Breast cancer knowledge and preventive behaviors: An urban emergency department-based survey

Effect of social support and barrier perceptions of disabled women on early detection of breast cancer

In the study, we examine the effect of social support and disability perception of disabled women on early diagnosis behaviors of breast cancer. The research was conducted as descriptive. The sample of the study consisted of 105 participants. The breast self-examination barrier perception point average of the participants applying the breast self-examination was statistically significantly lower than those not applying and the barrier perception point average of participants having mammography was statistically significantly lower than those not having it (p < 0.05).

The Effect of Breast Cancer Fear Levels of Female Seasonal Agricultural Laborers on Early-Diagnosis Behaviors and Perceptions of Breast Cancer

The purpose of this study was to determine the effect of breast cancer fear levels of female seasonal agricultural laborers between ages 40 and 60 on breast cancer early-diagnosis behaviors and perceptions. This is a cross-sectional study. The data of the study were collected between February and September 2014 in Şanlıurfa, Turkey. A sample of the study group consisted of 350 women. The data were assessed by using SPSS 16.0 statistics package software. Descriptive statistics, t test, chi-square, and correlation analysis were used to analyze the data. Considering that breast cancer fear levels are effective on the breast cancer early-diagnosis behaviors and health beliefs, it can be recommended for the health care staff to carry out initiative works to reduce the fear levels.

Psychosocial determinants of mammography follow-up after receipt of abnormal mammography results in medically underserved women

This article targets the relationship between psychosocial determinants and abnormal screening mammography follow-up in a medically underserved population. Health belief scales were modified to refer to diagnostic follow-up versus annual screening. A retrospective cohort study design was used. Statistical analyses were performed examining relationships among sociodemographic factors, psychosocial determinants, and abnormal mammography follow-up. Women with lower mean internal health locus of control scores (3.14) were two times more likely than women with higher mean internal health locus of control scores (3.98) to have inadequate follow-up (OR=2.53, 95% CI=1.12-5.36). Women with less than a high school education had lower cancer fatalism scores than women who had completed high school (47.5 vs. 55.2, p-value=.02) and lower mean external health locus of control scores (3.0 vs. 5.3) (p-value<.01). These constructs have implications for understanding mammography follow-up among minority and medically underserved women. Further comprehensive study of these concepts is warranted.

Compliance with recommended cancer screening among emergency department patients: a multicenter survey

OBJECTIVES

The objectives were to measure compliance with, and possible sociodemographic disparities for, cancer screening among emergency department (ED) patients.

METHODS

This was a cross-sectional survey in three academic EDs in Boston. The authors enrolled consecutive adult patients during two 24-hour periods at each site. Self-reported compliance with standard recommendations for cervical, breast, testicular, and prostate cancer screening were measured. The chi-square test was used test to evaluate associations between demographic variables and cancer screening compliance.

RESULTS

The authors enrolled 387 patients (81% of those eligible). The participants had a mean (+/- standard deviation) age of 44 (+/-18) years and were 52% female, 16% Hispanic, and 65% white. Sixty-seven percent (95% confidence interval [CI] = 60% to 73%) of all women reported Pap smear examinations in the past 3 years, 92% (95% CI = 85% to 96%) of women aged > or = 40 years reported clinical breast examinations, and 88% (95% CI = 81% to 94%) of women aged > or = 40 years reported mammography. Fifty-one percent (95% CI = 40% to 61%) of men aged 18-39 years reported testicular self-examinations, and among men aged > or = 40 years, 79% (95% CI = 69% to 87%) reported digital rectal examinations (DREs) and 51% (95% CI = 40% to 61%) reported prostate-specific antigen (PSA) testing. Racial and ethnic minorities reported slightly lower rates of clinical breast examinations and testicular self-examinations.

CONCLUSIONS

Most women and a majority of men in our ED-based study were compliant with recommended measures of cervical, breast, testicular, and prostate cancer screening. No large sociodemographic disparities in our patient population were identified. Based on these data, and the many other pressing public health needs of our ED population, the authors would be reluctant to promote ED-based cancer screening initiatives at this time.

