Barriers to breast self examination practice among Malaysian female students: a cross sectional study

Breast cancer screening motivation among women: an application of self-determination theory

BACKGROUND

Breast cancer is a major health concern worldwide, especially in Vietnam. This study aimed to explore women's motivation for and factors related to breast cancer screening.

METHODS

A mixed-methods study was conducted in Danang, Vietnam, using a convergent parallel approach. This study utilized both quantitative and qualitative methods to gather the data. The quantitative approach involved surveys to assess motivation levels and related factors, including demographic information and experience with breast cancer screening. In-depth qualitative interviews were used to gain deeper insights into participants' perspectives and experiences related to breast cancer screening.

RESULTS

The average motivation score for breast cancer screening was moderate (3.55 ± 0.55). Ethnicity, regular health check-ups, family history of breast cancer, receiving information about breast cancer, and women's health issues have direct relationships with breast cancer screening motivation. According to the qualitative data, three categories emerged: intrinsic motivation, external motivation/internalization, and amotivation. The individual, and sociocultural environmental factors impacted screening motivation.

CONCLUSIONS

This study highlights the motivations behind breast cancer screening among women. Healthcare providers could use these findings to improve screening policies and guidelines and encourage more women to undergo regular screening, ultimately reducing the incidence of breast cancer in the community.

Awareness about Breast Cancer and Breast Self-Examination among Undergraduate Female Students at the University of Agadir, Morocco: A Cross-Sectional Descriptive Study

Breast cancer is a pressing public health issue globally and in Morocco, with rising cases among women. This study aims to evaluate breast cancer awareness and self-examination practices among female university students, informing future educational interventions. A cross-sectional study surveyed 437 students at Ibn Zohr University, Agadir, using a questionnaire covering demographics, knowledge of breast cancer, risk factors, symptoms, and breast self-examination (BSE). Results showed high awareness of breast cancer (95.3%), with social networks and media being primary information sources. However, only 48.25% had intermediate knowledge levels, and BSE awareness was moderate (60.8%) with low practical skills (28.0%). Reasons for not performing BSE included lack of knowledge and discomfort. Significant associations were found between knowledge levels and age, year of study, study options, and information sources. Despite high awareness, there is a crucial need to enhance knowledge about breast cancer risk factors, symptoms, and BSE practices among young women in Morocco. Educational programs targeting university students are essential for promoting early detection and improving attitudes toward breast health.

Understanding Preventive Health Behavior: A Mixed-Methods Study to Explore Factors Influencing the Practice of Breast Self-Examination Among Indian Medical Students

INTRODUCTION

Breast cancer (BC) is among the most prevalent oncological cases in the world, and the global burden of the disease is expected to rise further in the coming years. Strategies aiming at early diagnosis, backed by research and a well-trained healthcare cadre, can aid low- and middle-income countries (LMIC) in tackling the possible cancer-caused strain on healthcare systems. Our study aimed to evaluate the level of knowledge of medical students concerning BC and explore barriers and facilitators of breast self-examination (BSE).

METHODS

A sequential explanatory mixed-methods study approach to better understand factors and beliefs influencing preventive health practice in BSE was conducted among students at a medical college in rural Maharashtra, India. One hundred and two female medical students completed the quantitative phase, and 15 of them gave in-depth interviews (IDIs) for the qualitative aspect.

RESULTS

Among the participants, 67.6% had good knowledge of risk factors, but only 10% knew the recommendations for BSE, clinical breast examination (CBE), and mammography. We found that being taught BSE by a trusted source and knowing a BC patient were significant facilitators. In contrast, lack of self-efficacy and two fear factors were found to be acting as barriers for BSE, one being the absence of fear of ever getting BC and the other fear of detecting a lump.

CONCLUSION

This study reveals a gap between knowledge of risk factors and their translation to disease prevention practice. The barriers elicited are modifiable by planning and implementing an appropriate training program covering risk factors and recommending all available screening and preventative modalities. A well-trained medical staff will be instrumental in improving the health status of our community and country.

Knowledge, attitude, and practice of breast self-examination is associated with general self-care and cultural factors: a study from Tamil Nadu, India

AIM

Breast cancer is the most prevalent type of cancer among women. One form of care related to early detection of breast cancer is breast self-examination (BSE). However, evidence on knowledge, attitude, and practice (KAP) of BSE and its determining factors are minuscule in an Indian context. Therefore, the present study primarily examined the prevalence of KAP of BSE. Further, its association with general self-care and cultural factors was determined.

METHODS

This cross-sectional study obtained data from 412 women (Mn age = 26.63) from two rural localities of Vellore district, Tamil Nadu, India. Self-reported questionnaires of KAP of BSE, self-care, and cultural factors were applied. Statistical analyses include independent sample t-test and binomial logistic regression.

RESULTS

The majority of the sample had inadequate knowledge (58%), unfavourable attitudes (73.8%), and poor practice (89.6%) of BSE. The general self-care among the sample was moderate. Self-care was found to be a significant predictor of knowledge (b = 0.07, p < .05) and attitude (b = 0.092, p < .05) toward BSE. Shyness was identified as a negative predictor of KAP. Discouraged breast health discussions predicted inadequate knowledge, and not being educated by family/friends had a negative impact on knowledge and practice. A preference for same-gender physicians led to an unfavourable attitude toward BSE.

CONCLUSION

The observed negative trends in KAP of BSE are concerning. The results imply that girls and women should be educated and encouraged to practice BSE and promote self-care behaviours. At the same time, efforts to reduce cultural barriers may be helpful to promote the KAP of BSE.

