclusion Less than half of women included in this study showed good awareness of BC symptoms. More targeted educational interventions are needed to promote Palestinian women’s awareness of BC symptoms to facilitate early diagnosis. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13224-7.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. .,Ministry of Health, Gaza, Palestine.
| | | | | | | | | | | | | | | | - Malak Ayman Qawasmi
- Department of Medical Laboratory Sciences, Hebron University, Hebron, Palestine
| | | | | | - Manar Ahmaro
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | - Faten Darwish Usrof
- Department of Medical Laboratory Sciences, Faculty of Sciences, Islamic University of Gaza, Gaza, Palestine
| | | | | | | | | | | | - Nour Ali Jaffal
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | | | | | | | - Tasneem Smerat
- Faculty of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
| | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Sarker R, Islam MS, Moonajilin MS, Rahman M, Gesesew HA, Ward PR. Effectiveness of educational intervention on breast cancer knowledge and breast self-examination among female university students in Bangladesh: a pre-post quasi-experimental study. BMC Cancer 2022; 22:199. [PMID: 35193526 PMCID: PMC8862195 DOI: 10.1186/s12885-022-09311-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 02/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer is a global health issue and a leading cause of death among women. Early detection through increased awareness and knowledge on breast cancer and breast cancer screening is thus crucial. The aim of the present study was to assess the effect of an educational intervention program on breast cancer knowledge and the practice of breast self-examination among young female students of a university in Bangladesh. METHODS A quasi-experimental (pre-post) study design was conducted at Jahangirnagar University in Bangladesh. Educational information on breast cancer and breast self-examination (BSE), demonstration of BSE procedure and leaflets were distributed among 400 female students after obtaining written informed consent. The stepwise procedures of BSE performance were demonstrated with images. Pre-intervention and 15 days post-intervention assessments were conducted to assess the changes in knowledge on breast cancer and practices of BSE. Mc-Nemar's tests and paired sampled t-tests were performed to investigate the differences between pre- and post-test stages. RESULTS A total of 400 female university students aged 18-26 years were included in the sample. Significant changes were found in knowledge and awareness about breast cancer and BSE practices after the educational intervention. The significant differences were measured in the mean scores of pre-test vs. post-test: breast cancer symptoms (2.99 ± 1.05 vs. 6.35 ± 1.15; p < 0.001), risk factors (3.35 ± 1.19 vs. 7.56 ± 1.04; p < 0.001), treatment (1.79 ± 0.90 vs. 4.63 ± 0.84; p < 0.001), prevention (3.82 ± 1.32 vs. 7.14 ± 1.03; p < 0.001), screening of breast cancer (1.82 ± 0.55 vs. 3.98 ± 0.71; p < 0.001) and process of BSE (1.57 ± 1.86 vs. 3.94 ± 0.93; p < 0.001). Likewise, a significant percentage of change in BSE practices was obtained between pre-test and post-test (21.3% vs. 33.8%; p < 0.001). CONCLUSIONS Study findings confirm that the study population had inadequate awareness and knowledge at baseline which was improved significantly after educational intervention. A nationwide roll-out with community-based interventions is recommended for the female population in both rural and urban areas.
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Affiliation(s)
- Rumpa Sarker
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Md Saiful Islam
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh. .,Centre for Advanced Research Excellence in Public Health, Savar, Dhaka, Bangladesh.
| | - Mst Sabrina Moonajilin
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Mahmudur Rahman
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Hailay Abrha Gesesew
- Department of Epidemiology, School of Health Sciences, Mekelle University, Mekelle, Ethiopia.,Centre for Health Policy Research, Torrens University, Adelaide, SA, Australia
| | - Paul R Ward
- Centre for Health Policy Research, Torrens University, Adelaide, SA, Australia
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13
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Alam NE, Islam MS, Ullah H, Molla MT, Shifat SK, Akter S, Aktar S, Khatun MM, Ali MR, Sen TC, Chowdhury K, Pervin R, Mohiuddin AKM. Evaluation of knowledge, awareness and attitudes towards breast cancer risk factors and early detection among females in Bangladesh: A hospital based cross-sectional study. PLoS One 2021; 16:e0257271. [PMID: 34516589 PMCID: PMC8437277 DOI: 10.1371/journal.pone.0257271] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 08/31/2021] [Indexed: 12/24/2022] Open
Abstract
Background Breast cancer (BCa) is a leading cause of mortality among women in Bangladesh. Many young women in Bangladesh have poor knowledge about breast cancer screening, including risk factors, warning signs/symptoms, diagnosis and early detection. We investigated awareness about breast cancer risk factors as a screening tool among women at the Sheikh Hasina Medical College (SHMC) of Tangail district in Bangladesh. Methods A cross sectional survey was conducted to collect data via a structured questionnaire from SHMC during the period of February to December 2019. A total of 1,007 participants (aged 33.47 (±12.37 years)) was considered for data analysis. Results Of the 1,007 women, about 50% were knowledgeable about the risk factors. Pain in the breast was identified as the most commonly warning sign/symptom of breast cancer. Only 32.2% of respondents knew at least one breast cancer screening method. The mean knowledge was scored 3.43 ± 2.25 out of a total possible score of 8. Awareness of BCa was associated with residence, family history of breast cancer, marital, literacy and socio-economic status (p <0.05). Only 14.7% of women who knew about BSE said they were conducting regular breast self-examination. Unmarried women (aOR: 2.971; 95% CI: 1.108–7.968) were more likely to have performed BSE compared to married women (p <0.05). Conclusion Although most participants were aware of breast cancer; knowledge about risk factors, warning signs/symptoms, early diagnosis and detection was relatively poor. Knowledge about performing BSE was particularly low. This highlights the importance of increasing awareness about breast cancer risk factors and early detection among young women in Bangladesh.
