Are Tri-Ethnic Low-Income Women with Breast Cancer Effective Teachers of the Importance of Breast Cancer Screening to Their First-Degree Relatives? Results from a Randomized Clinical Trial

Effects of health education on screening rate of first-degree relatives of cancer patients: A systematic review and meta-analysis

OBJECTIVE

To synthesize the effects of educational intervention on the screening rate of first-degree relatives of cancer patients.

METHODS

A total of eight Chinese and English databases were searched (PubMed, Embase, Cochrane Library, CINAHL, Web of Science, Scopus, Medline and China Biology Medicine disc) from the time of library establishment to June 2023, for randomized controlled trials investigating the effects of educational intervention on screening rate of first-degree relatives of cancer patients. Two researchers independently screened and evaluated the quality of studies. RevMan 5.3 software was used to calculate the pooled effect size.

RESULTS

Thirteen studies involving 5628 participants were chosen to include in the meta-analysis. The results revealed that health education can increase screening rate of first-degree relatives of cancer patients (RR = 1.39, 95% CI = 1.16-1.65, P = 0.0002). The effect shown after short-term follow-up (≤6 months) was insignificant in terms of improving screening rate (RR = 1.46, 95% CI = 0.94-2.26, P = 0.09), but after long-term follow-up (＞6 months) the improvement was greater (RR = 1.37, 95% CI = 1.13-1.65, P = 0.002).

CONCLUSION

Health education is effective in increasing the screening rate of first-degree relatives of cancer patients. The effect is more evident after long-term than short-term follow-up.

Screening Behaviors and Related Factors among the First-Degree Relatives of Chinese Patients with Gastric Cancer

Objective

This study was aimed at investigating the screening behaviors of the first-degree relatives (FDRs) of Chinese patients with gastric cancer as well as the factors influencing screening behaviors.

Methods

In a cross-sectional design, 197 FDRs of patients with gastric cancer were enrolled at the Peking University Cancer Hospital. Four questionnaires were used: a demographic questionnaire, a knowledge questionnaire of risk factors and warning symptoms for gastric cancer, the Gastric Cancer Health Belief Scale, and a questionnaire screening for behavioral motivators and barriers. Logistic regression analysis was performed to determine the factors influencing screening behaviors.

Results

Among the 197 FDRs of patients with gastric cancer, 30.96% (61/197) of patients had undergone gastric cancer screening. Among those who participated in gastric cancer screening, the most common screening methods were gastroscopy and the Helicobacter pylori testing, both of which were applied in 63.93% (39/61) of participants, followed by serum tumor marker testing (55.74%, 34/61) and barium meal examination of the upper digestive tract (29.51%, 18/61). The gastric cancer risk factor knowledge score was 9.02 ​± ​3.95, and the gastric cancer warning symptom knowledge score was 4.39 ​± ​1.85. The participants' knowledge score was moderate, at 13.41 ​± ​5.16. The total health beliefs score was low, at 88.91 ​± ​12.66. Factors independently associated with the screening behaviors of FDRs included educational background, knowledge of gastric cancer risk factors, and health motivation (P ​< ​0.05).

Conclusions

The participation rate in gastric cancer screening of FDRs of patients with gastric cancer was relatively low and was affected by multiple factors. Our results highlighted the urgent need for educational campaigns and precision interventions to raise gastric cancer awareness.

Interventions to increase the uptake of mammography amongst low income women: a systematic review and meta-analysis

Background

Two previous reviews found that access-enhancing interventions were effective in increasing mammography uptake amongst low-income women. The purpose of this study was to estimate the magnitude of the effect of interventions used to increase uptake of mammography amongst low-income women.

Methods

Searches were conducted in MEDLINE and EMBASE (2002–April 2012) using relevant MeSH terms and keywords. Randomised controlled trials which aimed to increase mammography use in an asymptomatic low-income population and which had as an outcome receipt of a mammogram, were eligible for inclusion. The primary outcome was the post-intervention difference in the proportion of women who had a mammogram in the intervention and control groups. The quality of the studies was assessed using the Cochrane risk of bias tool. We calculated summary estimates using random effects meta-analyses. Possible reasons for heterogeneity were investigated using sub-group analyses and meta-regression. Publication bias was assessed using Egger's test.

Results

Twenty-one studies met the inclusion criteria, including 33 comparisons. Interventions increased the uptake of mammography in low income women by an additional 8.9% (95% CI 7.3 to 10.4%) compared to the control group. There was some evidence that interventions with multiple strategies were more effective than those with single strategies (p  = 0.03). There was some suggestion of publication bias. The quality of the included studies was often unclear. Omitting those with high risk of bias has little effect on the results.

Conclusions

Interventions can increase mammography uptake among low-income women, multiple interventions being the most effective strategy. Given the robustness of the results to sensitivity analyses, the results are likely to be reliable. The generalisability of the results beyond the US is unclear.

A different approach to breast self-examination education: daughters educating mothers creates positive results in Turkey

Breast cancer is a common cancer among women, and early detection is important for breast cancer mortality and morbidity. The aim of this study was to determine the effects of daughters teaching their mothers about breast self-examination (BSE) and its health beliefs. In the study's first stage, 168 university students were trained by the School of Health students about BSE through group training methods. Then, these trained university students were asked to train their mothers about BSE. Data were collected before the training and then again after the training (1 month later). The study instruments included questionnaire forms and the Champion Health Belief Model Scale. The results were analyzed using paired- and unpaired-sample t test, analysis of variance, bivariate correlation analysis, and stepwise multiple regression analysis. The results show that women's knowledge level increased 2-fold after training, and the knowledge level difference between pretraining and post-training was significant (P = .000). The mothers' background information (hear-read) and BSE practice (P = .006 and .006, respectively) before the training process were found to be significant predictors of sociodemographic and other variables influencing the mothers' knowledge levels. The training increased the perceived benefit (P = .032) and confidence (P = .000) significantly. It was found that there was a negative but significant correlation between perceived barriers and BSE knowledge after the education (P = .019). It was found that mothers' knowledge level about BSE was higher after the education. Furthermore, perceived barriers decreased while other subscales increased. Education from daughter to mother can be used as a BSE training approach to increase women's knowledge about BSE.