The effectiveness of educational intervention based on the Health Action Model (HAM) in improving breast cancer screening behaviors

INTRODUCTION

Breast cancer disease is known as the most common cancer among women. Lack of knowledge and awareness is a leading cause of breast cancer, and since nearly all women are increasingly susceptible to this disease, training screening behaviors for early detection is proven essential in order to reduce breast cancer mortality. Therefore, the present study was designed to determine the effect of educational intervention based on the Health Action Model in improving breast cancer screening behaviors in women aged 30 to 69 in Kashan, Iran.

METHODS

This quasi-experimental study was conducted on 162 women aged 30-69 years old among the clients of Comprehensive health service centers in Kashan, Iran and they were assigned to intervention and control groups. The research instrument included a questionnaire assessed within three phases: baseline, 3-months, and 6-months, containing Health Action Model (HAM) structures and also three screening behaviors. The intervention consisted of a model-based education package and was carried out over 2 months. To evaluate the effect of the intervention, the mean of model structures and proportion screening behaviors in the third and sixth months were compared with the baseline phase. All analyses were carried out using SPSS, version 22.

RESULTS

The intervention and control groups were homogeneous regarding the structures of the HAM and the proportion of screening behaviors in the baseline phase (p > 0.05). In the 3-month (p < 0.05) and 6-month (p < 0.05) phases, the mean scores of the HAM constructs in the intervention group were found higher compared with the control group. Moreover, the proportion of clinical breast examinations in the intervention group was statistically higher than in the control group in the 3-month (p < 0.001) and 6-month (p < 0.001) phases. In addition, the proportion of mammography performed in the 3-month (p = 0.002) and 6-month (p < 0.001) phases were reported to be higher in the intervention group compared with the control group.

CONCLUSION

Overall, these results provide important insight into the effectiveness of the interventions based on the Health Action Model in promoting breast cancer screening behaviors and the determinants of such behaviors.

Influence of variables on breast self-examination: Potential barrier or enhancement of breast cancer prevention

INTRODUCTION

Breast self-examination (BSE) is an important tool for early detection of breast cancer and can contribute to increased awareness and familiarity with breast tissue. This study aimed to review factors that influenced BSE in preventing breast cancer.

METHODS

In the initial stage of searching for journal articles, 186 journals were obtained, then screening was carried out within a time span of 2019-2024 and using Indonesian and English 54 journals. Of the 12 journals reviewed, the results showed that 4 journals reviewed had conducted pre and post-BSE practices, and 8 journal reviews conducted BSE practices conducted by students and health workers.

RESULTS

Several factors play an important role in implementing BSE, namely age, knowledge, history of exposure to information, family history, ethnicity, and attitude. Overall, the study shows that the need to create awareness and educate women, especially rural women, on the importance of BSE as a preventive measure for breast cancer is paramount.

CONCLUSIONS

Factors influencing the implementation of BSE can be a barrier or an enhancement in breast cancer prevention.

The "Know Your Lemons" Tools: A strategy to improve breast cancer warning signs recognition in Malaysia

BACKGROUND

Breast cancer (BC) is the most common cancer in Malaysia, with many diagnosed at late stages. The "Know Your Lemons" (KYL) visual educational tools were developed by KYL Foundation. This study aimed to evaluate participants' confidence levels and perceived knowledge in identifying BC symptoms before and after exposure to KYL tools.

MATERIALS AND METHODS

A cross-sectional study was carried out among 788 participants in three KYL health campaigns from 2017 to 2020. Perceived knowledge (a 5-item Likert scale was used, zero means "very poor" and 4 means "excellent knowledge") and confidence in identifying BC symptoms were studied. A Wilcoxon Matched-Paired Signed-Rank Test was performed to assess the perceived knowledge.

RESULTS

There was a significant improvement in the perceived knowledge Mean (±SD) score (2.84 ± 1.02) versus (4.31 ± 0.66) before and after the campaign (P < 0.01). About 95.6% agreed that the language used in KYL materials was clear and understandable, 89.8% agreed it is acceptable in Malaysian culture, and 80% felt more confident in identifying BC symptoms. Therefore, 90.8% had the intention of breast self-examination and 90.8% would consult a doctor if symptomatic. The majority (92.7%) agreed that the KYL tools clarified the BC tests needed.

CONCLUSION

The KYL tools enhanced perceived BC symptom recognition knowledge and confidence levels.

Breast self-examination: Knowledge, practice and associated factors among 20 to 49 years aged women in Butwal sub-metropolitan, Rupandehi, Nepal

BACKGROUND

Breast cancer is the second most common cancer in the world and also among Nepalese women. Breast self-examination is an important, cheap, and easy method for early diagnosis of breast cancer which can be cured in the majority of cases if diagnosed in the early stages. In developing countries like Nepal where the awareness regarding breast cancer and breast self-examination is poor, breast cancers are diagnosed at late stages resulting in a poor prognosis of the disease. The study assessed knowledge, practice, and factors associated with breast self-examination.

METHODS

A cross-sectional survey was carried out among 262 women in the Butwal sub-metropolitan adopting multi-stage sampling. A pre-tested structured interview schedule and an observation checklist were used to collect the data. Data was entered in EPI-data and necessary univariate, bivariate, and multivariate analyses were done in SPSS.

RESULTS

The study found that more than half of the participants (55.3%) had poor knowledge of BSE. Only one-fourth (27.1%) of them were practicing BSE and among them, most of them (93.0%) had poor practice. The factors such as ethnicity from Brahmin/Chhetri [AOR = 2.099, 95% CI (1.106-3.981)], use of contraceptive devices [AOR = 9.487, 95% CI (2.166-41.558)], personal history of breast lump [AOR = 12.502, 95% CI (1.639-95.387)], family history of breast cancer [AOR = 5.729, 95% CI (1.337-97.512)], and knowledge of BSE [AOR = 4.407, 95% CI = 2.160-34.650)] were significant determinants of BSE practice among 20-49 years women.