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Affiliation(s)
- Nur E. Alam
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Md. Shariful Islam
- Department of Biology, University of Kentucky, Lexington, Kentucky, United States of America
| | - Hedayet Ullah
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Md. Tarek Molla
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Siratul Kubra Shifat
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Sumaiya Akter
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Salma Aktar
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Mst. Mahmuda Khatun
- Department of Biochemistry and Molecular Biology, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Md. Rayhan Ali
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Tapon Chandra Sen
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Kamal Chowdhury
- Department of Biology, Claflin University, Orangeburg, South Carolina, United States of America
| | - Rehana Pervin
- Department of Gynaecology and Obstetrics, Tangail Medical College, Tangail, Bangladesh
| | - A. K. M. Mohiuddin
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
- * E-mail:
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14
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Momenimovahed Z, Tiznobaik A, Taheri S, Hassanipour S, Salehiniya H. A review of barriers and facilitators to mammography in Asian women. Ecancermedicalscience 2020; 14:1146. [PMID: 33343705 PMCID: PMC7738271 DOI: 10.3332/ecancer.2020.1146] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Indexed: 11/29/2022] Open
Abstract
Aim Breast cancer is the most common cancer among women in Asia and one of the major health problems in most countries in the region. Despite extensive advances in treatment, early diagnosis is one of the main methods for increasing the survival rate. It is necessary to evaluate the barriers and facilitators of screening in different societies. This study was conducted to identify the barriers and facilitators of mammography in Asia. Materials and methods To identify the barriers and facilitators of mammography in Asia, a comprehensive search was carried out in databases such as Medline, Web of Science Core Collection and Scopus using keywords, including breast cancer, screening, mammography, barriers, facilitators and the names of each Asian country, as well as a combination of these keywords were used to help the search. Full-text, English language and original articles were included in this study. Results In total, 71 articles were entered into the study. The findings of this study revealed various barriers to mammography in Asian women, including knowledge, sociodemographic factors, cost and insurance, cultural factors, belief, attitude and feeling, fear, pain and embarrassment, self-efficacy, religious, psychological factors, time constraint, fatalism, professional recommendations, communication, social support and access. Also, knowledge, attitude and belief, perceived risk, professional and social factors were found to be facilitators of mammography. Conclusion Knowing the barriers and facilitators to access mammography is the first step in the development of a successful screening program. Awareness and various personal, professional and social factors have emerged as the major barriers to access to mammography in most Asian countries.
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Affiliation(s)
| | | | | | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
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15
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Liu N, Li P, Wang J, Guo PP, Zhang XH, Yang S, Yu L, Zhang XM, Zhang W. Factors influencing breast cancer awareness: a cross-sectional study in China. J Comp Eff Res 2020; 9:679-689. [PMID: 32648473 DOI: 10.2217/cer-2020-0037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aim: This study aimed to explore the factors that influence breast cancer awareness. Materials & methods: A community-based cross-sectional study was conducted between January and April 2019 in Changchun, Jilin Province, China. Results: A total of 274 women were recruited for this cross-sectional study. Participants had a moderate level of breast cancer awareness (median = 76.50 [68.75, 84.00]). Women in the action/maintenance stages reported higher breast cancer awareness (p = 0.044). Women's breast cancer awareness was positively associated with high health information literacy level, husbands' higher educational degrees, seeing doctors after detecting abnormal breast changes and living within a short distance from the nearest hospital. Conclusion: History of screening and higher health information literacy levels are important positive factors linked to higher breast cancer awareness.
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Affiliation(s)
- Na Liu
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Ping Li
- Department of Developmental Pediatrics, The Second Hospital of Jilin University, Changchun, Jilin Province, China
| | - Jie Wang
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Ping-Ping Guo
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Xue-Hui Zhang
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Shu Yang
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Lin Yu
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Xiu-Min Zhang
- School of Public Health of Jilin University, Changchun, Jilin Province, China
| | - Wei Zhang
- Nursing School, Jilin University, Changchun, Jilin Province, China
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16
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Amin MN, Uddin MG, Uddin MN, Rahaman MZ, Siddiqui SA, Hossain MS, Islam MR, Hasan MN, Uddin SMN. A hospital based survey to evaluate knowledge, awareness and perceived barriers regarding breast cancer screening among females in Bangladesh. Heliyon 2020; 6:e03753. [PMID: 32382673 PMCID: PMC7203067 DOI: 10.1016/j.heliyon.2020.e03753] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 02/03/2020] [Accepted: 04/02/2020] [Indexed: 11/30/2022] Open
Abstract
Background Early diagnosis of breast cancer is essential for mitigating its related morbidity and mortality. Therefore, high awareness is required. Objectives We aimed to evaluate the knowledge, awareness and perceived barriers among females in Bangladesh regarding breast cancer. Methods A hospital-based survey was performed from April 2019 to June 2019. A total of 500 females aged >18 years were recruited to the study. The participants were selected by trained personnel and physicians via simple random sampling. Results The mean participant age was 37.13 ± 12.66 years. Among all the participants, 79% were married, 4% were single, 3% were divorced and 14% were widowed. We observed that 80.6% of respondents were housewives, 5% were students and 14.4% were working women. The participants had a severe lack of knowledge and awareness, and perceived barriers regarding breast cancer screening. Breast cancer was more linked to personal history, occupation and, marital status. Shyness, fear, lack of knowledge and deficient awareness programs were the major perceived barriers. Conclusion Educational interventions and proper, appropriate and socially acceptable awareness programs will help to ameliorate knowledge and awareness by addressing barriers regarding breast cancer among the females in Bangladesh.
