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Ahmed ABM, Alrawa S, Yeddi AA, Alfadul ESA, Allah HMAA, Ahmed³ MBM. Breast cancer burden in eastern Sudan: seven-year retrospective study. Ecancermedicalscience 2024; 18:1704. [PMID: 39021556 PMCID: PMC11254413 DOI: 10.3332/ecancer.2024.1704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Indexed: 07/20/2024] Open
Abstract
Background Breast cancer (BC) is prevalent in Sudan, yet data on its epidemiology in Eastern Sudan is limited. This study aims to provide insights into the demographic and clinicopathologic features of BC patients treated at the East Oncology Centre (EOC) in Gadarif State, Eastern Sudan. Furthermore, we aim to identify the factors that contribute to a late-stage diagnosis. Methods This cross-sectional study included patients diagnosed with BC and treated in the EOC between 2016 and 2022. Data obtained from medical records were analysed using R software, with descriptive statistics and multiple logistic regressions applied to determine determinants of advanced-stage presentation. A p-value < 0.05 was considered statistically significant. Results Among the 394 patients studied, the majority were women (96%), married (66%) and from rural areas (43%). The peak years for BC diagnoses were 2018 and 2022, with a median age at diagnosis of 48 years. A family history of cancer was reported by 20% of patients. Clinical stages were distributed as follows: I (1.6%), II (17%), III (50%) and IV (32%). Twenty-five percent tested positive for human epidermal growth factor receptor 2, while 73% tested negative and 43% had triple-negative BC. Modified radical mastectomy was performed in 47% of patients, with 21% undergoing breast-conserving surgery. Treatment rates were 38% for radiotherapy, 84% for chemotherapy and 46% for hormonal therapy. Higher grade BC and lower education levels were associated with advanced-stage presentation, while a family history of cancer reduced the risk of advanced-stage disease (OR: 0.38, 95% CI: 0.18-0.78). Conclusion The study found that females in East Sudan often present at a young age and advanced stage, with a significant prevalence of triple-negative BC. Notably, family cancer history exhibited a protective effect against advanced-stage presentation, while grade 3 cancer was positively associated with advanced disease.
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Affiliation(s)
| | - Salma Alrawa
- Faculty of Medicine, University of Khartoum, Khartoum 11111, Sudan
| | - Ahmed A Yeddi
- Faculty of Medicine, University of Khartoum, Khartoum 11111, Sudan
| | | | | | - Muhannad Bushra Masaad Ahmed³
- Faculty of Medicine, University of Khartoum, Khartoum 11111, Sudan
- East Oncology Center, Ministry of Health, Gadarif 11111, Sudan
- Faculty of Medicine and Health Sciences, University of Gadarif, Gadarif 11111, Sudan
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2
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Shen S, Koonjoo N, Longarino FK, Lamb LR, Villa Camacho JC, Hornung TPP, Ogier SE, Yan S, Bortfeld TR, Saksena MA, Keenan KE, Rosen MS. Breast imaging with an ultra-low field MRI scanner: a pilot study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.01.24305081. [PMID: 38633799 PMCID: PMC11023648 DOI: 10.1101/2024.04.01.24305081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Breast cancer screening is necessary to reduce mortality due to undetected breast cancer. Current methods have limitations, and as a result many women forego regular screening. Magnetic resonance imaging (MRI) can overcome most of these limitations, but access to conventional MRI is not widely available for routine annual screening. Here, we used an MRI scanner operating at ultra-low field (ULF) to image the left breasts of 11 women (mean age, 35 years ±13 years) in the prone position. Three breast radiologists reviewed the imaging and were able to discern the breast outline and distinguish fibroglandular tissue (FGT) from intramammary adipose tissue. Additionally, the expert readers agreed on their assessment of the breast tissue pattern including fatty, scattered FGT, heterogeneous FGT, and extreme FGT. This preliminary work demonstrates that ULF breast MRI is feasible and may be a potential option for comfortable, widely deployable, and low-cost breast cancer diagnosis and screening.
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Austin JD, Jenkins SM, Suman VJ, Raygoza JP, Ridgeway JL, Norman A, Gonzalez C, Hernandez V, Ghosh K, Patel BK, Vachon CM. Breast Cancer Risk Perceptions Among Underserved, Hispanic Women: Implications for Risk-Based Approaches to Screening. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01949-7. [PMID: 38383839 PMCID: PMC11336027 DOI: 10.1007/s40615-024-01949-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Understanding factors that shape breast cancer risk perceptions is essential for implementing risk-based approaches to breast cancer detection and prevention. This study aimed to assess multilevel factors, including prior screening behavior, shaping underserved, Hispanic women's perceived risk for breast cancer. METHODS Secondary analysis of survey data from Hispanic women (N = 1325, 92% Spanish speaking, 64% < 50) enrolled in a large randomized controlled trial. Analyses were performed in two cohorts to account for the role of age on screening guideline recommendations (< 50 and 50 +). For each cohort, we examined differences in three common measures of perceived risk of breast cancer (percent lifetime, ordinal lifetime, comparative) by participant factors with chi-square or Kruskal-Wallis tests, as appropriate. Multivariate analyses examined the association between mammography history with percent perceived lifetime risk (outcome > 10 vs ≤ 10%). RESULTS Overall, 75% reported a lifetime risk between 0 and 10%, 96% rated their ordinal risk as "not high," and 50% rated their comparative risk as "much lower." Women < 50 with a family history of breast cancer reported significantly higher levels of perceived risk across all three measures. Among women 50 + , those reporting lower levels of perceived risk were significantly more likely to be Spanish speaking. No significant association was observed between mammography history and percent lifetime risk of breast cancer. CONCLUSION Factors shaping breast cancer risk perceptions differ by age. Prior screening may play less of role in constructing risk perceptions. Research is needed to develop culturally and linguistically appropriate strategies to improve implementation of risk-based screening.
