Breast cancer knowledge and early detection among Hispanic women with a family history of breast cancer along the U.S.-Mexico border

Breast Cancer Knowledge and Associated Behaviors in Northern Borders, Saudi Arabia: A Cross-Sectional Study

Background Breast cancer remains a significant public health issue globally and is notably pervasive within the female population, representing a leading cause of concern. It poses a challenge across different age groups and is influenced by diverse risk factors that include genetic predispositions and various elements of lifestyle. Saudi Arabia, mirroring the global situation, has also seen its share of this disease's impact, prompting a closer look at the factors contributing to its prevalence. Educating the public and advocating for lifestyle changes are crucial steps in cancer prevention. With early-stage diagnosis and screening, many lives can potentially be saved. Our research is focused on understanding the level of awareness and preventative practices among women in the Northern Border region of Saudi Arabia. It seeks to explore the influence of familial history on knowledge and perceptions surrounding breast cancer, which could guide future educational and screening programs. Methods This cross-sectional study engaged 643 female participants, aged 18 and above, from the Northern Border region of Saudi Arabia upon their informed consent. Data were compiled via a structured questionnaire encompassing sociodemographic information, breast cancer knowledge, and preventive practices. Results The data disclosed that a significant majority (86%) recognized breast lumps as indicative of breast cancer, with 69.1% cognizant of hereditary risks. Awareness about lactation as a preventative strategy was noted in 76.7% of the participants, followed by 70.6% acknowledging the merits of a healthy diet. The study unveiled no substantial awareness disparity between individuals with or without a family history of the disease. Alarmingly, 80.4% had never sought a breast examination, and a parallel 83.7% had not undergone mammography. Conclusion The study sheds light on the heterogeneity in breast cancer awareness among women in Saudi Arabia's Northern Border region. Although the recognition of lumps and the preventative role of lactation is relatively high, there remains a deficit in comprehending additional symptoms, signs, and risk factors. The conspicuously low rates of breast cancer examinations and mammography underscore an urgent need for enhanced educational initiatives and a strategic push toward bolstering participation in regular cancer screenings.

The relationship between family history of cancer and cancer attitudes & beliefs within the Community Initiative Towards Improving Equity and Health Status (CITIES) cohort

OBJECTIVE

To determine the relationship between family history of cancer with cancer attitudes and beliefs (CABs) and cancer screening knowledge.

METHODS

This study used data collected for the Community Initiative Towards Improving Equity and Health Status (CITIES) project which surveyed Ohioans ages 21-74. In the current analysis, we included data on age, gender, race, marital status, education, income, financial security, health insurance, CABs, knowledge about the correct age to begin cancer screenings, and presence of a first-degree relative with cancer. Multivariable logistic regression was used to examine the association of family history of cancer with CABs and knowledge about the correct age to begin cancer screening.

RESULTS

Participants were predominantly over the age of 41, female, and white. Out of 603 participants, 295 (48.92%) reported not having a first-degree relative with cancer and 308 (51.08%) reported having a first-degree relative with cancer. Overall, 109 (18.08%) participants reported negative CABs, 378 (62.69%) reported moderate CABs, and 116 (19.24%) reported positive CABs. Participants who reported a first-degree relative with cancer were more likely to report positive CABs, but the association was not significant (p = .11). We observed that older, more educated, and married participants were more likely to have positive CABs (all p < 0.05). Family history of cancer was not associated with differences in knowledge about the correct age for beginning colorectal cancer screening (p = .85) and mammography (p = .88).

CONCLUSIONS

Having a first-degree relative with cancer was not found to be associated with CABs or knowledge about cancer screening. However, age and socioeconomic status were associated with more positive CABs and increased knowledge about cancer screening. Future research should focus on standardizing a CABs scale and expanding the generalizability of our findings.

Hereditary Breast Cancer Risk Analysis in Uninsured Mexican-Origin Women Living in the U.S.–Mexico Border Region

Purpose:

This article describes the risk of hereditary breast cancer (HBC) in low-income Hispanic women living on the U.S.–Mexico border using the Pedigree Assessment Tool (PAT).