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Affiliation(s)
- Mohammad Nurul Amin
- Department of Pharmacy, Atish Dipankar University of Science and Technology, Dhaka 1230, Bangladesh.,Pratyasha Health Biomedical Research Center, Dhaka 1230, Bangladesh.,Department of Pharmacy, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Md Giash Uddin
- Pratyasha Health Biomedical Research Center, Dhaka 1230, Bangladesh.,Department of Pharmacy, University of Chittagong, Chittagong 4331, Bangladesh
| | - Md Nazim Uddin
- Department of Pharmacy, Atish Dipankar University of Science and Technology, Dhaka 1230, Bangladesh
| | - Md Zahedur Rahaman
- Department of Pharmacy, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Shafayet Ahmed Siddiqui
- Department of Pharmacy, Atish Dipankar University of Science and Technology, Dhaka 1230, Bangladesh.,Pratyasha Health Biomedical Research Center, Dhaka 1230, Bangladesh.,Department of Pharmacy, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Md Shahadat Hossain
- Department of Pharmacy, Atish Dipankar University of Science and Technology, Dhaka 1230, Bangladesh
| | - Md Rakibul Islam
- Department of Pharmacy, Atish Dipankar University of Science and Technology, Dhaka 1230, Bangladesh
| | - Md Nazmul Hasan
- Department of Pharmacy, University of Chittagong, Chittagong 4331, Bangladesh
| | - S M Naim Uddin
- Department of Pharmacy, University of Chittagong, Chittagong 4331, Bangladesh
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17
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Elshami M, Abu Kmeil H, Abu-Jazar M, Mahfouz I, Ashour D, Aljamal A, Mohareb N, Elbalaawi R, Dabbour R, Ghaith J, Hasan T, Abdelati M, Saleh E, Shawwa H, Al-Ghazali R, Obaid O, Albarqouni L, Böttcher B. Breast Cancer Awareness and Barriers to Early Presentation in the Gaza-Strip: A Cross-Sectional Study. J Glob Oncol 2019; 4:1-13. [PMID: 30372400 PMCID: PMC7010447 DOI: 10.1200/jgo.18.00095] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Timely detection of breast cancer (BC) is important to reduce its related deaths. Hence, high awareness of its symptoms and risk factors is required. This study aimed to assess the awareness level of BC among females in Gaza. MATERIALS AND METHODS A cross-sectional study was performed during September and October 2017 in Gaza, Palestine. Stratified sampling was used to recruit patients from four hospitals and seven high schools. The validated Breast Cancer Awareness Measure (BCAM) was used to assess confidence and behavior in relation to breast changes, awareness of BC symptoms and risk factors, barriers to seek medical help, and knowledge of BC screening. Women (age ≥ 18 years) visiting or admitted to any of the four hospitals, and female adolescents (age 15 to 17 years) in any of the seven schools, were recruited for face-to-face interviews to complete the BCAM. RESULTS Of 3,055 women approached, 2,774 participants completed the BCAM questionnaire (response rate, 90.8%); 1,588 (57.2%) were adults, and 1,186 (42.8%) were adolescents. Of these, 1,781 (64.2%) rarely (or never) checked their breasts, and 909 (32.8%) were not confident to notice changes. In total, 1,675 (60.4%) were aware of the availability of BC screening programs. The overall mean ± standard deviation score for awareness of BC symptoms was 5.9 ± 2.9 of 11, and that of risk factors 7.5 ± 3.1 of 16. Feeling scared was the most reported barrier to seeking advice reported among women (n = 802; 50.2%), whereas feeling embarrassed was the most reported in adolescents (n = 745; 62.8%). CONCLUSION Awareness of BC symptoms, risk factors, and screening programs is suboptimal in Gaza. Educational interventions are necessary to increase public awareness of BC and to train local female breast surgeons to address barriers to early detection.
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Affiliation(s)
- Mohamedraed Elshami
- Mohamedraed Elshami, Reem Dabbour, Tayseer Hasan, Esraa Saleh, and Haifa Shawwa, Ministry of Health; Hanan Abu Kmeil, Maymona Abu-Jazar, Ibtisam Mahfouz, Dina Ashour, Ansam Aljamal, Nada Mohareb, Reem Elbalaawi, Meral Abdelati, Reem Al-Ghazali, and Bettina Böttcher, Islamic University of Gaza School of Medicine; Jomana Ghaith, Alazhar University School of Medicine, Gaza, Palestine; and Loai Albarqouni, Centre for Research in Evidence-Based Practice, Bond University, Australia
| | - Hanan Abu Kmeil
- Mohamedraed Elshami, Reem Dabbour, Tayseer Hasan, Esraa Saleh, and Haifa Shawwa, Ministry of Health; Hanan Abu Kmeil, Maymona Abu-Jazar, Ibtisam Mahfouz, Dina Ashour, Ansam Aljamal, Nada Mohareb, Reem Elbalaawi, Meral Abdelati, Reem Al-Ghazali, and Bettina Böttcher, Islamic University of Gaza School of Medicine; Jomana Ghaith, Alazhar University School of Medicine, Gaza, Palestine; and Loai Albarqouni, Centre for Research in Evidence-Based Practice, Bond University, Australia
| | - Maymona Abu-Jazar