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Affiliation(s)
- Jessica D Austin
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, 13400 E. Shea Blvd, Scottsdale, AZ, 85259, USA.
| | - Sarah M Jenkins
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Vera J Suman
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Jhenitza P Raygoza
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, 13400 E. Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Jennifer L Ridgeway
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Aaron Norman
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Crystal Gonzalez
- Department of Integrated Nutrition Services and Collaborative Research, Mountain Park Health Center, Phoenix, AZ, USA
| | - Valentina Hernandez
- Department of Integrated Nutrition Services and Collaborative Research, Mountain Park Health Center, Phoenix, AZ, USA
| | - Karthik Ghosh
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Bhavika K Patel
- Department of Diagnostic Radiology, Mayo Clinic, Phoenix, AZ, USA
| | - Celine M Vachon
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
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4
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Guan Y, Shen J, Lu J, Fuemmeler BF, Shock LS, Zhao H. Association between allostatic load and breast cancer risk: a cohort study. Breast Cancer Res 2023; 25:155. [PMID: 38115125 PMCID: PMC10729373 DOI: 10.1186/s13058-023-01754-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Allostatic load (AL) reflects the collective load of chronic stress during lifetime. Previous studies have shown that higher AL is associated with poor clinical outcomes among breast cancer patients. However, the relationship between AL and breast cancer risk is still unclear. METHODS To fill the gap, we analyzed the association between AL and the development of breast cancer in 181,455 women identified from the UK Biobank. RESULTS During the follow-up from 2006 to 2020, 5,701 women were diagnosed with incident breast cancer. Significantly higher AL was observed among incident breast cancer cases than all study participants (mean: 2.77 vs. 2.63, P < 0.01). Univariate Cox regression analysis indicated the risk of breast cancer was increased by 5% per one AL unit increase (hazard ratio (HR) = 1.05, 95% confidence interval (CI) 1.04, 1.07). In multivariate analyses, after adjusting demographics, family history of breast cancer, reproductive factors, socioeconomic status, lifestyle factors, and breast cancer polygenic risk score (PRS), the significant association remained (HR = 1.05, 95%CI 1.03, 1.07). The significant relationship was further confirmed in the categorical analysis. Compared with women in the low AL group (AL: 0 ~ 2), those in the high AL group (AL: 3 ~ 11) had a 1.17-fold increased risk of breast cancer (HR = 1.17, 95%CI 1.11, 1.24). Finally, in the stratified analysis, joint effects on the risk of breast cancer were observed between the AL and selected known breast cancer risk factors, including age, family history of breast cancer, PRS, income, physical activity, and alcohol consumption. CONCLUSION In summary, those findings have demonstrated that higher AL was associated with an increased breast cancer risk in women. This association is likely independent of known breast cancer risk factors. Thus, the AL could be a valuable biomarker to help breast cancer risk prediction and stratification.
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Affiliation(s)
- Yufan Guan
- Departments of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23284, USA
| | - Jie Shen
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, 22903, USA
| | - Juan Lu
- Departments of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23284, USA
| | - Bernard F Fuemmeler
- Departments of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23284, USA
| | - Lisa S Shock
- Departments of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23284, USA
| | - Hua Zhao
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, 22903, USA.
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Jane Ling MY, Ahmad N, Aizuddin AN. Risk perception of non-communicable diseases: A systematic review on its assessment and associated factors. PLoS One 2023; 18:e0286518. [PMID: 37262079 PMCID: PMC10234567 DOI: 10.1371/journal.pone.0286518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 05/17/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND The burden of non-communicable diseases (NCDs) is increasing. Risk perception of NCDs is an important factor towards the uptake of preventive health interventions. There are various questionnaires assessing risk perception of NCDs, but no internationally standardized questionnaire has been available. Identification of factors associated with risk perception of NCDs may facilitate the development of targeted interventions. This systematic review aims to identify available questionnaire assessing risk perception of NCDs and the factors associated with risk perception of NCDs. METHODS The reporting of this systematic review is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We carried out a literature search through three databases (Scopus, PubMed, Web of Science) and targeted original article published in English between 2012 and 2021. Quality appraisal of the eligible articles was conducted using the Mixed Methods Appraisal Tool. Findings were synthesized using content analysis. RESULTS A total of 86 studies were included. We found a variety of questionnaires assessing risk perception of NCDs, with many differences in their development, domains, items and validity. We also identified several personal, sociopsychological and structural factors associated with risk perception of NCDs. LIMITATIONS Most of the included studies were of cross-sectional design, and therefore the quality of evidence was considered low and exhibit a high risk of bias. The role of publication bias within this systematic review should be acknowledged as we did not include grey literature. Additionally, language bias must be considered as we only included English-language publications. CONCLUSION Further development and testing of available questionnaire is warranted to ensure their robustness and validity in measuring risk perception of NCDs. All the identified factors deserve further exploration in longitudinal and experimental studies.