Method:

The PAT was administered as part of the El Paso and Hudspeth County Breast Cancer Education, Screening and NavigaTion program (BEST). Baseline data ( n = 1,966) from this program was used to analyze risk factors for HBC. Analysis was conducted to determine significant covariates associated with the presence of any PAT risk factors.

Results:

The PAT identified 17% (95% CI [15%, 19%]) of the women in the study as having some risk of HBC. Having had a mammogram within 3 years was significantly associated with having any PAT risk factors (odds ratio [OR] = 1.79, p = .006). Women who immigrated to the United States during childbearing age (OR = 0.610, p = .009) or during peri/menopause (OR = 0.637, p = .024) were significantly less likely to have any PAT risk factors.

Discussion:

The PAT instrument detected a substantial pool of women who may be at risk for HBC. A significant proportion of these women were not up to date mammogram.

Conclusions:

The PAT is an effective tool to identify women at risk for HBC and encourage regular screening.

Factors associated with ever use of mammography in a limited resource setting. A mixed methods study

Objective

To evaluate facilitators and barriers influencing mammography screening participation among women.

Design

Mixed methods study.

Setting

Three hospital catchment areas in Hidalgo, Mexico.

Participants

Four hundred and fifty-five women aged 40-69 years.

Intervention

Three hundred and eighty women completed a survey about knowledge, beliefs and perceptions about breast cancer screening, and 75 women participated in semi-structured, in-person interviews. Survey data were analyzed using logistic regression; semi-structured interviews were transcribed and analyzed using elements of the grounded theory method.

Main Outcome Measure

Women were categorized as never having had mammography or having had at least one mammogram in the past.

Results

From survey data, having had a Pap in the past year was associated with ever having had breast screening (odds ratio = 2.15; 95% confidence interval 1.30-3.54). Compared with never-screened women, ever-screened women had better knowledge of Mexican recommendations for the frequency of mammography screening (49.5% vs 31.7% P < 0.001). A higher percentage of never-screened women perceived that a mammography was a painful procedure (44.5% vs 33.8%; P < 0.001) and feared receiving bad news (38.4% vs 22.2%; P < 0.001) compared with ever-screened women. Women who participated in semi-structured, in-person interviews expressed a lack of knowledge about Mexican standard mammographic screening recommendations for age for starting mammography and its recommended frequency. Women insured under the 'Opportunities' health insurance program said that they are referred to receive Pap tests and mammography.

Conclusions

Local strategies to reduce mammogram-related pain and fear of bad news should work in tandem with national programs to increase access to screening.

Change in Breast Cancer Screening Knowledge is Associated With Change in Mammogram Intention in Mexican-Origin Women After an Educational Intervention

Purpose:

To determine the relationship between breast cancer screening knowledge and intent to receive a mammogram within 6 months in a sample of Mexican-origin women living in El Paso, Texas.

Methods:

A total of 489 uninsured Mexican-origin women were assigned to treatment or control and completed surveys at pre- and postintervention. Pre-post associations between breast cancer screening knowledge and intent were tested.

Results:

Participants were on average were 56.7 years of age and spoke primarily Spanish (92.6%). Most of the samples had not had a mammogram in 3 or more years (51.6%) and 14.6% had never had a mammogram. At baseline, the majority intended to be screened for breast cancer within the next 6 months (93.4%). At postintervention, half of the intervention group changed their 6-month intent to be screened for breast cancer from likely to unlikely. Change in intent was associated with a change in knowledge of risk of having a first child by the age of 30 and breast cancer being rare after the age of 70.

Discussion:

Intent to be screened for breast cancer in Mexican-origin women may be influenced by the type of knowledge.

Conclusions:

Change in screening knowledge may influence perceived risk that influences intention to be screened.