- Mohamedraed Elshami, Reem Dabbour, Tayseer Hasan, Esraa Saleh, and Haifa Shawwa, Ministry of Health; Hanan Abu Kmeil, Maymona Abu-Jazar, Ibtisam Mahfouz, Dina Ashour, Ansam Aljamal, Nada Mohareb, Reem Elbalaawi, Meral Abdelati, Reem Al-Ghazali, and Bettina Böttcher, Islamic University of Gaza School of Medicine; Jomana Ghaith, Alazhar University School of Medicine, Gaza, Palestine; and Loai Albarqouni, Centre for Research in Evidence-Based Practice, Bond University, Australia
| | - Ibtisam Mahfouz
- Mohamedraed Elshami, Reem Dabbour, Tayseer Hasan, Esraa Saleh, and Haifa Shawwa, Ministry of Health; Hanan Abu Kmeil, Maymona Abu-Jazar, Ibtisam Mahfouz, Dina Ashour, Ansam Aljamal, Nada Mohareb, Reem Elbalaawi, Meral Abdelati, Reem Al-Ghazali, and Bettina Böttcher, Islamic University of Gaza School of Medicine; Jomana Ghaith, Alazhar University School of Medicine, Gaza, Palestine; and Loai Albarqouni, Centre for Research in Evidence-Based Practice, Bond University, Australia
| | - Dina Ashour
- Mohamedraed Elshami, Reem Dabbour, Tayseer Hasan, Esraa Saleh, and Haifa Shawwa, Ministry of Health; Hanan Abu Kmeil, Maymona Abu-Jazar, Ibtisam Mahfouz, Dina Ashour, Ansam Aljamal, Nada Mohareb, Reem Elbalaawi, Meral Abdelati, Reem Al-Ghazali, and Bettina Böttcher, Islamic University of Gaza School of Medicine; Jomana Ghaith, Alazhar University School of Medicine, Gaza, Palestine; and Loai Albarqouni, Centre for Research in Evidence-Based Practice, Bond University, Australia
| | - Ansam Aljamal
- Mohamedraed Elshami, Reem Dabbour, Tayseer Hasan, Esraa Saleh, and Haifa Shawwa, Ministry of Health; Hanan Abu Kmeil, Maymona Abu-Jazar, Ibtisam Mahfouz, Dina Ashour, Ansam Aljamal, Nada Mohareb, Reem Elbalaawi, Meral Abdelati, Reem Al-Ghazali, and Bettina Böttcher, Islamic University of Gaza School of Medicine; Jomana Ghaith, Alazhar University School of Medicine, Gaza, Palestine; and Loai Albarqouni, Centre for Research in Evidence-Based Practice, Bond University, Australia
| | - Nada Mohareb
- Mohamedraed Elshami, Reem Dabbour, Tayseer Hasan, Esraa Saleh, and Haifa Shawwa, Ministry of Health; Hanan Abu Kmeil, Maymona Abu-Jazar, Ibtisam Mahfouz, Dina Ashour, Ansam Aljamal, Nada Mohareb, Reem Elbalaawi, Meral Abdelati, Reem Al-Ghazali, and Bettina Böttcher, Islamic University of Gaza School of Medicine; Jomana Ghaith, Alazhar University School of Medicine, Gaza, Palestine; and Loai Albarqouni, Centre for Research in Evidence-Based Practice, Bond University, Australia
| | - Reem Elbalaawi
- Mohamedraed Elshami, Reem Dabbour, Tayseer Hasan, Esraa Saleh, and Haifa Shawwa, Ministry of Health; Hanan Abu Kmeil, Maymona Abu-Jazar, Ibtisam Mahfouz, Dina Ashour, Ansam Aljamal, Nada Mohareb, Reem Elbalaawi, Meral Abdelati, Reem Al-Ghazali, and Bettina Böttcher, Islamic University of Gaza School of Medicine; Jomana Ghaith, Alazhar University School of Medicine, Gaza, Palestine; and Loai Albarqouni, Centre for Research in Evidence-Based Practice, Bond University, Australia
| | - Reem Dabbour
- Mohamedraed Elshami, Reem Dabbour, Tayseer Hasan, Esraa Saleh, and Haifa Shawwa, Ministry of Health; Hanan Abu Kmeil, Maymona Abu-Jazar, Ibtisam Mahfouz, Dina Ashour, Ansam Aljamal, Nada Mohareb, Reem Elbalaawi, Meral Abdelati, Reem Al-Ghazali, and Bettina Böttcher, Islamic University of Gaza School of Medicine; Jomana Ghaith, Alazhar University School of Medicine, Gaza, Palestine; and Loai Albarqouni, Centre for Research in Evidence-Based Practice, Bond University, Australia
| | - Jomana Ghaith
- Mohamedraed Elshami, Reem Dabbour, Tayseer Hasan, Esraa Saleh, and Haifa Shawwa, Ministry of Health; Hanan Abu Kmeil, Maymona Abu-Jazar, Ibtisam Mahfouz, Dina Ashour, Ansam Aljamal, Nada Mohareb, Reem Elbalaawi, Meral Abdelati, Reem Al-Ghazali, and Bettina Böttcher, Islamic University of Gaza School of Medicine; Jomana Ghaith, Alazhar University School of Medicine, Gaza, Palestine; and Loai Albarqouni, Centre for Research in Evidence-Based Practice, Bond University, Australia
| | - Tayseer Hasan
- Mohamedraed Elshami, Reem Dabbour, Tayseer Hasan, Esraa Saleh, and Haifa Shawwa, Ministry of Health; Hanan Abu Kmeil, Maymona Abu-Jazar, Ibtisam Mahfouz, Dina Ashour, Ansam Aljamal, Nada Mohareb, Reem Elbalaawi, Meral Abdelati, Reem Al-Ghazali, and Bettina Böttcher, Islamic University of Gaza School of Medicine; Jomana Ghaith, Alazhar University School of Medicine, Gaza, Palestine; and Loai Albarqouni, Centre for Research in Evidence-Based Practice, Bond University, Australia
| | - Meral Abdelati
- Mohamedraed Elshami, Reem Dabbour, Tayseer Hasan, Esraa Saleh, and Haifa Shawwa, Ministry of Health; Hanan Abu Kmeil, Maymona Abu-Jazar, Ibtisam Mahfouz, Dina Ashour, Ansam Aljamal, Nada Mohareb, Reem Elbalaawi, Meral Abdelati, Reem Al-Ghazali, and Bettina Böttcher, Islamic University of Gaza School of Medicine; Jomana Ghaith, Alazhar University School of Medicine, Gaza, Palestine; and Loai Albarqouni, Centre for Research in Evidence-Based Practice, Bond University, Australia
| | - Esraa Saleh