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Affiliation(s)
- Miaw Yn Jane Ling
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Norfazilah Ahmad
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Azimatun Noor Aizuddin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
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Faryabi R, Daneshi S, Davarani ER, Yusefi AR, Arabpour M, Ezoji K, Movahed E, Daneshi-Maskooni M, Hussaini SM. The assessment of risk factors and risk perception status of breast cancer in Northern Iran. BMC Womens Health 2023; 23:268. [PMID: 37194061 PMCID: PMC10189944 DOI: 10.1186/s12905-023-02422-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 05/09/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Breast cancer (BC) is the most common malignancy in women. Identifying and avoiding the preventable risk factors of BC reduces its occurrence effectively. So, this study aimed to assess BC's risk factors and risk perception status in Babol, Northern Iran. METHODS This cross-sectional study was conducted on 400 women aged 18 to 70 in Babol, Northern Iran. According to the eligibility criteria, the selected participants completed the demographic characteristics and researcher-made valid and reliable questionnaires. The statistical software was SPSS20. RESULTS The significant risk factors related to BC were old age (60 years old and more) (30.2%), obesity (25.8%), history of radiation (10%), and familial history of BC (9.5%), respectively (P < 0.05). Suspected symptoms of BC were observed in 78 (19.5%) women, including indentations in 27 (6.75%), redness in 15 (3.75%), pain in 16 (4%), and enlargement of lymph nodes in 20 (5%). The BC risk perception score was 107.72±13.22. CONCLUSION Most participants had at least one risk factor for BC. It is essential to implement intervention programs to control obesity and BC screening programs in obese and overweight women to prevent BC and its complications. Further studies are needed.
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Affiliation(s)
- Reza Faryabi
- School of Public Health, Jiroft University of Medical Sciences, Jiroft, Kerman Iran
| | - Salman Daneshi
- School of Public Health, Jiroft University of Medical Sciences, Jiroft, Kerman Iran
| | - Esmat Rezabeigi Davarani
- Health in Disasters and Emergencies Research Centre, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Reza Yusefi
- School of Public Health, Jiroft University of Medical Sciences, Jiroft, Kerman Iran
| | - Mahdieh Arabpour
- School of Medicine, Jiroft University of Medical Sciences, Jiroft, Kerman Iran
| | - Khadijeh Ezoji
- Social Determinants of Health Research Centre, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ehsan Movahed
- School of Public Health, Jiroft University of Medical Sciences, Jiroft, Kerman Iran
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Padamsee TJ, Muraveva A, Meadows RJ, Hils M, Yee LD, Wills CE, Paskett ED. Racial differences in prevention decision making among U.S. women at high risk of breast cancer: A qualitative study. PLoS One 2023; 18:e0278742. [PMID: 36857397 PMCID: PMC9977014 DOI: 10.1371/journal.pone.0278742] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 11/19/2022] [Indexed: 03/02/2023] Open
Abstract
PURPOSE Women at high risk of breast cancer face complex decisions about how to manage those risks. Substantial gaps in current knowledge include how women make these decisions and how decision making may differ across sub-populations. Among these critical gaps are the questions of (a) whether racial differences exist between the experiences of high-risk women navigating breast cancer risk, and (b) what consequences those racial differences might have on women's ability to manage their cancer risks. The present study is designed to address these questions directly. METHODS Fifty semi-structured interviews were conducted with high-risk Black (n = 20) and white women (n = 30) between May 2015 and March 2016 in person in Ohio and by phone. Transcribed data were analyzed using grounded theory methods. MAIN FINDINGS Our analyses suggest that many of the core decision-making dynamics high-risk women navigate differ by race. The experiences of white and Black women in our study differ in terms of (a) contextualizing risk-how women make sense of their own breast cancer risk, the degree to which they worry about risk, and how they prioritize risk within the contexts of their broader lives; (b) conceptualizing risk management-how, how much, and from whom women learn about and conceptualize their options for preventing cancer and/or ensuring that cancer gets diagnosed early; and (c) constraints-the external barriers women face throughout their decision-making and risk-management processes. In sum, the Black women we interviewed reported feeling less well-situated to consider and cope actively with breast cancer risk, less well-informed about risk-management options, and more constrained in their use of these options. CONCLUSIONS High-risk women's accounts of the complex dynamics that shape breast cancer prevention decisions suggest that these dynamics vary substantially by race, such that Black women may experience disadvantages relative to whites.