CONCLUSION

The study concluded that most of the women had poor knowledge and practice of breast self-examination. The study also indicated the influence of ethnicity, contraceptives, personal and family history of cancer/early warning signs, and knowledge for practicing breast self-examination. There is an immediate need to increase the knowledge and practice of breast self-examination to prevent and detect breast cancer in its early stage.

Prediction of Breast Self-Examination Behavior Among Omani Undergraduate Students Using Champion's Health Belief Model

Introduction

Breast cancer (BC) is a most common and frequently occurring malignancy of women worldwide. Breast self-examination (BSE) is important for the early detection and prevention of BC and to limit the morbidity and mortality. Young students are ideal people to understand and motivate other women to perform BSE.

Objective

BSE behavior of undergraduate students was predicted using Champion's Health Belief Model Scale (CHBMS).

Methods

A descriptive cross-sectional design was adopted. This study was conducted in all nine colleges of Sultan Qaboos University, , Oman. Three-hundred eighty-one female undergraduate students were selected through convenient sampling technique. The health belief towards BSE was predicted using CHBMS.

Results

The mean and SD of beliefs about the benefits of performing BSE showed 10.84 and 3.2, respectively. Mean and SD of confidence in performing BSE indicated 56.24 and 10.8. Likewise, the mean and SD of barriers in performing BSE are 13.58 and 4.2. Source of information is found to be a statistically significant predictor of barrier in performing BSE at p < .05.

Conclusion

If the self- confidence of women in performing BSE improves, the women will uptake BSE more frequently thereby they can be prevented from developing the adverse consequences of advanced stages of breast cancer.

The effect of video-based multimedia training on knowledge, attitude, and performance in breast self-examination

Background/Objectives

Breast neoplasm is one of the most common cancers in Iranian women due to the late diagnosis. Awareness of breast neoplasm and using Breast Self-Examination (BSE) assist in the early detection and treatment of cancer. This study examined the effectiveness of video-based multimedia training versus face-to-face training in awareness of breast neoplasm and BSE and possible factors affecting their effectiveness.

Methods

This research was a pre-test, a post-test experimental study comparing the knowledge, attitude, and performance of women about BSE across two training intervention groups (face-to-face versus video-based multimedia). The study was conducted at Shiraz University of Medical Sciences (SUMS), and 100 women between 20 to 60 years old were allocated to each intervention group via multi-stage cluster sampling (n:110). Three valid and reliable researcher-made questioners were used. Data were analyzed using SPSS 24 with independent t-test, paired t-test, and ANOVA.

Results

Both video-based multimedia and face-to-face training methods significantly increased the participant's knowledge, attitude, and skills about breast self-examination (P < 0.001). In the sub-categories, the results showed that the face-to-face training improved negligence and forgetfulness in applying BSE (P = 0.03) and correcting or modifying the previous knowledge around the issue (P = 0.02). The effect of the video-based method on participants with university education was more than on non-university (P = 0.04).

Conclusion

Incorporating video-based multimedia training in awareness of breast neoplasm and breast self-examination provides an easy, flexible, and affordable way for detection, particularly considering crisis restrictions. This can be of particular attention in more populated, developing/low-income countries and rural and remote areas to enhance equitable access to training and facilitation diagnosis and treatment if applicable.

Breast Self-Examination: Knowledge, Practice, and Beliefs Among Females in Jordan

Introduction

Worldwide, breast cancer is one of the most common types of cancer. It is the leading cause of cancer-related deaths among females in Jordan.

Objectives

The current study aimed to evaluate breast cancer knowledge levels and practice and assess health beliefs regarding the model supporting self-breast examination (BSE) in a group of females aged between 20 and 60 in Jordan.

Methods

Descriptive, cross-sectional, correlational design was used; Two hundred females participated in the study, employing convenient sampling. The adjusted version of the Champion's Health Belief Model Scale (CHBMS) was utilized to collect the data.

Results

Most participants were married (F = 128, 64%), and the mean of the participants' age was (36.18, SD = 10.87). About 73 participants (36.5%) don't practice BSE; however, 53 participants (26.5%) plan to practice BSE in the future monthly. The logistic regression model showed that the impact of confidence as positive predictive value on practicing BSE in the last year (B = 0.141, p < .001) and this year (B = 0.130, p < .001) was statistically significant.

Conclusion

Implications for practice include identifying culturally specific barriers and improving health education programs to trigger breast self-examination utilization.

Perceptions and knowledge of breast cancer and breast self-examination among young adult women in southwest Ethiopia: Application of the health belief model

Background

Breast cancer is still a recognized public health issue in Ethiopia. Despite this, the viewpoints and comprehensions of young women about the situation are unknown. Therefore, this study was carried out to assess the knowledge and perceptions of young adult women in Southwest Ethiopia about breast cancer and breast self-examination (BSE).

Methods

A community-based cross-sectional study was carried out in the Gurage zone, southwest Ethiopia, in 2021. A total of 392 young adult women were randomly selected from both urban and rural strata using a three-stage stratified sampling process. A pretested questionnaire was used to collect the data. For data entry, Epi-data 4.6 with a double-entry approach was used, and for analysis, SPSS 26 was used. Bivariate and multivariable logistic regression analyses were performed to identify variables associated with BSE behavior. A p-value of 0.05 or below was considered statistically significant with a 95% CI.

Results

The respondents’ ages ranged from 20 to 24, with a mean of 21.25 (±1.32) years. Breast cancer and BSE were unknown to more than 80% of the study participants. A large proportion of young adult women had low perceived susceptibility (97.6%), low threat of breast cancer (96%), and low self-efficacy to perform BSE (91.4%). BSE was conducted by 23.1% of the participants occasionally. Being married (AOR = 5.31, 95% CI = 2.19–12.90), having good outcome expectations of BSE (AOR = 2.05, 95% CI = 1.16–3.61), having good BSE knowledge (AOR = 1.22, 95% CI = 1.04–1.45), having high perceived susceptibility (AOR = 1.12, 95% CI = 1.05–1.20), high perceived severity (AOR = 1.78, 95% CI = 1.02–3.09), and having high self-efficacy to do BSE (AOR = 1.05, 95% CI = 1.01–1.09) were all significant predictors of BSE practice.