- Mohamedraed Elshami, Reem Dabbour, Tayseer Hasan, Esraa Saleh, and Haifa Shawwa, Ministry of Health; Hanan Abu Kmeil, Maymona Abu-Jazar, Ibtisam Mahfouz, Dina Ashour, Ansam Aljamal, Nada Mohareb, Reem Elbalaawi, Meral Abdelati, Reem Al-Ghazali, and Bettina Böttcher, Islamic University of Gaza School of Medicine; Jomana Ghaith, Alazhar University School of Medicine, Gaza, Palestine; and Loai Albarqouni, Centre for Research in Evidence-Based Practice, Bond University, Australia
| | - Haifa Shawwa
- Mohamedraed Elshami, Reem Dabbour, Tayseer Hasan, Esraa Saleh, and Haifa Shawwa, Ministry of Health; Hanan Abu Kmeil, Maymona Abu-Jazar, Ibtisam Mahfouz, Dina Ashour, Ansam Aljamal, Nada Mohareb, Reem Elbalaawi, Meral Abdelati, Reem Al-Ghazali, and Bettina Böttcher, Islamic University of Gaza School of Medicine; Jomana Ghaith, Alazhar University School of Medicine, Gaza, Palestine; and Loai Albarqouni, Centre for Research in Evidence-Based Practice, Bond University, Australia
| | - Reem Al-Ghazali
- Mohamedraed Elshami, Reem Dabbour, Tayseer Hasan, Esraa Saleh, and Haifa Shawwa, Ministry of Health; Hanan Abu Kmeil, Maymona Abu-Jazar, Ibtisam Mahfouz, Dina Ashour, Ansam Aljamal, Nada Mohareb, Reem Elbalaawi, Meral Abdelati, Reem Al-Ghazali, and Bettina Böttcher, Islamic University of Gaza School of Medicine; Jomana Ghaith, Alazhar University School of Medicine, Gaza, Palestine; and Loai Albarqouni, Centre for Research in Evidence-Based Practice, Bond University, Australia
| | - Ola Obaid
- Mohamedraed Elshami, Reem Dabbour, Tayseer Hasan, Esraa Saleh, and Haifa Shawwa, Ministry of Health; Hanan Abu Kmeil, Maymona Abu-Jazar, Ibtisam Mahfouz, Dina Ashour, Ansam Aljamal, Nada Mohareb, Reem Elbalaawi, Meral Abdelati, Reem Al-Ghazali, and Bettina Böttcher, Islamic University of Gaza School of Medicine; Jomana Ghaith, Alazhar University School of Medicine, Gaza, Palestine; and Loai Albarqouni, Centre for Research in Evidence-Based Practice, Bond University, Australia
| | - Loai Albarqouni
- Mohamedraed Elshami, Reem Dabbour, Tayseer Hasan, Esraa Saleh, and Haifa Shawwa, Ministry of Health; Hanan Abu Kmeil, Maymona Abu-Jazar, Ibtisam Mahfouz, Dina Ashour, Ansam Aljamal, Nada Mohareb, Reem Elbalaawi, Meral Abdelati, Reem Al-Ghazali, and Bettina Böttcher, Islamic University of Gaza School of Medicine; Jomana Ghaith, Alazhar University School of Medicine, Gaza, Palestine; and Loai Albarqouni, Centre for Research in Evidence-Based Practice, Bond University, Australia
| | - Bettina Böttcher
- Mohamedraed Elshami, Reem Dabbour, Tayseer Hasan, Esraa Saleh, and Haifa Shawwa, Ministry of Health; Hanan Abu Kmeil, Maymona Abu-Jazar, Ibtisam Mahfouz, Dina Ashour, Ansam Aljamal, Nada Mohareb, Reem Elbalaawi, Meral Abdelati, Reem Al-Ghazali, and Bettina Böttcher, Islamic University of Gaza School of Medicine; Jomana Ghaith, Alazhar University School of Medicine, Gaza, Palestine; and Loai Albarqouni, Centre for Research in Evidence-Based Practice, Bond University, Australia
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18
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Solikhah S, Promthet S, Hurst C. Awareness Level about Breast Cancer Risk Factors, Barriers, Attitude and Breast Cancer Screening among Indonesian
Women. Asian Pac J Cancer Prev 2019; 20:877-884. [PMID: 30912407 PMCID: PMC6825774 DOI: 10.31557/apjcp.2019.20.3.877] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Globally, breast cancer is the second most common cancer in women and is a leading cause of mortality
in Indonesia. Raising awareness of breast cancer is particularly important to help at risk women seek medical treatment
for this disease. This study aimed to comprehensively investigate the Indonesian women’s level of knowledge about
breast cancer risk factors, barriers, attitude and breast cancer screening. Methods: This population-based cross-sectional
study administered the breast cancer awareness Indonesian scale (BCAS-I) to 856 Indonesian women. Samples were
selected in rural and urban combinations from three provinces by stratified random sampling. The ordinal logistic
model was used to investigate the clustering effect of the participant’s characteristics in this study. Results: Of the
women, 62% lived in rural areas and 38% lived in urban areas. Living in an urban area was significantly associated
with a lower knowledge of the risk factors. However, living in an urban area was significantly associated with better
attitudes and healthier behaviours related to breast cancer awareness. Women with higher education levels had 70%
worse attitudes toward breast cancer awareness. Women living South of Sumatera, women living in Yogyakarta, and
unmarried women were 5.03, 3.84, and 1.56 times as likely to have higher perceived barriers, respectively. Conclusion:
Urban women had a poorer level of knowledge of breast cancer risk factors compared to women living in more rural
areas. The result of this study may reflect inadequate breast cancer awareness campaigns or a lack of breast cancer
awareness campaigns. These findings suggest that additional education programs aiming to increase awareness and
educate the public are needed.