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Affiliation(s)
- Tasleem J. Padamsee
- Division of Health Services Management and Policy at the Ohio State University College of Public Health, and Faculty Affiliate of the James Comprehensive Cancer Center, Columbus, OH, United States of America
- * E-mail:
| | - Anna Muraveva
- Division of Health Services Management and Policy at the Ohio State University College of Public Health, Columbus, OH, United States of America
| | - Rachel J. Meadows
- Center for Epidemiology & Healthcare Delivery Research JPS Health Network, Ft. Worth, TX, United States of America
| | - Megan Hils
- Division of Health Services Management and Policy at the Ohio State University College of Public Health, Columbus, OH, United States of America
| | - Lisa D. Yee
- City of Hope National Medical Center, Duarte, CA, United States of America
| | - Celia E. Wills
- The Ohio State University College of Nursing, Columbus, OH, United States of America
| | - Electra D. Paskett
- The Ohio State University College of Medicine and James Comprehensive Cancer Center, Columbus, OH, United States of America
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Poon PKM, Tam KW, Lam T, Luk AKC, Chu WCW, Cheung P, Wong SYS, Sung JJY. Poor health literacy associated with stronger perceived barriers to breast cancer screening and overestimated breast cancer risk. Front Oncol 2023; 12:1053698. [PMID: 36686831 PMCID: PMC9850080 DOI: 10.3389/fonc.2022.1053698] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/02/2022] [Indexed: 01/07/2023] Open
Abstract
Background Low health literacy (HL) is negatively associated with mammography screening uptake. However, evidence of the links between poor HL and low mammography screening participation is scarce. Methods We conducted a cross-sectional questionnaire survey among participants of a cancer screening program. We measured HL using a validated Chinese instrument. We assessed breast cancer screening-related beliefs using the Health Belief Model and the accuracy of risk perception. We used multivariable regression models to estimate the relationship between HL and the outcomes. Results A total of 821 females were included. 264 (32.2%) had excellent or sufficient, 353 (43.0%) had problematic, and 204 (24.8%) had inadequate health literacy (IHL). Women with IHL were more likely to agree that high price (β = -0.211, 95% CI -0.354 to -0.069), lack of time (β = -0.219, 95% CI -0.351 to -0.088), inconvenient service time (β = -0.291, 95% CI -0.421 to -0.160), long waiting time (β = -0.305, 95% CI -0.447 to -0.164), fear of positive results (β = -0.200, 95% CI -0.342 to -0.058), embarrassment (β = -0.225, 95% CI -0.364 to -0.086), fear of pain (β = -0.154, 95% CI -0.298 to -0.010), fear of radiation (β = -0.177, 95% CI -0.298 to -0.056), lack of knowledge on service location (β = -0.475, 95% CI -0.615 to -0.335), and lack of knowledge on mammography (β = -0.360, 95% CI -0.492 to -0.228) were barriers. They were also less likely to have an accurate breast cancer risk perception (aOR 0.572, 95% CI 0.341 to 0.956). Conclusion Women with lower HL could have stronger perceived barriers to BC screening and an over-estimation of their breast cancer risk. Tackling emotional and knowledge barriers, financial and logistical assistance, and guidance on risk perception are needed to increase their breast cancer screening uptake.
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Affiliation(s)
- Paul K. M. Poon
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,*Correspondence: Paul K. M. Poon,
| | - King Wa Tam
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Thomas Lam
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Arthur K. C. Luk
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Winnie C. W. Chu
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Polly Cheung
- Hong Kong Breast Cancer Foundation, Hong Kong, Hong Kong SAR, China
| | - Samuel Y. S. Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Joseph J. Y. Sung
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Beidler LB, Kressin NR, Wormwood JB, Battaglia TA, Slanetz PJ, Gunn CM. Perceptions of Breast Cancer Risks Among Women Receiving Mammograph Screening. JAMA Netw Open 2023; 6:e2252209. [PMID: 36689223 PMCID: PMC9871800 DOI: 10.1001/jamanetworkopen.2022.52209] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/02/2022] [Indexed: 01/24/2023] Open
Abstract
Importance Breast density is an independent risk factor for breast cancer. Despite the proliferation of mandated written notifications about breast density following mammography, there is little understanding of how women perceive the relative breast cancer risk associated with breast density. Objective To assess women's perception of breast density compared with other breast cancer risks and explore their understanding of risk reduction. Design, Setting, and Participants This mixed-methods qualitative study used telephone surveys and semistructured interviews to investigate perceptions about breast cancer risk among a nationally representative, population-based sample of women. Eligible study participants were aged 40 to 76 years, reported having recently undergone mammography, had no history of prior breast cancer, and had heard of breast density. Survey participants who had been informed of their personal breast density were invited for a qualitative interview. Survey administration spanned July 1, 2019, to April 30, 2020, with 2306 women completing the survey. Qualitative interviews were conducted from February 1 to May 30, 2020. Main Outcomes and Measures Respondents compared the breast cancer risk associated with breast density with 5 other risk factors. Participants qualitatively described what they thought contributed to breast cancer risk and ways to reduce risk. Results Of the 2306 women who completed the survey, 1858 (166 [9%] Asian, 503 [27%] Black, 268 [14%] Hispanic, 792 [43%] White, and 128 [7%] other race or ethnicity; 358 [19%] aged 40-49 years, 906 [49%] aged 50-64 years, and 594 [32%] aged ≥65 years) completed the revised risk perception questions and were included in the analysis. Half of respondents thought breast density to be a greater risk than not having children (957 [52%]), having more than 1 alcoholic drink per day (975 [53%]), or having a prior breast biopsy (867 [48%]). Most respondents felt breast density was a lesser risk than having a first-degree relative with breast cancer (1706 [93%]) or being overweight or obese (1188 [65%]). Of the 61 women who were interviewed, 6 (10%) described breast density as contributing to breast cancer risk, and 43 (70%) emphasized family history as a breast cancer risk factor. Of the interviewed women, 17 (28%) stated they did not know whether it was possible to reduce their breast cancer risk. Conclusions and Relevance In this qualitative study of women of breast cancer screening age, family history was perceived as the primary breast cancer risk factor. Most interviewees did not identify breast density as a risk factor and did not feel confident about actions to mitigate breast cancer risk. Comprehensive education about breast cancer risks and prevention strategies is needed.