Conclusions

Young adult women were less concerned about breast cancer and had insufficient knowledge of breast cancer and breast self-examination. They have little knowledge of, confidence in, or experience with BSE. The practice of BSE was associated with increased perceived susceptibility, self-efficacy, severity, outcome expectations, and BSE knowledge. Therefore, these variables should be considered when developing educational interventions for young women.

Knowledge of breast cancer and breast self-examination practices and its barriers among university female students in Bangladesh: Findings from a cross-sectional study

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.

Breast Self-Examination Knowledge and its Determinants among Female Students at Addis Ababa University, Ethiopia: An Institution-Based Cross-Sectional Study

Introduction

Breast self-examination is a noninvasive, low-cost screening method for breast cancer detection. A thorough awareness of breast self-examination enables the early detection of breast abnormalities and dramatically lowers breast cancer complications and mortality. The purpose of this study was to investigate the level of knowledge about breast self-examination and its associated factors among female students at Addis Ababa University, Ethiopia.

Methods

An institution-based cross-sectional study design was employed. The final calculated sample size was 407, and participants were recruited using a proportionate stratified random sampling approach. For data entry and coding, EPI Data 3.1 statistical software was utilized, and for data analysis, SPSS version 18 was employed. The data was described using descriptive analysis. Bivariate and multivariate logistic regression analyses were performed to determine the strength of the association between the predictor and the outcome variables. A 95% confidence interval and a p-value of less than 0.05 were used to declare statistical significance.

Results

The findings of this study revealed that 49.9% of respondents possessed good breast self-examination knowledge. Previously, urban residents were about two times more likely to have good knowledge of BSE than their rural counterparts (AOR =2.16, 95% CI (1.18–39.91), p =0.011). The odds of having good BSE knowledge were about three times more likely among those who had a good attitude than those who had a poor attitude (AOR =3.17, 95% CI (2.02–4.74), p <0.001). Those who knew someone with a diagnosis of breast cancer were almost three times more likely to have good knowledge than those who did not know (AOR =2.95, 95% CI (1.77-4.91), p <0.001).

Conclusion

According to the findings of this survey, less than half of the students who participated had good knowledge of breast self-examination. This justifies raising awareness about breast self-examination among female students.

Factors Influencing the Practice of Breast Self-Examination among Female Tertiary Students in Ho, Ghana

Background. Despite the implementation of various interventions towards the reduction of breast cancer prevalence, many women still report late symptoms to health facilities, and this decreases their chances of survival. Breast self-examination (BSE) is the most convenient form of examination to detect the development of breast cancer. We examined the factors that influence the practice of breast self-examination among female tertiary students in Ho, Volta Region of Ghana. Methods. This was a descriptive cross-sectional study that recruited 506 female students from four tertiary institutions in the Ho Municipality in Ghana using questionnaires. Descriptive and inferential statistics comprising frequency, percentage, Chi-square, and binary logistic regression were used in analyzing the data. Results. About 73% of the respondents had ever practised BSE. Out of the respondents who have ever practiced BSE, 79% were practising it at the time of the study. Students in their fourth year were above 4 times more likely (95% CI = 1.73–9.29, $p=0.014$ ) to practise BSE than those in their first year. Also, students with good knowledge of BSE were 4 times more likely to practice BSE [(95% CI = 1.1–13.46), $p=0.036$ ] and students with good perception about BSE were 12 times more likely to practice BSE [(95% CI = 1.21–122.73), $p=0.034$ ]. Conclusion. The study found that 27% of the female students had never practised BSE. Those who practice BSE did not practice regularly and appropriately. Also, good knowledge and perception are associated with the practice of BSE. The implication of this result is the late presentation of breast cancer cases to health facilities and increases in breast cancer-related deaths in the country. Therefore, it is recommended that the Ministry of Health, the Ghana Health Service, and other stakeholders in Ghana’s healthcare should develop and implement innovative approaches and policies such as peer and support groups’ learning, and mass media BSE awareness aimed at ensuring better understanding and access to BSE education. This should be intensified during the foundation years such as the secondary and tertiary education levels to ensure the adoption of breast self-examination practice. It is also recommended that another study must be done using a qualitative approach to get an in-depth understanding of the steps and ways, by which female students practice BSE.

Ethiopian women's breast cancer self-examination practices and associated factors. A systematic review and meta-analysis

BACKGROUND

Breast neoplasm is the most frequently diagnosed and the leading cause of cancer death in the vast majority of the countries. Breast cancer self-examination is a check-up of a woman does at home to look for changes or problems in the breast tissue. The benefit of early recognition is for early treatment that is more effective, higher long-term survival rates and better quality of life. The aim of this review was to determine the pooled prevalence of breast cancer self-examination practice and identify its associated factors among Ethiopian women.

METHODS

Google Scholar, PubMed, Science Direct, web of science, and Cochrane Library were used for search of articles. This review includes thirty four articles conducted in Ethiopia between 2011 and 2020. The review contains 14,908 women to determine the ever pooled prevalence of breast cancer self-examination practice. Health workers and students made up 28.35% of the total participants. Data were extracted using a standardized data extraction format prepared in Microsoft Excel and analyzed with Stata 14. To assess heterogeneity I² test were used. A random effect meta-analysis model was used to estimate the pooled breast cancer self-examination (BCSE) practice of Ethiopian women. Moreover associated factors were also assessed.