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Affiliation(s)
- Solikhah Solikhah
- Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia.
| | - Supannee Promthet
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.,ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Cameron Hurst
- Biostatistics Center of Excellence, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Catalyzing Novel Approaches to Rapid, Accurate, and Affordable Early Cancer Detection. ACTA ACUST UNITED AC 2019; 24:115-120. [PMID: 29794535 DOI: 10.1097/ppo.0000000000000314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Inspired by the Cancer Moonshot, a dedicated team of professionals worked with leaders across the cancer ecosystem to look for an opportunity to radically reduce cancer mortality globally by focusing on early cancer detection. After an initial survey of cancer innovation, progress, and pitfalls, the team believed that if new rapid, affordable, and accurate early detection solutions were appropriately brought to market, it would be possible to intervene earlier when cancer is most treatable.An extensive process began, informed by dozens of experts in the cancer ecosystem. The Cancer XPRIZE team designed a prize competition where "the winning team will develop a means to rapidly, accurately, and affordably screen for early cancers where intervention can reduce human suffering."The following outlines the Cancer XPRIZE's experience using a powerful approach-the radical prize design-to catch more cancers in time to make a difference saving lives, dollars, and suffering.
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Baig M, Sohail I, Altaf HN, Altaf OS. Factors influencing delayed presentation of breast cancer at a tertiary care hospital in Pakistan. Cancer Rep (Hoboken) 2019; 2:e1141. [PMID: 32721102 DOI: 10.1002/cnr2.1141] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 09/09/2018] [Accepted: 09/11/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Breast cancer is the leading cause of death despite the continuous development of newer and more effective modalities of treatment for breast cancer. In Asia, Pakistan has the highest rate of breast cancer. Breast cancer treatment shows better prognosis when it is diagnosed at an early stage, but mortality increases significantly with delayed diagnosis and advanced stage of disease. Delay in diagnosis and nonavailability of treatment are the major factors responsible for advanced stage and low survival. AIMS The objective of our study was to identify the factors responsible for delayed presentation of patients with breast carcinoma. METHODS AND RESULTS A cross-sectional study using a questionnaire method was conducted at the Foundation University Medical College from January 2015 to December 2016. A total of 89 patients gave consent and were interviewed using a prestructured questionnaire during the study. Age ranged from 25 to 64 years. Majority of patients were in stage T3N1M0 (31.5%). Second most common stage was T4N0M0 (14.6%). Thirteen patients (12.4%) were in stage T3N0M0, and 10 patients (11.2%) were in T3N2M0. Delay ranged from 3 months to more than 1 year; 43.8% presented with delay of 3 to 6 months. The reasons for delay were lack of knowledge about breast cancer (41%), lack of availability of health care services (32.6%), purdah and religious reasons (6.7%), and fear of being diagnosed with cancer (10.1%). CONCLUSION The main reasons for delay identified in our study were lack of knowledge and availability of appropriate health care facilities. In order to improve outcome of breast cancer, more focus is needed on spreading awareness and improving health care services in rural areas.
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Affiliation(s)
- Mehreen Baig
- MRCS General Surgery, Department of surgery, Surgical Unit I, Foundation University Medical College, Rawalpindi, Pakistan
| | - Iram Sohail
- FRCS Histopathology, Department of Pathology, Foundation University Medical College, Rawalpindi, Pakistan
| | - Humera Naz Altaf
- FCPS General Surgery, Department of Surgery, Shifa College of Medicine, Shifa Tameer e' Millat University, Islamabad, Pakistan
| | - Omar Shahzad Altaf
- Tehsil Head Quarter Hospital Hazro Khebar Pakhtoonkhawa, Hazro, Pakistan
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Steiness HS, Villegas-Gold M, Parveen H, Ferdousy T, Ginsburg O. Barriers to care for women with breast cancer symptoms in rural Bangladesh. Health Care Women Int 2018; 39:536-554. [PMID: 29505392 DOI: 10.1080/07399332.2018.1446958] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Breast cancer survival rates in lower-income countries like Bangladesh are approximately 50%, versus over 80% in high income countries. Anecdotal reports suggest that, beyond economic and health system barriers, sociocultural factors may influence a woman's care-seeking behavior and resultant early stage diagnoses. To understand these barriers, we conducted 63 interviews (43 women with breast cancer symptoms and 20 men) in Khulna, Bangladesh. We identified socio-cultural barriers like neglect and indifference toward women, women's lack of power to use resources, and reduced support from family due to stigma. Interventions must address these barriers and improve the status of women in Bangladesh.