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Affiliation(s)
- Laura B. Beidler
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | - Nancy R. Kressin
- Section of General Internal Medicine, Boston University Chobanian and Avedesian School of Medicine, Boston, Massachusetts
| | | | - Tracy A. Battaglia
- Section of General Internal Medicine, Boston University Chobanian and Avedesian School of Medicine, Boston, Massachusetts
| | - Priscilla J. Slanetz
- Department of Radiology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
| | - Christine M. Gunn
- Dartmouth Cancer Center, The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
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10
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Miller MM, Vasiliadis T, Rochman CM, Repich K, Patrie JT, Anderson RT, Harvey JA. Factors associated with perceived personal risk for breast cancer among women with dense breasts. Clin Imaging 2022; 93:34-38. [DOI: 10.1016/j.clinimag.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/26/2022] [Accepted: 11/01/2022] [Indexed: 11/09/2022]
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11
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Rezaei M, Gilan NR, Almasi A, Khezeli M, Nazar FJ, Shushtari ZJ, Salimi Y, Najafi F, Sarabi N, Saeidi S, Saeidi S. The role of risk perception, risk communication, and demographic factors in COVID-19 preventive behaviors: an online survey in Iran. Osong Public Health Res Perspect 2022; 13:282-289. [PMID: 36097750 PMCID: PMC9468687 DOI: 10.24171/j.phrp.2021.0345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 08/01/2022] [Indexed: 12/04/2022] Open
Abstract
Objectives This study investigated preventive behaviors toward coronavirus disease 2019 (COVID-19) and related factors in a Kurdish Iranian sample. Methods This online survey was conducted among the population aged 18 and above in Kermanshah Province, in western Iran, in April 2020. Samples were invited and recruited through social media. Data were collected using a questionnaire consisting of 4 sections (questions on demographic variables, risk perception, risk communication, and COVID-19 preventive behaviors) and analyzed using Stata ver. 8. Results The Pearson correlation test showed that risk communication was significantly correlated with COVID-19 preventive behaviors (r=0.320, p<0.01). In the final model, where the explanatory power increased with the entry of the risk communication variable, the variables explained a total of 14% of variance in COVID-19 preventive behaviors. Sex (β=−0.482), risk perception (β=0.047), and risk communication (β=0.662) were significant determinants. Conclusion Risk communication and risk perception related to COVID-19, as well as being a woman, were determinants of COVID-19 preventive behaviors.
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12
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Mehta J, MacLaughlin KL, Millstine DM, Faubion SS, Wallace MR, Shah AA, Fields HE, Ruddy BE, Bryan MJ, Patel BK, Buras MR, Golafshar MA, Kling JM. A Comparison of Perceived Lifetime Breast Cancer Risk to Calculated Lifetime Risk Using the Gail Risk Assessment Tool. J Womens Health (Larchmt) 2022; 31:356-361. [PMID: 35041492 DOI: 10.1089/jwh.2019.8231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Understanding the accuracy of a woman's perceived breast cancer risk can enhance shared decision-making about breast cancer screening through provider and patient discussion. We aim to report and compare women's perceived lifetime breast cancer risk to calculated lifetime breast cancer risk. Methods: Women presenting to Mayo Clinic in Arizona and Minnesota in July 2016 completed a survey assessing their perceived breast cancer risk. Lifetime Gail risk scores were calculated from questions pertaining to health history and were then compared with perceived breast cancer risk. Results: A total of 550 predominantly white, married, and well-educated (≥college) women completed surveys. Using lifetime Gail risk scores, 5.6% were classified as high risk (>20% lifetime risk), 7.7% were classified as intermediate risk (15%-20%), and 86.6% were classified as average risk (<15%). Of the 27 women who were classified as high risk, 18 (66.7%) underestimated their risk and of the 37 women who were intermediate risk, 12 (32.4%) underestimated risk. Women more likely to underestimate their risk had a reported history of an abnormal mammogram and at least one or more relative with a history of breast cancer. Surveyed women tended to overestimate risk 4.3 (130/30) times as often as they underestimated risk. Conclusion: In a group of predominantly white, educated, and married cohort of women, there was a large portion of women in the elevated risk groups who underestimated risk. Specific aspects of medical history were associated with underestimation including a history of abnormal mammogram and family history of breast cancer. Overall, in our sample, more women overestimated than underestimated risk.