Patterns, knowledge, and barriers of mammography use among women in Saudi Arabia

OBJECTIVES

To assess mammography utilization and knowledge, and to determine barriers associated with mammography utilization among Saudi women. Methods: We conducted a cross-sectional survey in 5 main geographic regions of Saudi Arabia from February 2015 to May 2015. The sample comprised women aged ≥40 years. Associations between socio-demographic factors and mammography use were tested using chi-square test. Predictors of mammography use were assessed by logistic regression. Results: A total of 3,245 women were surveyed, with 40% reporting ever having a mammogram. As indicated by the univariable analyses, older age (≥60 years), being single or divorced, having less than 2 children, not completing high school, and having a family history (hx) of breast cancer were significantly associated with never having a mammogram. Participants of older age (odds ratio [OR] 51-60 versus 41-50 = 0.6, 95% CI: 0.5-0.7 and OR less than 60 versus 41-50 = 0.5, 95% CI: 0.3-0.8), and divorced (OR divorced versus married = 0.6, 95% CI: 0.5-0.8] were less likely to have had a mammogram, while participants with no family hx of breast cancer (OR no family hx versus family hx = 1.5, 95%CI: 1.3-1.8)were more likely to have had a mammogram. Conclusion: Mammography utilization and knowledge are low in Saudi Arabia. Increasing the awareness of breast cancer screening through educational programs could help women overcome existing barriers and misconceptions.

The Effect of Telephone Counseling and Education on Breast Cancer Screening in Family Caregivers of Breast Cancer Patients

BACKGROUND

Breast cancer is the most common form of malignancy among females. Family history is a key risk factor for breast cancer. Breast cancer screening practices are vital in patients with family history of breast cancer. Telephone counseling and education may be appropriate for improved breast cancer screening. This study was done to determine family caregiver patients' knowledge of risk factors for breast cancer and practice of breast cancer screening and also to assess the effect of telephone counseling and education on mammography screening.

METHODS

This study was a community-based trial. The participants of the study were 90 caregivers who were randomly divided into an experimental group, telephone counseling and education, and a control group. The intervention group received counseling and education phone calls. A three-section questionnaire was responded and filled out through telephone interviews with the participants. The collected data were analyzed with SPSS18, using descriptive and inferential statistics.

RESULTS

The results showed that 88.9% of the participants did not know when to do breast self-exam (BSE). Mammography was performed by the participants before and after the telephone counseling in intervention group (P<0.00), which were 13.3% and 77.8% respectively). Moreover, the major cause of failure to participate in mammography was lack of enough knowledge in 73.3% of the participants.

CONCLUSION

This study concluded that knowledge and practice on breast cancer screening in family caregiver of breast cancer patients was low. Telephone counseling and educating may provide a suitable technique for earlier detection of breast cancer in family caregivers of breast cancer patients and it can influence the decision making regarding mammography screening among 40-year-old or older women. Trial Registration Number: 2017052316870N3.

A survey of overall life satisfaction and its association with breast diseases in Chinese women

To investigate the association between overall life satisfaction and healthy lifestyle, knowledge of breast cancer, physical examination, and detection rate of breast cancer and benign breast disease in Chinese women. In a multicentered breast disease screening program in China, we enrolled 33,057 women aged 45-65 years without prior diagnosis of breast cancer. After completing an epidemiological questionnaire, all participants were examined by clinical breast examination, breast ultrasound, and mammography independently. All breast cancer cases and a selected sample of benign breast diseases were confirmed pathologically. Univariate and multivariate odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to estimate the association between life satisfaction and lifestyle, knowledge of breast cancer, physical examination, and detection rate of breast diseases. Overall life satisfaction was positively associated with women's healthy lifestyle. Compared with less satisfied women, satisfied women were less likely to be smokers (OR = 0.54; 95% CI: 0.47-0.62), have more exercise (OR = 1.49; 95% CI: 1.26-1.75), eat less fried (OR = 0.60; 95% CI: 0.50-0.71), smoked (OR = 0.54, 95% CI: 0.47-0.63), pickled (OR = 0.66, 95% CI: 0.55-0.79), and grilled (OR = 0.63, 95% CI: 0.54-0.74) foods. Satisfied women were more likely to have knowledge of breast cancer (OR = 1.48, 95% CI: 1.29-1.70), and have regular physical examinations (OR = 1.11, 95% CI: 1.01-1.12). Compared to less satisfied women, we found significantly lower detection rate of benign breast diseases (OR = 0.90, 95% CI: 0.82-0.99), and lower but nonsignificant detection rate of breast cancer (OR = 0.66, 95% CI: 0.35-1.25) in satisfied women. Women with a higher overall life satisfaction are more likely to have healthy lifestyle, knowledge of breast cancer, and regular physical examination, thus resulting in a lower detection rate of breast diseases in screening.

