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Chan DNS, Kwok C. Factors Influencing the Mammographic Screening Practices of South Asian Women in Hong Kong: A Qualitative Study. Cancer Nurs 2024:00002820-990000000-00218. [PMID: 38417126 DOI: 10.1097/ncc.0000000000001332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
BACKGROUND Breast cancer is a common type of cancer in South Asian women. Early detection by mammographic screening plays a significant role in improving survival rates. South Asian minorities in many countries have reported low mammographic screening rates. OBJECTIVE This study aimed to understand the factors that influence mammographic screening uptake among South Asian women in Hong Kong. METHODS This was a qualitative exploratory descriptive study. South Asian women 40 years or older with no history of breast cancer were recruited. In-depth face-to-face interviews were conducted following a semistructured interview guide. Thematic analysis was conducted to analyze the data. RESULTS A total of 31 South Asian women consented to participate. Among them, only 7 had ever undergone mammographic screening. The following themes of facilitating factors were identified: (1) influence of doctors, family, and friends; (2) strong sense of commitment to the family; and (3) accessibility and availability of mammographic screening information and services. The following themes for barriers to screening were identified: (1) beliefs about health management and social norms, (2) lack of knowledge and understanding of breast cancer and mammographic screening, (3) logistical barriers, and (4) physical barriers. CONCLUSION This study identified important facilitators and barriers that influence the uptake of mammographic screening among South Asian women in Hong Kong. IMPLICATIONS FOR PRACTICE The study findings can be used to guide the development and implementation of culturally relevant interventions to address barriers to screening, including the expected gender roles and responsibilities among women in their respective families.
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Affiliation(s)
- Dorothy Ngo Sheung Chan
- Author Affiliations: The Nethersole School of Nursing, The Chinese University of Hong Kong (Dr Chan), China; and School of Nursing, Paramedicine and Health Care Science, Faculty of Science and Health, Charles Sturt University, New South Wales (Dr Kwok), Australia
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Nguyen D, Gilad O, Drogan CM, Eilers Z, Liao C, Kupfer SS. Risk perception and surveillance uptake in individuals at increased risk for pancreatic ductal adenocarcinoma. J Med Genet 2024; 61:270-275. [PMID: 37852748 DOI: 10.1136/jmg-2023-109539] [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: 07/26/2023] [Accepted: 09/26/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Surveillance for pancreatic ductal adenocarcinoma (PDAC) is recommended for high-risk individuals with genetic variants in PDAC-associated genes and/or family history. Surveillance uptake and adherence may depend on the perception of PDAC risk and cancer worry. We aimed to determine PDAC risk perception in at-risk individuals and assess factors associated with PDAC surveillance uptake. METHODS At-risk individuals identified from a prospective academic registry were sent a survey electronically. PDAC risk perception, cancer worry and surveillance uptake were surveyed. Factors associated with increased risk perception and surveillance were assessed. Five-year PDAC risk was calculated using the PancPRO risk assessment model, and correlation with subjective risk assessment was assessed. RESULTS The overall survey response rate was 34% (279/816). The median perceived PDAC risk was twofold (IQR 1-4) above respondents' estimates of general population risk. Factors significantly associated with higher perceived PDAC risk included non-Hispanic white race, post-graduate education level, PDAC-affected first-degree relative, genetic variants and lack of personal cancer history. Cancer worry had a very weak correlation across PDAC risk estimates (r=0.16). No correlation between perceived PDAC risk and 5-year calculated PDAC risk was found. Older age, having a first-degree relative with PDAC, meeting with a medical provider about PDAC cancer risk and awareness of surveillance modalities were significant predictors of undergoing PDAC surveillance. CONCLUSIONS Individuals at risk for PDAC do not report risk perception that correlates with calculated risk. This presents an opportunity for counselling of at-risk patients to individualise management and improve surveillance uptake for eligible individuals.
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Affiliation(s)
- Denis Nguyen
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Ophir Gilad
- Section of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Christine M Drogan
- Section of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Zoe Eilers
- Section of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Chuanhong Liao
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA
| | - Sonia S Kupfer
- Section of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Chicago, Chicago, Illinois, USA
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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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Tran ATN, Hwang JH, Choi E, Lee YY, Suh M, Lee CW, Kim Y, Choi KS. Impact of Awareness of Breast Density on Perceived Risk, Worry, and Intentions for Future Breast Cancer Screening among Korean Women. Cancer Res Treat 2020; 53:55-64. [PMID: 32810929 PMCID: PMC7812003 DOI: 10.4143/crt.2020.495] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/17/2020] [Indexed: 01/29/2023] Open
Abstract
PURPOSE This study sought to examine perceived risk and concerns for breast cancer according to awareness of breast density and states thereof among Korea women and to identify the impact of such awareness on screening intentions. Materials and Methods This study was based on the 2017 Korean National Cancer Screening Survey of a nationally representative and randomly selected sample of Koreans. Ordinal logistic regression was conducted to examine associations for awareness of and knowledge on breast density in relation to psychological factors. Multivariate logistic regression analyses were conducted to investigate significant factors associated with intentions to undergo breast cancer screening. RESULTS Among a total of 1,609 women aged 40-69 years, 62.0% were unaware of their breast density, and only 29.7% had good breast density knowledge. Awareness of one's breast density and knowledge about breast density were positively associated with perceptions of absolute and comparative risk and cancer worry. Women aware of their breast density (adjusted odds ratio [aOR], 1.35 for women aware of having a non-dense breast; aOR, 4.17 for women aware of having a dense breast) and women with a good level of breast density knowledge (aOR, 1.65) were more likely to undergo future breast cancer screening. CONCLUSION Breast density awareness and knowledge showed positive associations with psychological factors and breast cancer screening intentions. However, the majority of Korean women were not aware of their breast density status and demonstrated poor knowledge about breast density. These results demonstrate a need for better health communication concerning breast density.