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Affiliation(s)
- Jaya Mehta
- Department of General Internal Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA
| | | | - Denise M Millstine
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | - Stephanie S Faubion
- Mayo Clinic, Jacksonville, Florida, USA.,Division of General Internal Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Mark R Wallace
- Department of Community Internal Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | - Amit A Shah
- Department of Community Internal Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | - Heather E Fields
- Department of Community Internal Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | - Barbara E Ruddy
- Department of Community Internal Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | - Michael J Bryan
- Department of Family Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | - Bhavika K Patel
- Department of Radiology, Mayo Clinic, Scottsdale, Arizona, USA
| | - Matthew R Buras
- Division of Biostatistics and Bioinformatics, Department of Health Sciences Research, Scottsdale, Arizona, USA
| | - Michael A Golafshar
- Division of Biostatistics and Bioinformatics, Department of Health Sciences Research, Scottsdale, Arizona, USA
| | - Juliana M Kling
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, Arizona, USA.,Mayo Clinic, Jacksonville, Florida, USA
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Padmanabhan H, Hassan NT, Wong SW, Lee YQ, Lim J, Hasan SN, Yip CH, Teo SH, Thong MK, Mohd Taib NA, Yoon SY. Psychosocial outcome and health behaviour intent of breast cancer patients with BRCA1/2 and PALB2 pathogenic variants unselected by a priori risk. PLoS One 2022; 17:e0263675. [PMID: 35167615 PMCID: PMC8846504 DOI: 10.1371/journal.pone.0263675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 01/24/2022] [Indexed: 11/22/2022] Open
Abstract
There is an increasing number of cancer patients undertaking treatment-focused genetic testing despite not having a strong family history or high a priori risk of being carriers because of the decreasing cost of genetic testing and development of new therapies. There are limited studies on the psychosocial outcome of a positive result among breast cancer patients who are at low a priori risk, particularly in women of Asian descent. Breast cancer patients enrolled under the Malaysian Breast Cancer Genetic Study between October 2002 and February 2018 were tested for BRCA1, BRCA2 and PALB2 genes. All 104 carriers identified were invited by a research genetic counsellor for result disclosure. Of the 104 carriers, 64% (N = 66) had low a priori risk as determined by PENN II scores. Psychosocial, risk perception and health behaviour measures survey were conducted at baseline (pre-result disclosure), and at two to six weeks after result disclosure. At baseline, younger carriers with high a priori risk had higher Cancer Worry Scale scores than those with low a priori risk but all scores were within acceptable range. Around 75% and 55% of high a priori risk carriers as well as 80% and 67% of low a priori risk carriers had problems in the "living with cancer" and "children" psychosocial domains respectively. All carriers regardless of their a priori risk demonstrated an improved risk perception that also positively influenced their intent to undergo risk management procedures. This study has shown that with sufficient counselling and support, low a priori risk carriers are able to cope psychologically, have improved perceived risk and increased intent for positive health behaviour despite having less anticipation from a family history prior to knowing their germline carrier status.
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Affiliation(s)
| | - Nur Tiara Hassan
- Genetic Counselling Unit, Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
| | - Siu-Wan Wong
- Genetic Counselling Unit, Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
| | - Yong-Quan Lee
- Genetic Counselling Unit, Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
| | - Joanna Lim
- Core Laboratory Unit, Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
| | | | - Cheng-Har Yip
- Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia
| | - Soo-Hwang Teo
- Cancer Prevention and Population Science Unit, Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
| | - Meow-Keong Thong
- Department of Paediatrics, Genetic Medicine Unit, Faculty of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
- * E-mail: (SYY); (MKT)
| | - Nur Aishah Mohd Taib
- Department of Surgery, Faculty of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Sook-Yee Yoon
- Genetic Counselling Unit, Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
- * E-mail: (SYY); (MKT)
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Mammography screening and mortality by risk status in the California teachers study. BMC Cancer 2021; 21:1341. [PMID: 34922473 PMCID: PMC8684058 DOI: 10.1186/s12885-021-09071-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/25/2021] [Indexed: 01/05/2023] Open
Abstract
Background The debate continues among medical professionals regarding the frequency, starting age, and stopping age for mammography screening. Some experts suggest tailoring recommendations based on individuals’ personal breast cancer risk. Previous studies have not compared the impact of annual versus biennial mammography stratified by age group and risk category. The purpose of this study was to examine the relationship between mammography frequency and mortality by age group and risk category in the California Teachers Study. Methods Using data from study questionnaires from 93,438 women between the ages of 40 and 85 and linkages to the California Cancer Registry and other indices, overall and breast cancer-specific mortality by mammography frequency were estimated using multivariable Cox proportional hazards models, stratified by age group and risk category at baseline as determined by the Gail breast cancer risk model. Results During the follow-up period of 20 years, overall mortality risk was lower in women who had annual or biennial mammography compared to less frequent or no mammography in all age groups. Annual mammography was associated with lower overall mortality risk compared to biennial mammography among women age 50–85. This difference was especially apparent in women age 60–74, regardless of estimated Gail risk category at baseline. Breast cancer-specific mortality was lower among women who had annual mammography compared to biennial or less frequent mammography among women age 60–74, regardless of their baseline risk. Conclusions Our findings suggest that at least biennial mammography is beneficial to most women age 40–85 and that annual mammography is more beneficial than biennial mammography to most women age 50–85 in terms of overall mortality. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-09071-1.
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15
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Castellini G, Palamenghi L, Savarese M, Barello S, Leone S, Previtali E, Armuzzi A, Graffigna G. Patient Engagement in Health Management as a Mediator Between Perceived Risk and COVID-19 Related Distress in Patients With IBD: A Structural Equation Model. Front Psychiatry 2021; 12:733544. [PMID: 34777043 PMCID: PMC8578824 DOI: 10.3389/fpsyt.2021.733544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/23/2021] [Indexed: 11/29/2022] Open
Abstract
Objective: This study aimed to evaluate the impact of the COVID-19 emergency on patients with IBD's psychological distress, understanding the role of patient engagement as a mediator. Methods: An online questionnaire was created, measuring perceived risk susceptibility toward COVID-19, perceived stress, and patient engagement. The questionnaire was distributed to a purposive sample of IBD patients who belonged to the Italian Association for patients with IBD (AMICI Onlus) in April 2020. Structural equation models were implemented. Results: The effect of the perceived risk susceptibility toward COVID-19 contagion on the perceived stress is fully mediated by patient engagement (β = 0.306, p < 0.001). Moreover, the patient engagement mitigates the perceived stress (β = -0.748, p < 0.001) in our sample of IBD patients, and it is negatively influenced by the perceived risk susceptibility toward COVID-19 (β = -0.410, p < 0.001). Conclusion: Patient engagement is the key factor that explains how the perceived risk susceptibility toward COVID-19 affects the perceived psychological distress in patients with IBD, underlining that the perceived risk of contagion increases their perceived level of stress through a decrease of patient engagement.