RESULTS

In Ethiopian women, the overall ever and regular pooled breast cancer self-examination practice was 36% (95% CI: 28, 43) and 16% (95% CI: 28, 43) respectively. The ever pooled prevalence for health workers or students was 53% (95% CI: 41, 65), whereas for other participants it was 25% (95% CI: 19, 30). Good knowledge about breast self-examination (AOR: 3.69: 95% CI: 2.70, 5.05), positive attitude towards BCSE (AOR: 2.72: 95% CI: 1.74, 4.24), Getting to know people with breast cancer(AOR: 2.77: 95% CI: 1.51, 5.09), family history of breast cancer (AOR: 2.49: 95% CI: 1.60, 3.88) and personal history of breast cancer (AOR: 2.26: 95% CI: 1.70, 3.01) were associated factors to BCSE practice among Ethiopian women. All of the studies included in this review were conducted in a cross-sectional design was a limitation of this review and meta-analysis.

CONCLUSION

This review and meta-analysis showed the ever and regular pooled prevalence of BCSE among Ethiopian women. More than one third of Ethiopian women ever practiced BCSE. We recommend that awareness creation should be perform in order to tackle the risk of breast cancer.

Relationship between demographic factors, health education, breast cancer-related knowledge, attitudes, and breast self-examination behavior among Chinese female college student: A structural equation analysis

AIMS

This study aimed to create a structural equation model to evaluate the associations among demographic factors, health education, breast cancer-related knowledge, attitudes, and breast self-examination behavior among Chinese female college students.

METHODS

A survey was undertaken using a self-administered questionnaire and targeting 2233 students from Eastern China. Structural equation modeling with the bootstrap approach was utilized to estimate the interrelationships and the strength of the associations among measured variables based on the hypothetical model.

RESULTS

Among the total participants, 14.7% of the female college students reported having performed breast self-examination. The final structural equation model showed highly satisfactory fitness on indices. Breast self-examination behavior was significantly linked to demographic factors, breast cancer related-knowledge, attitudes, and health education. Health education had the greatest influence on breast self-examination behavior. In addition, breast cancer related-knowledge was significantly associated with demographic factors and health education. Health education and knowledge all significantly affected attitudes towards breast cancer.

CONCLUSION

Breast self-examination behavior was influenced by demographic factors, breast cancer related-knowledge, attitudes towards breast cancer, and health education in a sample of female college students in China. Health education was the most important predictor of breast self-examination behavior.

Breast self-examination practice and its determinants among women in Ethiopia: A systematic review and meta-analysis

BACKGROUND

The survival rate from breast cancer is lowest in African countries and the distribution of breast self-examination practice of and its determinants are not well investigated in Ethiopia. Therefore, this systematic review and meta-analysis was designed to determine the pooled prevalence of breast self-examination and its associated factors among women in Ethiopia.

METHODS

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for this systematic review and meta-analysis. The databases used were; PUBMED, Cochrane Library, Google Scholar, CINAHL, African Journals Online, Dimensions and Summon per country online databases. Search terms used were; breast self-examination, breast cancer screening, early detection of breast cancer and Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. The meta-analysis was conducted using STATA 15 software. The pooled meta-analysis was computed to present the pooled prevalence and relative risks (RRs) of the determinate factors with 95% confidence intervals (CIs).

RESULTS

We identified 2,637 studies, of which, 40 articles (with 17,820 participants) were eligible for inclusion in the final meta-analysis. The pooled estimate of breast self-examination in Ethiopia was 36.72% (95% CI: 29.90, 43.53). The regional distribution breast self-examination ranged from 21.2% (95% CI: 4.49, 37.91) in Tigray to 61.5% (95% CI: 53.98, 69.02) in Gambela region. The lowest prevalence of breast self-examination was observed among the general population (20.43% (95% CI: 14.13, 26.72)). Women who had non-formal educational status (OR = 0.4 (95% CI: 0.21, 0.77)), family history of breast cancer (OR = 2.04 (95% CI: 1.23, 3.39)), good knowledge of breast self-examination (OR = 4.8 (95% CI: 3.03, 7.6)) and favorable attitude toward breast self-examination (OR = 2.75, (95% CI: 1.66, 4.55)) were significantly associated with practice of breast self-examination.

CONCLUSIONS

Only a third of women in Ethiopia practiced breast examination despite WHO guidelines advocating for this practice among all women of reproductive age. Intervention programs should address the factors that are associated with breast self-examination. Population specific programs are needed to promote breast self-examination.

A Qualitative Focus Group Study for the Exploration of Knowledge and Attitudes of Informal Caregivers Toward Breast Cancer: Perceptions of Informal Caregivers and Healthcare Professionals in Three European Countries

Breast cancer (BC) early screening and detection is a main component for the outcome of the treatment and overall survival. Informal caregivers (ICGs) are less likely to initiate early BC screening methods and utilize health services. The purpose of this study was to explore ICGs’ knowledge and perceptions, including educational and training opportunities or barriers, in promoting early detection practices for BC, as well as healthcare professionals’ (HCP) respective perceptions concerning ICGs in order to identify the need of selected health literacy interventions. A qualitative focus group study was implemented in 3 European countries, using a purposive sampling technique. In total, 26 ICGs and 18 HCPs were involved. The themes that emerged from the focus groups interviews included knowledge, perceptions, attitudes, and beliefs concerning BC; motivational factors and barriers that influence early screening practices and personal involvement. Motivators and barriers concerning BC screening adherence were linked to knowledge, beliefs and perceptions. Health promotion strategies and user-friendly tools should be developed, targeting on the implementation of BC early detection practices among informal caregivers.