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Affiliation(s)
- Anh Thi Ngoc Tran
- National Cancer Center, Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Ji Hae Hwang
- National Cancer Center, Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Eunji Choi
- National Cancer Center, Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Yun Yeong Lee
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Mina Suh
- National Cancer Center, Graduate School of Cancer Science and Policy, Goyang, Korea.,National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Chan Wha Lee
- National Cancer Center, Graduate School of Cancer Science and Policy, Goyang, Korea.,Center for Cancer Prevention and Detection, National Cancer Center Hospital, National Cancer Center, Goyang, Korea
| | - Yeol Kim
- National Cancer Center, Graduate School of Cancer Science and Policy, Goyang, Korea.,National Cancer Control Institute, National Cancer Center, Goyang, Korea.,Center for Cancer Prevention and Detection, National Cancer Center Hospital, National Cancer Center, Goyang, Korea
| | - Kui Son Choi
- National Cancer Center, Graduate School of Cancer Science and Policy, Goyang, Korea.,National Cancer Control Institute, National Cancer Center, Goyang, Korea
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So WKW, Law BMH, Choi KC, Chan DNS, Chan CWH. A Mixed-Method Study Examining Cancer Screening Uptake among South Asian Ethnic Minorities in Hong Kong. Asia Pac J Oncol Nurs 2019; 7:12-17. [PMID: 31879679 PMCID: PMC6927150 DOI: 10.4103/apjon.apjon_36_19] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 07/12/2019] [Indexed: 11/30/2022] Open
Abstract
Objective: Utilization of cancer screening is an effective means of cancer prevention. However, South Asian ethnic minorities in Western countries are reported to face barriers in cancer screening utilization, resulting in a low screening uptake by these individuals. The purpose of this mixed-method study is to assess the uptake rate of cancer screening among South Asian ethnic minorities in the Chinese Society of Hong Kong and to examine the factors affecting their participation in cancer screening. Methods: This study utilized a sequential mixed-method design, involving two phases. Following the implementation of a self-report survey among South Asian participants via an author-developed questionnaire with 1547 participants in Phase 1, a focus group interview was conducted with 34 participants in Phase 2 to assess the barriers to screening utilization. Convenience sampling was adopted to recruit participants at South Asian community centers in Phase 1, whereas purposive sampling was used for recruiting participants in Phase 2. Results: The findings revealed a low (<40%) uptake rate of cancer screening among the participants. Health illiteracy, language barrier, limited access to health information and screening services, and cultural issues were the major barriers to their cancer screening utilization. Conclusions: Our findings provided valuable information for both policymakers and health professionals to better understand the needs of ethnic minorities in Hong Kong. As cancer death rates can be lowered by early detection and primary preventive measures, health professionals should focus on the development of culture-specific interventions. Similarly, training the community health workers can strengthen the primary care system in enhancing knowledge on cancer, its prevention, and access to cancer screening services among local ethnic minorities.
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Affiliation(s)
- Winnie K W So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Bernard M H Law
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Kai Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Dorothy N S Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Carmen W H Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
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Barbosa YC, Oliveira AGC, Rabêlo PPC, Silva FDS, Santos AMD. Fatores associados à não realização de mamografia: Pesquisa Nacional de Saúde, 2013. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 22:e190069. [DOI: 10.1590/1980-549720190069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 10/05/2018] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Introdução: O acesso à mamografia, principal exame de detecção precoce do câncer de mama, não é igualitário entre as mulheres brasileiras. Objetivou-se analisar os fatores associados à não realização desse exame num período inferior a dois anos no Brasil e por macrorregião, considerando-se características sociodemográficas, condições de saúde, hábitos de vida e uso dos serviços de saúde. Método: Estudo transversal que utilizou dados da Pesquisa Nacional de Saúde (PNS). A amostra consiste de 10.571 mulheres (≥ 40 anos) residentes em todas as regiões brasileiras. Modelo de regressão de Poisson com abordagem hierarquizada foi utilizado para estimar razões de prevalência. Resultados: As características associadas à não realização de mamografia foram: idade ≥ 60 anos, baixa escolaridade, viver sem companheiro, avaliar negativamente o próprio estado de saúde, possuir alguma doença crônica, não praticar exercício físico, não realizar o exame clínico da mama até um ano, ou o exame de Papanicolaou até três anos, não ter consultado com médico no último ano, não possuir plano de saúde, sentir-se discriminada por profissional de saúde e ter cadastro em uma unidade de saúde da família. Variáveis sociodemográficas se sobressaíram no Norte e Nordeste; e nas outras regiões, condições de saúde e hábitos de vida. Conclusão: Variáveis relacionadas ao uso dos serviços de saúde tiveram destaque na não realização da mamografia. Ações que reduzam a desigualdade no acesso ao exame devem ser adotadas em cada macrorregião do Brasil.