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Affiliation(s)
- Greta Castellini
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Faculty of Agriculture, Food and Environmental Sciences, Università Cattolica del Sacro Cuore, Cremona, Italy
| | - Lorenzo Palamenghi
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Faculty of Agriculture, Food and Environmental Sciences, Università Cattolica del Sacro Cuore, Cremona, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Mariarosaria Savarese
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Faculty of Agriculture, Food and Environmental Sciences, Università Cattolica del Sacro Cuore, Cremona, Italy
| | - Serena Barello
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- Faculty of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Salvatore Leone
- AMICI Onlus, Associazione Nazionale per le Malattie Infiammatorie Croniche dell'Intestino, Milan, Italy
| | - Enrica Previtali
- AMICI Onlus, Associazione Nazionale per le Malattie Infiammatorie Croniche dell'Intestino, Milan, Italy
| | | | - Guendalina Graffigna
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Faculty of Agriculture, Food and Environmental Sciences, Università Cattolica del Sacro Cuore, Cremona, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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16
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Lee MH, Hong S, Merighi JR. The Association Between Fatalism and Mammography Use in Korean American Immigrant Women. HEALTH EDUCATION & BEHAVIOR 2021; 49:740-749. [PMID: 34396786 DOI: 10.1177/10901981211029253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Fatalism is reported as a salient cultural belief that influences cancer screening disparities in racial and ethnic minority groups. Previous studies provide a range of measures and descriptions of cancer fatalism, but no studies to our knowledge have analyzed how fatalistic views cluster together within subgroups to form distinct profiles, and how these profiles can be predicted. This study identified subgroups of Korean American immigrants with similar fatalistic beliefs toward cancer and examined the influence of fatalism, health belief variables, and health literacy on mammography use. A cross-sectional survey design was used to obtain a convenience sample of 240 Korean American immigrant women in Los Angeles, California. Latent class analysis was used to identify unobserved subgroups of fatalism. Hierarchical logistic regression models were used to identify predisposing, enabling, and need factors associated with recent mammography use. The latent class analysis model identified three cancer fatalism subgroups: high fatalism (17.8%), moderate fatalism (36.7%), and low fatalism (45.5%). Women in the high fatalism subgroup were more likely to have had a mammogram within the past 2 years than women in the low fatalism subgroup. Regression analysis revealed three facilitators of recent mammogram use: level of fatalism, perceived barriers to mammogram, and family history of cancer. Although cultural beliefs can have a powerful influence on health-seeking behavior, it is important to weigh individual and contextual factors that may weaken or mediate the relationship between fatalism and engaging in preventive care such as having a mammogram.
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Affiliation(s)
- Mi Hwa Lee
- East Carolina University, Greenville, NC, USA
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17
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Evaluation of the Clinical and Imaging Findings of Breast Examinations in a Tertiary Facility in Ghana. Int J Breast Cancer 2021; 2021:5541230. [PMID: 34336291 PMCID: PMC8315890 DOI: 10.1155/2021/5541230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 12/24/2022] Open
Abstract
Breast diseases have been one of the major battles the world has been fighting. In winning this fight, the role of medical imaging cannot be overlooked. Breast imaging reveals hidden lesions which aid physicians to give the appropriate diagnosis and definitive treatment, hence this study, to determine the clinical and imaging findings of breast examinations to document the radiologic features in our setting. This cross-sectional retrospective study reviewed the sociodemographics, imaging reports (mammography and ultrasonography with BI-RADS scores and their features), and the clinical data of 425 patients from September 2017 to September 2020 in the Cape Coast Teaching Hospital. 72 solid lesions with their histology reports were also reviewed. Data obtained were organized, coded, and analyzed using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, USA) version 20.0. The results obtained were presented in appropriate tables and charts. A chi-squared test was employed for associations and statistical significance was specified at p ≤ 0.05. 63.29% of the patients were married, but only 18.59% had a positive family history of breast cancer. BI-RADS scores 1(57.46%) and 2(27.99%) were the most recurrent findings. The most common BI-RADS 2, 3, 4, and 5 imaging features were benign-looking axillary lymph nodes (66.33%), well-defined solid masses (61.54%), ill-defined solid masses (42.86%), and ill-defined solid masses with suspicious-looking axillary lymph nodes (100.00%), respectively. The most frequent indications were routine screening (49.18%), mastalgia (26.59%), and painless breast masses (19.77%). There was significant association between duration of symptoms and breast cancer (p value = 0.007). In conclusion, routine breast screening and mastalgia were the topmost indications for breast imaging. BI-RADS 1 and 2 were the commonest BI-RADS scores, and benign-looking axillary lymph nodes and simple cysts were the most frequent imaging features for BI-RADS 2 and ill-defined solid masses and suspicious-looking axillary lymph nodes for BI-RADS 4 and 5.