A path analytic model of health beliefs on the behavioral adoption of breast self-examination

BACKGROUND

In Malaysia, breast cancer accounted for 34.1% of all female cancer cases with women presenting breast cancer at late stages. Breast cancer has a higher five-year survival rate if detected early. An increase of approximately 30% in the five-year survival rate is indicated if breast cancer is detected at stage III compared to stage IV. Thus, survival rate of breast cancer can be increased by creating awareness and encouraging breast cancer screening amongst women. Breast self-examination (BSE) is highly recommended for breast cancer screening due to its simplicity with no incurred cost. The Health Belief Model is used in this study to explain and predict the adoptive behavior of BSE amongst women in Kuantan, Pahang.

MATERIALS AND METHODS

This study employed a multi-stage sampling method using a simple proportion formula at 5% type 1 error, p < 0.05 and absolute error at 2% which resulted in a sample of 520 participants. The data for the study was obtained using a validated bilingual self-constructed questionnaire and the model constructed using Mplus software.

RESULTS

Perceived severity, benefits and barriers were found to significantly influence the behavioral adoption of BSE. Married women aged from 45 to 55 years and knowledge were found to significantly moderate the relationship between perceived benefits and behavioral adoption of BSE. Further, self-efficacy was found as the core construct that mediates the relationship between married women aged 45 to 55 years and the behavioral adoption of BSE.

CONCLUSION

Self-efficacy is found in the study to influence the behavioral adoption of BSE. This is undeniable as self-efficacy can promote confidence in initiating and maintenance of behavioral change if the perceived change is beneficial at an acceptable cost.

Knowledge and Practice of Breast Self-Examination Among Young Women in Tertiary Education in Addis Ababa, Ethiopia

Background

Breast cancer is the top cancer among women both in the developed and the developing world. Many deaths can be avoided if breast cancer can be detected and treated early. The practice of breast self-examination (BSE) is a convenient, no-cost tool that can be used regularly for detecting breast cancer at an early stage. Therefore, this study sought to assess the knowledge and practice of breast self-examination among young females in Addis Ababa, Ethiopia.

Methods

Institutional-based cross-sectional study was conducted among 358 females using a pre-tested and self-administered questionnaire. The data were cleaned and analyzed using SPSS version 23, and the descriptive statistics, linear and logistic regression were used for analysis. The possible predictors were identified using the odds ratio with a 95% confidence interval and a P-value of 0.05.

Results

Almost half of 188 (52.5%) respondents had heard about breast cancer self-examination, while the media were the main source of information. The study revealed that only as little as 47 (13.1%) respondents did appropriate BSE. While confounding factors were controlled for, the linear multivariate regression analysis indicated that the healthcare providers as information sources about BSE (β = 1.9; CI= 0.62, 2.9; p < 0.01) makes the greatest unique contribution to explaining the BSE knowledge level. Moreover, the study indicated that the more age (β = 1.4; CI=1.1, 1.8; p < 0.01) and knowledge (β = 1.34; CI=1.1, 1.64; p < 0.01) the females have, the more likely it is that they will report practicing BSE.

Conclusion

This study showed that a few females implemented regular BSE. Further implementations are needed in addressing young females, making awareness and advocacy campaigns about BSE to increase early diagnosis of breast cancer that raises the chances for successful treatment in Ethiopia.

Breast self-examination and associated factors among women in Wolaita Sodo, Ethiopia: a community-based cross-sectional study

Background

The early detection of breast cancer plays an important role in decreasing morbidity and mortality of breast cancer. Breast self-examination (BSE) is one screening method used for the early detection of breast cancer. BSE involves the woman looking at and feeling each breast for possible lumps, distortions, or swellings. BSE is a simple exercise that can potentially save women’s lives, but BSE receives relatively little attention and no study has yet addressed BSE at the community level. Here we assessed BSE and associated factors among women aged 20–65 years in Wolaita Sodo city, Ethiopia.

Methods

This was a community-based, cross-sectional study. Systematic random sampling was used to select 626 women aged 20–65 years old. Data were collected using a pre-tested and structured questionnaire. Data were recorded using EpiData version 3.5.1 and exported to SPSS version 21 for cleaning and statistical analysis. Bivariable analysis was performed, and variables with a p-value < 0.25 were used in multiple logistic regression analysis. Multiple logistic regression was employed, and variables with p-values < 0.05 were considered statically significant.

Results

A total of 629 women aged between 20 and 65 years were included in the study. Over half (60.9%) of participants were aged between 20 and 29 years, and 8.2% were < 50 years old. Women who mentioned BSE as a method for the early detection of breast problems were 6.36-times (95% CI: 3.72, 10.71) more likely to perform BSE than those who reported that they did not know of any method. Those who had breast fed for 13–24 months were 2.43 times (95% CI: 1.28, 4.59) more likely to examine their breasts than those who breast fed for different durations or used other methods. Employed study participants were 3.13-times (95% CI: 1.14, 8.58) more likely to practice BSE than those who were not employed. Likewise, students were 3.73-times (95% CI: 1.19, 11.73) more likely to perform BSE.

Conclusions

In our sample, women’s practice of BSE was relatively low. Knowledge of BSE, breastfeeding up to 24 months, being employed, and being a student were factors affecting performing BSE. Educating girls and increasing awareness, including through electronic media, are important to encourage BSE and improve breast cancer outcomes.

The relationship of socio-demographic characteristics and knowledge of breast cancer on stage of behavioral adoption of breast self-examination

Background/aim

In Malaysia, breast cancer is the most common cancer among women. As such, early diagnosis and screening practices are important to increase the survival rate. Breast self-examination (BSE) is one of the main screening methods for breast cancer. Socio-demographic characteristics and knowledge of breast cancer are amongst the crucial roles in determining women's behavioral adoption in performing BSE. This study aims to assess the relationship of socio-demographic factors and knowledge of breast cancer on the stage of behavioral adoption of BSE among Malaysian women in Kuantan, Pahang.