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Sano H, Goto R, Hamashima C. Does lack of resources impair access to breast and cervical cancer screening in Japan? PLoS One 2017; 12:e0180819. [PMID: 28704430 PMCID: PMC5509210 DOI: 10.1371/journal.pone.0180819] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 06/21/2017] [Indexed: 11/29/2022] Open
Abstract
Objectives To assess the impact of the quantity of resources for breast and cervical cancer screening on the participation rates in screening in clinical settings in municipalities, as well as to clarify whether lack of resources impairs access to cancer screening in Japan. Methods Of the 1,746 municipalities in 2010, 1,443 (82.6%) and 1,469 (84.1%) were included in the analyses for breast and cervical cancer screening, respectively. In order to estimate the effects of the number of mammography units and of gynecologists on the participation rates in breast and cervical cancer screening in clinical settings, multiple regression analyses were performed using the interaction term for urban municipalities. Results The average participation rate in screening in clinical settings was 6.01% for breast cancer, and was 8.93% for cervical cancer. The marginal effect of the number of mammography units per 1,000 women was significantly positive in urban municipalities (8.20 percent point). The marginal effect of the number of gynecologists per 1,000 women was significantly positive in all municipalities (2.54 percent point) and rural municipalities (3.68 percent point). Conclusions Lack of mammography units in urban areas and of gynecologists particularly in rural areas impaired access to breast and cervical cancer screening. Strategies are required that quickly improve access for the residents and increase their participation rates in cancer screening.
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Affiliation(s)
- Hiroshi Sano
- Faculty of Economics, Shiga University, Hikone, Shiga, Japan
- * E-mail:
| | - Rei Goto
- Graduate School of Business Administration, Keio University, Yokohama, Kanagawa, Japan
| | - Chisato Hamashima
- Division of Cancer Screening Assessment and Management, Center for Public Health Science, National Cancer Center, Chuo-ku, Tokyo, Japan
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Choi E, Lee YY, Yoon HJ, Lee S, Suh M, Park B, Jun JK, Kim Y, Choi KS. Relationship between Cancer Worry and Stages of Adoption for Breast Cancer Screening among Korean Women. PLoS One 2015; 10:e0132351. [PMID: 26186652 PMCID: PMC4506072 DOI: 10.1371/journal.pone.0132351] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 06/13/2015] [Indexed: 11/20/2022] Open
Abstract
Background The possibility of developing breast cancer is a concern for all women; however, few studies have examined the relationship between cancer worry and the stages of adoption for breast cancer screening in Korea. Here, we investigated the associations between cancer worry, the stages of adopting breast cancer screening, and socio-demographic factors known to influence screening behaviors. Methods This study was based on the 2013 Korean National Cancer Screening Survey, an annual cross-sectional survey that utilized nationally representative random sampling to investigate cancer screening rates. Data were analyzed from 1,773 randomly selected women aged 40–74 years. Chi-squared tests and multinomial logistic analyses were conducted to determine the associations between cancer worry and the stages of adoption for breast cancer screening and to outline the factors associated with each stage. Results Korean women were classified into the following stages of adoption for breast cancer screening: pre-contemplation (24.7%), contemplation (13.0%), action/maintenance (50.8%), relapse risk (8.9%), and relapse (2.6%). Women in the action/maintenance stages reported more moderate to higher levels of worry about getting cancer than those in the pre-contemplation stage. Further, age of 40–49 years and having private cancer insurance were associated with women in the action/maintenance stages. Conclusion Interventions to address breast cancer worry may play an important role in increasing participation and equity in breast cancer screening.
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Affiliation(s)
- Eunji Choi
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea
| | - Yoon Young Lee
- National Cancer Control Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - Hyo Joong Yoon
- National Cancer Control Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - Sangeun Lee
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea
| | - Mina Suh
- National Cancer Control Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - Boyoung Park
- National Cancer Control Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - Jae Kwan Jun
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea
- National Cancer Control Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - Yeol Kim
- National Cancer Control Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - Kui Son Choi
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea
- National Cancer Control Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea
- * E-mail:
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