Socioecological determinants of mammography screening in Mexican rural areas

Purpose

– The purpose of this paper is to determine which socioecological factors encourage rural women to participate in mammographies rather than avoiding taking the test.

Design/methodology/approach

– The study mainly uses data from the 2007 Rural Households Evaluation Survey (ENCEL-2007). These crossover data are analyzed using the framework proposed in the Spatial-Interaction Model of Mammography Use (SIMMU), through a three-level logistic regression model to examine the likelihood that a woman will choose to participate in a mammography.

Findings

– At the woman-household level, the completion of the Pap smear and the asset index is the strongest determinant of mammography participation. Obtaining preventive medicine services or being enrolled in the Popular Insurance System prevent women from undergoing screening. At the interpersonal level, the probability of screening use decreases with lower social coverage. At the intermediate level, availability of health centers is negatively related to the use of screening.

Research limitations/implications

– The study fails to take into account the fact that women’s propensity to have a mammography may vary over time relatively to life changes. Moreover, findings were restricted to women ages from 40 to 49 and limited due to the lack of published data or data quality issues.

Practical implications

– The results of this research can give health planners, policymakers and social marketers a platform for how to approach social change and promote the cancer screening health behavior through the marketing mix (price, place, promotion and product) in the design of their programs.

Originality/value

– In addition to be informative and persuasive with people to change their behavior, this paper also seeks to provide a direction for using commercial marketing tools through social marketing to “sell” the health behavior. Due to target population variation, this paper addresses the health behavior change strategy by audience segmentation, regarded as essential to successful health communication campaigns.

Academic-Community Partnership to Develop a Patient-Centered Breast Cancer Risk Reduction Program for Latina Primary Care Patients

This collaborative study sought to address Latina breast cancer (BC) disparities by increasing health literacy (HL) in a community health center situated on the US-Mexico border region of San Diego County. An academic-community partnership conducted formative research to develop a culturally tailored promotora-based intervention with 109 individuals. The Spanish language program, entitled Nuestra Cocina: Mesa Buena, Vida Sana (Our Kitchen: Good Table, Healthy Life), included six sessions targeting HL, women's health, BC risk reduction, and patient-provider communication; sessions include cooking demonstrations of recipes with cancer-risk-reducing ingredients. A pilot study with 47 community health center Latina patients was conducted to examine the program's acceptability, feasibility, and ability to impact knowledge and skills. Pre- and post-analyses demonstrated that participants improved their self-reported cancer screening, BC knowledge, daily fruit and vegetable intake, and ability to read a nutrition label (p < 0.05). Results of the pilot study demonstrate the importance of utilizing patient-centered culturally appropriate noninvasive means to educate and empower Latina patients.

Breast cancer knowledge, attitude and screening behaviors among Hispanics in South Texas colonias

This study examines breast cancer knowledge, attitudes and screening behaviors of Hispanic women living in the South Texas colonias of Maverick and Val Verde Counties. We used the Health Belief Model to analyze the effects of HBM constructs on clinical breast exam (CBE) and mammogram screening. Using a multistage systematic sampling approach we interviewed women living within these colonias. Logistic regression analysis was used to predict CBE and mammography screening behaviors. The results indicate that knowledge, susceptibility, barriers and source of health information were statistically significant in predicting CBE among these women. In addition, background variables such as marital status and health insurance were also significant in predicting CBE. Findings further indicate that source of health information, barriers, and health insurance significantly predicts mammography screening behaviors. Results suggest that for women living in colonias along the South Texas Border socio-demographic variables play a significant role in CBE and mammography utilization.

A systematic review of barriers and facilitators to mammography in Hispanic women

PURPOSE

A systematic review of the research on barriers and facilitators to mammography in Latinas was conducted to determine if the challenges faced by these women are unique to this population.

METHOD

Medline and CINAHL database searches for the years 2005-2013 were included. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used to guide this review.