Materials and methods

A cross-sectional study was conducted on 520 women from three different government health clinics in Kuantan and IIUM Family Health Clinic from February to April 2018. Data were collected using a self-administered questionnaire on socio-demographic factors and knowledge of breast cancer and its effect on the behavioral adoption of BSE.

Results

Significant difference was found between socio-demographic characteristics and behavioral adoption of BSE. However, only breast screening and the best time for screening were found to be significant with the behavioral adoption of BSE and knowledge of breast cancer.

Conclusion

It is found that most women in Kuantan, Pahang perform BSE but were still unaware of the importance of performing BSE for early breast cancer detection. This study was expected to enhance women's awareness of the benefits of performing BSE.

Practice and Barriers toward Breast Self-Examination among Palestinian Women in Gaza City, Palestine

Breast self-examination (BSE) is one of many first-line screening practices aimed at early detection and prevention of fatal outcomes of breast cancer. The present study aimed to identify Palestinian women's practices, awareness, and barriers to BSE. Using descriptive-analytical methods, a previously validated questionnaire was administered to a conveniently selected sample of women. The study was conducted among women who visited primary health clinics (PHCs) in Gaza City. A total of 390 participants who met the selection criteria answered the self-administered questionnaires. We used SPSS version 24.0 to analyze the data. The findings suggest that the practice of BSE among women in Gaza is low, with only 40% of the study participants reporting that they never practiced BSE before, even though 76.7% reported that they were aware of BSE. In general, the main barriers to BSE practices were that participants had wrong perceptions and lacked knowledge about BSE. Others also reported fear of detecting breast cancer as a barrier. The practice of BSE among Palestinian women in the Gaza Strip is low and marred with trivial issues as barriers that could be eliminated with dedicated and extensive educational campaigns in the area.

Factors Affecting Breast Self-examination Behavior Among Female Healthcare Workers in Iran: The Role of Social Support Theory

OBJECTIVES

In women, breast cancer is the most common cancer and the leading cause of cancer death. Screening tests are the basis for early diagnosis. In Iranian women, the mortality rate of breast cancer is high due to insufficient screening examinations and delayed visits for care. Therefore, this study aimed to determine the factors affecting breast self-examinations among Iranian women employed in medical careers.

METHODS

This cross-sectional study included 501 women working in the medical professions at Hamadan University of Medical Sciences in western Iran in 2018. The subjects were selected by stratified random sampling. Data were collected using a researcher-developed, self-report questionnaire that contained demographic information and questions based on protection motivation theory and social support theory. Descriptive data analysis was conducted using SPSS version 23 and model fitting with PLS version 2.

RESULTS

The mean age of the participants was 37.1±8.3 years, and most of the women (80.4%) were married. Most women had a bachelor's degree (67.5%). The findings of this study showed that the coping appraisal construct was a predictor of protection motivation (β=0.380, p<0.05), and protection motivation (β=0.604, p<0.05) was a predictor of breast self-examination behavior. Additionally, social support theory (β=0.202, p<0.05) had a significant positive effect on breast self-examination behavior.

CONCLUSIONS

The frequency of practicing self-examinations among women employees in the medical sector was low; considering the influence of social support as a factor promoting screening, it is necessary to pay attention to influential people in women's lives when designing educational interventions.

Using Google Trends Data to Study Public Interest in Breast Cancer Screening in Malaysia

Objective:

This study aims to investigate the public pattern in seeking breast cancer screening information in Malaysia using Google Trends.

Methods:

The Google Trends database was evaluated for the relative Internet search popularity of breast cancer and screening-related search terms from 2007 to 2018.

Results:

Result showed downward trends in breast cancer search, whereas mammogram and tomosynthesis search fluctuated consistently. A significant increment was found during Pink October month. Breast cancer search term achieved the highest popularity in the east coast of Malaysia with [x² (5, N=661) = 110.93, P<0.05], whereas mammogram attained the highest search volume in central Malaysia [x² (4, N=67) = 18.90, P<0.05]. The cross-correlation for breast cancer was moderate among northern Malaysia, Sabah, and Sarawak (0.3 ≤ r_s ≤ 0.7).

Conclusion:

Public interest trend in breast cancer screening is strongly correlated with the breast cancer awareness campaign, Pink October. Breast cancer screening should be promoted in the rural areas in Malaysia.

An Application of the Protection Motivation Theory to Predict Breast Self-Examination Behavior among Female Healthcare Workers

OBJECTIVE

Breast cancer is the most prevalent cancer among women and has the highest mortality rate among the women around the world. Early diagnosis of this cancer increases the survival of the patients. The aim of this study was to determine the predictor factors for breast self-examination (BSE) based on the Protection Motivation Theory (PMT) among female healthcare workers in Hamadan University of Medical Sciences.

MATERIALS AND METHODS

This analytical-descriptive study was conducted on 501 employed women in age range of 20-61 years old in Hamadan University of Medical Sciences in west of Iran during 2018. Participants in the study were random stratified sampling selected. Data collection tools were demographic information and the constructs of PMT. The data were analyzed by descriptive statistics and the logistic regression tests.

RESULTS

The results showed that only 9% of participants performed BSE regularly and monthly. The most important reason for lack of BSE was its triviality. Linear regression analysis showed that the structure of perceived threat appraisal is the predictor of the intention to perform BSE (R2=0.027). Moreover, the logistic regression analysis showed that the protection motivation construct was a strong predictor for BSE (R2=0.25).

CONCLUSION

The frequency of practice of BSE in female healthcare workers is low. Therefore, it is imperative to periodically emphasize the importance of early breast cancer diagnosis for them and the design of educational programs based on the PMT can increase the regular of BSE behavior.