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Affiliation(s)
- Heather Story Steiness
- a Human Evolution and Social Change, Arizona State University College of Liberal Arts and Sciences , St. Phoenix, Arizona , USA
| | - Michelle Villegas-Gold
- a Human Evolution and Social Change, Arizona State University College of Liberal Arts and Sciences , St. Phoenix, Arizona , USA
| | - Homaira Parveen
- a Human Evolution and Social Change, Arizona State University College of Liberal Arts and Sciences , St. Phoenix, Arizona , USA
| | | | - Ophira Ginsburg
- c Perlmutter Cancer Center, Section for Global Health , Department of Population Health, NYU Langone Health, New York , New York , USA
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22
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Islam RM, Billah B, Hossain MN, Oldroyd J. Barriers to Cervical Cancer and Breast Cancer Screening Uptake in Low-Income and Middle-Income Countries: A Systematic Review. Asian Pac J Cancer Prev 2017; 18:1751-1763. [PMID: 28749101 PMCID: PMC5648375 DOI: 10.22034/apjcp.2017.18.7.1751] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Cervical cancer (CCa) and breast cancer (BCa) are the two leading cancers in women worldwide. Early detection and education to promote early diagnosis and screening of CCa and BCa greatly increases the chances for successful treatment and survival. Screening uptake for CCa and BCa in low and middle - income countries (LMICs) is low, and is consequently failing to prevent these diseases. We conducted a systematic review to identify the key barriers to CCa and BCa screening in women in LMICs. Methods: We performed a systematic literature search using Ovid MEDLINE, EMBASE, PsycINFO, SCOPUS, CINHAL Plus, and Google scholar to retrieve all English language studies from inception to 2015. This review was done in accordance with the PRISMA-P guidelines. Results: 53 eligible studies, 31 CCa screening studies and 22 BCa screening studies, provided information on 81,210 participants. We found fewer studies in low-income and lower - middle - income countries than in upper - middle - income countries. Lack of knowledge about CCa and BCa, and understanding of the role of screening were the key barriers to CCa and BCa screening in LMICs. Factors that are opportunities for knowledge acquisition, such as level of education, urban living, employment outside the home, facilitated CCa and BCa screening uptake in women in LMICs. Conclusions: Improvements to CCa and BCa screening uptake in LMICs must be accompanied by educational interventions which aim to improve knowledge and understanding of CCa and BCa and screening to asymptomatic women. It is imperative for governments and health policy makers in LMICs to implement screening programmes, including educational interventions, to ensure the prevention and early detection of women with CCa and BCa. These programmes and policies will be an integral part of a comprehensive population-based CCa and BCa control framework in LMICs.
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Affiliation(s)
- Rakibul M Islam
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Population Sciences, University of Dhaka, Dhaka, Bangladesh
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Alkhasawneh E, Al-Farsi Y, Al-Simadi F, Leocadio M. Development and Validation of a Culturally-Tailored Breast Cancer Health Education Programme for Arab Women. Sultan Qaboos Univ Med J 2017; 17:e181-e190. [PMID: 28690890 DOI: 10.18295/squmj.2016.17.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/08/2016] [Accepted: 10/13/2016] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES This study aimed to develop and validate a health education programme to encourage breast cancer awareness and early detection behaviours among Arab women. METHODS This study took place between December 2015 and March 2016. The Enabling Systems Raising Awareness model was used to develop a breast cancer health education programme which was subsequently implemented by trained health educators at three female-only fitness clubs in Muscat, Oman. Breast cancer knowledge among 53 women was assessed using the breast module of the Cancer Awareness Measure before and after each health education session. Overall pre- and post-session knowledge scores were then compared. Additionally, three focus group discussions were conducted with 10 participants from each location. Thematic analysis was used to analyse the transcribed discussions and collect feedback on the programme. RESULTS The health education sessions resulted in a statistically significant increase in overall mean knowledge scores (P <0.001). Participants also reported significantly improved intentions to undertake early detection practices (P <0.001). The focus group discussions yielded distinct themes and valuable feedback which can be utilised in the future to create an improved version of the programme. CONCLUSION While the health education programme significantly improved breast cancer and early detection knowledge among a cohort of Arab women, it still required critical improvements in terms of structure and administration. Additional studies are required in order to evaluate long-term behavioural outcomes resulting from the improved programme.
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Affiliation(s)
- Esra Alkhasawneh
- Department of Maternal & Child Health Nursing, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Yahya Al-Farsi
- Department of Family Medicine, College of Medicine, Sultan Qaboos University, Muscat, Oman
| | - Fayez Al-Simadi
- Department of Sociology, College of Arts & Social Sciences, Yarmouk University, Irbid, Jordan
| | - Michael Leocadio
- Department of Fundamentals & Administration, College of Nursing, Sultan Qaboos University, Muscat, Oman
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Čačala SR, Gilart J. Factors Relating to Late Presentation of Patients With Breast Cancer in Area 2 KwaZulu-Natal, South Africa. J Glob Oncol 2017; 3:497-501. [PMID: 29094088 PMCID: PMC5646898 DOI: 10.1200/jgo.2016.008060] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Purpose Patients with breast cancer (BC) in Area 2 KwaZulu-Natal, South Africa, often present with advanced disease. We performed a review of the patients’ sociodemographic characteristics and their reasons for late presentation to identify what changes could be made to improve time to presentation. Patients and Methods Fifty women with T1, T2, T3, or T4 BC were assessed for sociodemographic data. Patients in T3 and T4 groups were asked to provide reasons for late presentation. Results Of 172 patients, 50 had T2, T3, or T4 BC, and 22 had T1. Age ranged from 23 to 100 years (average, 56 years). There was no significant difference in age for different tumor sizes. The average size of a T1 tumor was 1.8 cm; T2, 3.6 cm; T3, 11.4 cm; and T4, 14.8 cm. Regarding education, 19% of patients had never attended school (T1, 5%; T2, 12%; T3, 22%; T4, 32%), and 19% had completed their education (finished 12th grade). The average education level was 6th grade. Patients with larger tumors had less education (P < .05). Of the patients who lived in rural areas, 41% had T1, 52% had T2, 66% had T3, and 78% had T4 tumors (P < .01). Patients with larger tumors were associated with having less electricity in their homes than patients with smaller tumors (P < .05). Patients presented with a variety of symptoms. A breast lump was the presenting complaint in 96% of T1 and T2, 68% of T3 and 32% of T4; with a nipple or skin change, 2% of T3 and 8% of T4; because their families insisted, 6% of T3 and 8% of T4; because of pain, 24% of T3; and because of pain with malodorous smell, 50% of T4. Patients’ reasons for late presentation were fear (40%), not aware of disease severity (40%), fear of losing a breast (40%), referral problems (34%), financial problems (8%), and transportation problems (6%). Approximately 33% sought medical help from traditional healers, and 65% regularly attended clinics. Conclusion Patients who presented late often lived in rural areas with fewer amenities (such as having no electricity in their homes), less education, and poor understanding of BC. Pictorial information about BC needs to be introduced to people who live in rural communities, and opportunistic screening needs to be provided at local clinics.