RESULTS

Of the 174 articles identified, 18 articles met inclusion criteria. The most consistent findings were that income and education were associated with screening.

CONCLUSIONS

Financial barriers and social characteristics were significant predictors of mammography in these studies, which were composed almost exclusively of low-income Latinas. These findings are similar to those found in other populations of low-income women and therefore are not likely unique to Latinas.

IMPLICATIONS FOR PRACTICE

It is likely that there is little difference between poor Latinas and other populations of poor, non-English-speaking women in barriers and facilitators to mammography.

Exploring Potential Use of Internet, E-mail, and Instant Text Messaging to Promote Breast Health and Mammogram Use among Immigrant Hispanic Women in Los Angeles County

Breast cancer is now the leading cause of death in Hispanic women (HW). Internet, e-mail, and instant text messaging may be cost-effective in educating HW about breast health and in reducing breast cancer mortality. We surveyed 905 HW women attending a free health fair about their technology use, acculturation, insurance status, mammography use, and breast cancer knowledge. Data were analyzed by t test or χ2 tests. Mean age was 51.9 ± 14.2 years (range, 18 to 88 years). Ninety-two per cent were foreign-born. Most had completed some high school (39%) or elementary (38%) education. Most (62%) were uninsured. The majority spoke (67%) and read (66%) only Spanish. Only 60 per cent of HW older than 40 years had a recent mammogram. HW older than 40 years who had not had a recent mammogram were younger (mean 54.9 ± 10.8 vs 58 ± 10.4 years) and less likely to have health insurance (25 vs 44%; P < 0.001). Most HW never use the Internet (58%) or e-mail (64%). However, 70 per cent have mobile phones (66% older than 40 years), and 65 per cent use text messaging daily (58% older than 40 years, P = 0.001). In fact, 45 per cent wish to receive a mammogram reminder by text. Text messaging may be an inexpensive way to promote breast health and screening mammography use among uninsured HW.

Women's knowledge, attitudes and practice about breast cancer screening in the region of Monastir (Tunisia)

Breast cancer remains a worldwide public health problem. In Tunisia, it is considered to be the primary women's cancer and causes high morbidity and mortality. This study aimed to investigate female knowledge, attitudes and practice of breast cancer screening in the region of Monastir (Tunisia). We conducted a descriptive cross-sectional design exploring knowledge, attitudes and practices of women in the region of Monastir on breast cancer screening. The study was conducted in health centres of this region from 1 March 2009 to 30 June 2009. Data were collected via a structured questionnaire containing 15 items on demographic status, knowledge of risk factors and screening methods and attitudes towards the relevance and effectiveness of breast cancer screening. A scoring scheme was used to score women's responses. A total of 900 women agreed to take part in the study. Their mean age was 41.6±12.4 years and 64% did not exceed the primary level of education. According to the constructed scores, 92% of participants had poor knowledge of the specific risk factors for breast cancer and 63.2% had poor knowledge of the screening methods. Proper practice of breast cancer screening was observed in 14.3% of cases. Multiple logistic regression analysis showed that good knowledge of risk factors and screening methods, higher level of education and positive family history of breast cancer were independently correlated with breast cancer screening practice. This study revealed poor knowledge of breast cancer and the screening methods as well as low levels of practice of breast cancer screening among women in the region of Monastir. Results justify educational programs to raise women's adherence to breast cancer screening programs in Tunisia.

Expression of urokinase-type plasminogen activator (uPA), its receptor (uPAR), and inhibitor (PAI-1) in human breast carcinomas and their clinical relevance