Barriers to Breast Self-examination among Iranian Women

Background

Breast cancer is a very common cancer in women which is diagnosable using inexpensive, accessible, and easy screening programs in the early stages of the disease. Culture, beliefs, and opinions of women affect adoption of screening techniques. Nursing professionals are supposed to be aware of such influencing factors. Therefore, this study was conducted to investigate barriers to breast self-examination (BSE) among women in Isfahan province.

Materials and Methods

During a cross-sectional descriptive and correlational study in 2017, 1509 women in rural and urban areas of Isfahan province were selected using multistage sampling method. Data were collected by visiting homes, using a questionnaire, and conducting interviews and were analyzed using descriptive and analytical statistics.

Results

The results showed that barriers consisted of lack of awareness about breast examination (p = 0.006), lack of awareness about BSE techniques (p < 0.001), and lack of training by personnel of healthcare centers (p = 0.016), which were significantly associated with residency areas (i.e., urban and rural areas). Moreover, women's educational level was significantly associated with 5 of 10 barriers and their occupation was significantly associated with 2 of 10 barriers to BSE.

Conclusions

Among the several factors that may affect BSE, a part of them in Isfahan women act as obstacle that they are moderated by some demographic factors such as residency areas, education level, and occupation. Therefore, nursing plans and interventions aimed at developing BSE should be tailored to suit the unique demographic characteristics of women.

An educational intervention on based information, motivation and behavior skills model and predicting breast self-examination

Introduction

Breast self-examination recommend as a breast screening method in developing countries where there are limited access to other screening methods. Therefore promoting breast self-examination required to identify effective interventions and relevant factors.

Methods

This study was a quasi-experimental design carried out among 314 women 20-69 years in community cultural centers in Isfahan city, Iran. Sampling was conducted from April to 10 August, 2016. A structured questionnaire was used for data collection in before and after the educational intervention. Then participants were followed by phone call after one month for breast self-examination performance. We used descriptive statistical analysis (mean, standard division, frequency distribution), and also other statistical methods (Paired t-test, Pearson’s correlation and logistic regression).The data were analyzed using SPSS version 18 with considering a significant level less than 0.05.

Results

There was significant difference between mean scores of information, motivation and behavior skill before and after intervention (P < .0001). After one month following 205 of women (72.2%) reported to perform breast self-examination. Pearson’s correlation showed that breast self-examination significantly correlated with information (r = .305, p = .000), motivation (r = .128, p = .031) and behavior skills (r = .161, p = .006). Also the logistic regression results demonstrated that information (p < .001, OR = 1.071), motivation (p = .045, OR = .978) and behavior skills (p = .001, OR = 1.033) predicted breast self- examination.

Conclusions

Considering the results of this study, it appears that the use of educational interventions based on three constructs of information, motivation and behavior skills can be used to promote breast self-examination. Moreover these results can apply to improve breast self-examination among women by health care providers.

Practices of Breast Self-Examination and Associated Factors among Female Debre Berhan University Students

Background

Breast cancer is the most prevalent form of cancer in Ethiopia of all female cancers. It is considered to be a progressive disease with a poor prognosis if detected late. Breast self-examination is an important prevention method of breast cancer. This study was aimed at assessing practice and associated factors of breast self-examination (BSE) among female Debre Berhan University students in Ethiopia.

Methods

A cross-sectional study was conducted in 2015 among 420 using self-administrated questionnaire. Multistage sampling technique was used to select the study participants. Bivariate and multivariate logistic regression analysis were done.

Results

Majority of the study participants, 338 (84.5%), were between 20 and 24 years old with the mean age of 21.1 ± 1.65. Only 14 (3.5%) had family history of breast cancer. Two hundred fifty-six (64%) of the participants had heard about BSE and 30.25% had good knowledge about BSE. Mass media were the most common source of information about breast cancer. Few of the participants (28.3%) had performed BSE. Lack of knowledge on how to perform BSE was cited as the main reason for not practicing BSE. Knowing how to perform, when to perform, and position to perform BSE and having a perception that BSE is important and useful to detect breast cancer were significant predictors of practices of BSE.

Conclusions

This study revealed that most of the participants had low knowledge and practice of BSE. Therefore, it important to develop health educational programs in the university to raise awareness about BSE and breast cancer so as to practice self-breast examination.

Result of randomized control trial to increase breast health awareness among young females in Malaysia

Background

Breast cancer is the most common cancer and the second principal cause of cancer deaths in women worldwide as well as in Malaysia. Breast self-examination (BSE) has a role in raising breast cancer awareness among women and educational programs play an important role in breast cancer preventive behavior. The aim of this study is to develop, implement and evaluate the effectiveness of Breast Health Awareness program based on health belief model on knowledge of breast cancer and breast-selfexamination and BSE practice among female students in Malaysia.

Methods

A single-blind randomized controlled trial was carried out among 370 female undergraduate students from January 2011 to April 2012 in two selected public universities in Malaysia. Participants were randomized to either the intervention group or the control group. The educational program was delivered to the intervention group. The outcome measures were assessed at baseline, 6, and 12 months after implementing the health educational program. Chi-square, independent samples t-test and two-way repeated measures ANOVA (GLM) were conducted in the course of the data analyses.

Results

Mean scores of knowledge on breast cancer (p<0.003), knowledge on breast self examination (p<0.001), benefits of BSE (p<0.00), barrier of BSE (0.01) and confidence of BSE practice (p<0.00) in the intervention group had significant differences in comparison with those of the control group 6 and 12 months after the intervention. Also, among those who never practiced BSE at baseline, frequency of BSE practice increased 6 and 12 months after the intervention (p<0.05).

Conclusion

The Breast Health Awareness program based on health the belief model had a positive effect on knowledge of breast cancer and breast self-examination and practice of BSE among females in Malaysia.

Trial registration

The ANZCTR clinical trial registry (ACTRN12616000831482), retrospectively registered on Jun 23, 2016 in ANZCTR.org.au.