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Affiliation(s)
- Sharon R Čačala
- All authors: Grey's Hospital, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - José Gilart
- All authors: Grey's Hospital, University of KwaZulu-Natal, Pietermaritzburg, South Africa
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Islam RM, Bell RJ, Billah B, Hossain MB, Davis SR. The prevalence of symptomatic pelvic floor disorders in women in Bangladesh. Climacteric 2016; 19:558-564. [PMID: 27763801 DOI: 10.1080/13697137.2016.1240771] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To investigate the prevalence of, and risk factors for, pelvic floor disorders (PFDs) in women in Bangladesh. METHODS A nationally representative sample of 1590 Bangladeshi women, aged 30-59 years, was recruited using a multistage cluster sampling technique, between September 2013 and March 2014. Urinary incontinence (UI), fecal incontinence (FI) and pelvic organ prolapse (POP) were assessed using validated questionnaires. The weighted prevalence and the factors associated with each PFD were investigated using multivariable weighted logistic regression. RESULTS The weighted prevalence of UI was 23.7% (95% confidence interval (CI) 21.3-26.0%), FI 5.3% (95% CI 4.0-6.6%), POP 16.2% (95% CI 14.2-18.2%), and having at least one PFD 35.3% (95% CI 32.6-37.9%). Women were more likely to have at least one PFD if aged 40-49 years (adjusted odds ratio (AOR) 1.46, 95% CI 1.02-2.08; p = 0.040) or 50-59 years (AOR 2.39, 95% CI 1.59-3.58; p < 0.0001), compared with women aged 30-39 years. Having at least one PFD was positively associated with having three or more versus fewer children (AOR 1.61, 95% CI 1.14-2.27; p = 0.007), being in the middle (AOR 3.05, 95% CI 1.72-5.41; p < 0.0001), second lowest (AOR 2.49, 95% CI 1.39-4.47; p = 0.002) or lowest (AOR 3.13, 95% CI 1.68-5.86; p < 0.0001) wealth quintile compared with the highest, and self-reporting diabetes (AOR 2.55, 95% CI 1.54-4.23; p < 0.0001). CONCLUSIONS One-third of Bangladeshi women aged 30-59 years had at least one symptomatic PFD. Risk factors included greater age, higher parity, lower wealth status and self-reported diabetes. The diagnosis, treatment, and prevention of PFDs in Bangladesh need greater attention, as the prevalence of these disabling conditions is likely to increase with the aging of the population.
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Affiliation(s)
- R M Islam
- a Women's Health Research Program, School of Public Health and Preventive Medicine , Monash University , Melbourne , Victoria , Australia.,b Department of Population Sciences , University of Dhaka , Dhaka , Bangladesh
| | - R J Bell
- a Women's Health Research Program, School of Public Health and Preventive Medicine , Monash University , Melbourne , Victoria , Australia
| | - B Billah
- c Biostatistics Unit, School of Public Health and Preventive Medicine , Monash University , Melbourne , Victoria , Australia
| | - M B Hossain
- b Department of Population Sciences , University of Dhaka , Dhaka , Bangladesh
| | - S R Davis
- a Women's Health Research Program, School of Public Health and Preventive Medicine , Monash University , Melbourne , Victoria , Australia
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Brennan ME. The role of clinical breast examination in cancer screening for women at average risk: A mini review. Maturitas 2016; 92:61-63. [PMID: 27621240 DOI: 10.1016/j.maturitas.2016.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 07/17/2016] [Accepted: 07/18/2016] [Indexed: 10/21/2022]
Abstract
As the debate about the potential benefits and harms of screening mammography continues, it is timely to consider the role of clinical breast examination in screening for women at average risk of breast cancer. This article reviews the results from clinical trials and discusses the varied recommendations around the world. It concludes that the evidence does not support routine clinical breast examination for women participating in screening mammography programs, but there may be a benefit for women not do not have mammographic screening, especially in developing nations where health literacy and 'breast awareness' levels may be lower. This review provides information for clinicians to support women who are making decisions about the increasingly complex issue of breast cancer screening.
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A major flaw in "Awareness of breast cancer and barriers to breast screening uptake in Bangladesh: A population based survey". Maturitas 2016; 88:45. [PMID: 27105696 DOI: 10.1016/j.maturitas.2016.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 03/10/2016] [Indexed: 11/24/2022]
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