Correlates of women's cancer screening and contraceptive knowledge among female emergency department patients

Background

Lack of knowledge regarding preventive health services for women might impede campaigns to expand these services in the emergency department setting. For 18–55-year-old English-speaking women visiting an urban emergency department, we aimed to: (1) Ascertain their knowledge regarding the applicability, purpose, and recommended intervals of three women's cancer screening and three contraceptive methods; and (2) Determine if patient age, race/ethnicity, medical insurance status, and current or recent usage of these methods are associated with greater or lesser knowledge about them.

Methods

Emergency department-based survey on recent or current usage and knowledge about Pap smears, breast self-examinations, mammograms, condoms, birth control, and emergency contraception. Analyses included calculation of summary statistics and creation of multivariable logistic regression models.

Results

Of 1,100 patients eligible for the study, 69.9% agreed to participate. Most of the participants were < age 35, white, single (never married and no partner), Catholic, and had private medical insurance. Participant's recent or current usage of a particular cancer screening or contraceptive method varied by type of method: Pap smear within the past year (69.1%), breast self-exam within the past month (45.5%), mammogram within the past year (65.7% for women age 45–55), condom usage during every episode of sexual intercourse (15.4%), current usage of birth control pills (17.8%), and ever use of emergency contraception (9.3%). The participants correctly answered 87.9% of all survey questions about condoms, 82.5% about birth control pills, 78.5% about breast self-exams, 52.9% about Pap smears, 35.4% about mammograms, and 25.0% about emergency contraception. In multivariable logistic regression models, survey participants who had private medical insurance and those who recently or currently used a given screening or contraceptive method had a greater odds of correctly answering all questions about each cancer screening or contraceptive method.

Conclusion

Although these female ED patients demonstrated strong knowledge on some women's cancer screening and contraceptive methods, there were several areas of knowledge deficit. Women without private medical insurance and those who have not used a particular cancer screening or contraceptive method demonstrated less knowledge. Reduced knowledge about women's cancer screening and contraceptive methods should be considered during clinical encounters and when instituting or evaluating emergency department-based initiatives that assess the need for these methods.

Breast Self-Examination Among Chinese Immigrant Women

The incidence of breast cancer is rising rapidly among the fast-growing demographic group of Asian American and Pacific Islanders (AAPIs). In this study, the authors assessed the awareness of breast self-exam (BSE) and factors predicting practice of BSE among Chinese immigrant women living in San Francisco. Three hundred and ninety-seven women participated in a telephone survey; 80.9% reported having heard of BSE but only 53.9% reported practice of BSE during the past year. Logistic regression modeling found that increased length of stay in the United States, higher income, socializing with more Chinese than non-Chinese, and a birthplace other than U.S. and Chinese communities predicted BSE practice. The findings indicate that although familiarity with BSE is high among this group of Chinese immigrant women, self-reported actual practice is far from optimal. This study points to the need for culturally appropriate interventions that will encourage and motivate immigrant Chinese women to practice BSE on a monthly basis.

Computerized Training in Breast Self-examination

Fifty-eight women recruited from a community health center completed either a brief interactive multimedia training program on breast self-examination using a breast model and computer guided feedback on accuracy of lump detection or read a National Cancer Institute pamphlet on breast self-examination and breast lumps. Women using the computer program as compared to the pamphlet group reported a higher sense of self-efficacy for being able to perform a breast self-examination immediately after their educational session and 1 month later. However, the increase in self-efficacy for the computer group diminished over 4 weeks, underscoring the importance of an environment that reminds and reinforces learning for women about the performance of regular breast self-examination. The increase in sense of self-efficacy to perform breast self-examination with roughly 20 minutes of computer-based training and the partial maintenance of that self-efficacy 30 days later suggests the utility of incorporating short, focused interventions in busy primary healthcare settings.