Serine proteases convert plasminogen to plasmin which is involved in tissue remodeling under physiologic and pathophysiologic conditions, including breast carcinoma invasion and progression. Both urokinase-type plasminogen activator (uPA) and pro-uPA associate with uPA receptor (uPAR) on target cells, where plasminogen activator inhibitors (e.g., PAI-1) may modulate their activities. Expression levels of these factors were compared in breast carcinomas relative to patient characteristics, carcinoma features, and clinical outcome. uPA, uPAR, and PAI-1 were quantified by enzyme-linked immunosorbent assay (ELISA) in extracts of 226 biopsies while estrogen receptor (ER) and progestin receptor (PR) were determined by enzyme immunoassay (EIA) or radio-ligand binding. Each set of assays contained a novel reference specimen with known quantities of each of these five analytes. Levels in ng/mg protein of these biomarkers exhibited ranges: uPA (0-12.3); uPAR (0-19.5); PAI-1 (0-91.2). When considered independently, expression of uPA, uPAR, or PAI-1 was unrelated to patient age or menopausal status. Although no correlation was observed between each analyte with stage, grade, or ER/PR status, levels appeared to differ with pathology and nodal status. A dendrogram from hierarchical clustering of uPA, uPAR, and PAI-1 levels in 106 specimens revealed three clusters of breast cancer patients. Kaplan-Meier analyses of uPA, uPAR, and PAI-1 indicated a correlation with overall survival (OS), suggesting collective examination of these biomarkers is useful in predicting clinical outcome of breast cancer.

Factors that influence mammography use and breast cancer detection among Mexican-American and African-American women

OBJECTIVE

This study examined factors that influence mammography use and breast cancer detection, including education, health insurance, and acculturation, among Mexican-American (MA) and African-American (AA) women.

METHODS

The study included 670 breast cancer cases (388 MAs and 282 AAs), aged 40-86 years at diagnosis. Data on mammography use, detection, and delay in seeking care were collected via questionnaires and medical records. Using a language-based bidimensional acculturation measure, MAs were classified as English-dominant (n = 67), bilingual (n = 173), and Spanish-dominant (n = 148). Mammography prior to diagnosis was assessed by racial/ethnic acculturation subgroup using logistic regression.

RESULTS

In age-adjusted models, mammography use was non-significantly lower among English-dominant (OR = 0.84; 95% CI: 0.45-1.59) and bilingual (OR = 0.86; 95% CI: 0.55-1.35) MAs and significantly lower among Spanish-dominant MAs (OR = 0.53; 95% CI: 0.34-0.83) than among AA women. After adjustment for education or insurance, there was no difference in mammography use by race/ethnicity and acculturation subgroup. Despite high self-reported mammography use (75%), a large proportion of cases reported self-detection (59%) and delay in seeking care >90 days (17%).

CONCLUSIONS

These findings favor promoting culturally appropriate messaging about the benefits and limitations of mammography, education about breast awareness, and prompt reporting of findings to a health professional.

Breast cancer knowledge, attitudes, and early detection practices in United States-Mexico border Latinas

INTRODUCTION

Evidence suggests Latinas residing along the United States-Mexico border face higher breast cancer mortality rates compared to Latinas in the interior of either country. The purpose of this study was to investigate breast cancer knowledge, attitudes, and use of breast cancer preventive screening among U.S. Latina and Mexican women residing along the U.S.-Mexico border.

METHODS

For this binational cross-sectional study, 265 participants completed an interviewer-administered questionnaire that obtained information on sociodemographic characteristics, knowledge, attitudes, family history, and screening practices. Differences between Mexican (n=128) and U.S. Latina (n=137) participants were assessed by Pearson's chi-square, Fischer's exact test, t tests, and multivariate regression analyses.

RESULTS

U.S. Latinas had significantly increased odds of having ever received a mammogram/breast ultrasound (adjusted odds ratio [OR]=2.95) and clinical breast examination (OR=2.67) compared to Mexican participants. A significantly greater proportion of Mexican women had high knowledge levels (54.8%) compared to U.S. Latinas (45.2%, p<0.05). Age, education, and insurance status were significantly associated with breast cancer screening use.

CONCLUSIONS

Despite having higher levels of breast cancer knowledge than U.S. Latinas, Mexican women along the U.S.-Mexico border are not receiving the recommended breast cancer screening procedures. Although U.S. border Latinas had higher breast cancer screening levels than their Mexican counterparts, these levels are lower than those seen among the general U.S. Latina population. Our findings underscore the lack of access to breast cancer prevention screening services and emphasize the need to ensure that existing breast cancer screening programs are effective in reaching women along the U.S.-Mexico border.