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18
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Makhnoon S, Tran G, Levin B, Mattie KD, Dreyer B, Volk RJ, Grana G, Arun BK, Peterson SK. Uptake of cancer risk management strategies among women who undergo cascade genetic testing for breast cancer susceptibility genes. Cancer 2021; 127:3605-3613. [PMID: 34157779 DOI: 10.1002/cncr.33668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/21/2021] [Accepted: 04/27/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Uptake of cancer risk management based on inherited predispositions, which encompasses bilateral mastectomy (BLM), bilateral salpingo-oophorectomy (BSO), and intensified screening, is the primary motivation for cascade testing for hereditary breast and ovarian cancer (HBOC). However, long-term outcome data for cascade testers are lacking. METHODS Medical records were abstracted for all unaffected women with pathogenic variants in HBOC genes from 2 cancer hospitals (2013-2019) with at least 1 year of follow-up to compare the uptake of surgery and screening between cascade and noncascade testers. RESULTS Cascade testers (79.8%) were younger than noncascade testers (mean age, 37.6 vs 43.5 years; P = .002). Among women aged ≥40 years, 43% underwent BLM, and 71.6% underwent BSO, with no significant difference in uptake between cascade and noncascade testers. The mean time to BSO among cascade testers was shorter among women aged ≥40 years versus those aged <40 years (11.8 vs 31.9 months; P = .04); no such difference was observed among noncascade testers. Mammography and breast magnetic resonance imaging rates were low in the recorded 6 years for both groups after genetic counseling. CONCLUSIONS Management uptake among cascade testers is high with rates comparable to those for unaffected BRCA-positive women. A large proportion of women act on cascade test results, and this represents a novel report of utilization of cancer management strategies.
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Affiliation(s)
- Sukh Makhnoon
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Grace Tran
- Clinical Cancer Genetics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Brooke Levin
- William G. Rohrer Cancer Genetics Program, Division of Hematology and Medical Oncology, MD Anderson Cancer Center at Cooper University Health Care, Camden, New Jersey
| | - Kristin D Mattie
- William G. Rohrer Cancer Genetics Program, Division of Hematology and Medical Oncology, MD Anderson Cancer Center at Cooper University Health Care, Camden, New Jersey
| | | | - Robert J Volk
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Generosa Grana
- William G. Rohrer Cancer Genetics Program, Division of Hematology and Medical Oncology, MD Anderson Cancer Center at Cooper University Health Care, Camden, New Jersey
| | - Banu K Arun
- Clinical Cancer Genetics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Susan K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Causal Attributions in Breast Cancer Patients Planning to Undergo Adjuvant Endocrine Therapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115931. [PMID: 34073064 PMCID: PMC8198340 DOI: 10.3390/ijerph18115931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/24/2021] [Accepted: 05/28/2021] [Indexed: 12/24/2022]
Abstract
The aim of this study was to explore causal attributions among Korean breast cancer patients who were planning to undergo adjuvant endocrine therapy (AET) as well as the relationships between patient demographic and clinical characteristics and their causal attributions. Causal attributions were assessed with an open-ended response item, which asked patients to list what they thought were the three most important causal factors of their illness. The relationships between patient characteristics and causal attributions were determined through univariate analysis, and the relationships between causal attributions were obtained using social network analysis. A total of 299 participants provided 707 responses. Stress, diet, and exercise were believed to be the three most likely causes of breast cancer. There were no significant differences between causal attributions and the age, education level, marital status, or cancer stage of patients. However, there were differences in the associations between personality, genetics, and reproductive history and patient-identified causal attributions according to the patients' family history of cancer. Patients with a family history of cancer were more likely to believe that personality and genetics/family history were causes of breast cancer compared to patients without such a history. Therefore, it is necessary to educate patients to perceive stress and lifestyle-related factors as modifiable causal factors in order to have a positive effect on their adherence to AET.
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20
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Perceived Breast Cancer Risk among Female Undergraduate Students in Ghana: A Cross-Sectional Study. JOURNAL OF ONCOLOGY 2021; 2021:8811353. [PMID: 33953748 PMCID: PMC8064772 DOI: 10.1155/2021/8811353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 03/21/2021] [Accepted: 04/08/2021] [Indexed: 12/24/2022]
Abstract
Background While breast cancer accounts for the highest mortality among women across the globe, little is known about its perceived risks among them. We examined the perceived risk of breast cancer among undergraduate female university students in Ghana. Methods This was a cross-sectional survey of 358 undergraduate female students at the University of Health and Allied Sciences, Ghana. Descriptive and inferential statistics comprising frequencies, percentages, chi-square, and binary logistic regression analyses were used in analysing the data collected. All analyses were done using STATA Version 13.1. Results Seventy-three percent were aware of breast cancer and 45.2% out of this did not perceive themselves to be at risk of breast cancer. Academic year (p=0.02), school (p=0.01), knowledge of someone with breast cancer (p < 0.001), family history of breast cancer (p < 0.001), current use of oral pills/injectable contraception (p=0.03), history of breast cancer screening (p < 0.001), and intention to perform breast self-examination (p < 0.001) were the risk factors of breast cancer risk perception. Students without a family history of breast cancer were 90% less likely to perceive breast cancer risk (AOR = 0.10, 95% CI = 0.04-0.29) compared with those having a family history of breast cancer. Students who had never screened for breast cancer were also 62% less likely to perceive that they were at risk of breast cancer (AOR = 0.10, 95% CI = 0.04-0.29) compared with those who had ever screened for breast cancer. Conclusion This study showed that female university students tend to estimate their breast cancer risk based on their experience of breast cancer. Students who have ever screened for breast cancer and those with the intention to perform breast self-examination in the future are more likely to perceive themselves as being at risk and thus take action to avoid getting breast cancer.
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21
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Tahergorabi Z, Mohammadifard M, Salmani F, Moodi M. Breast cancer screening behavior and its associated factors in female employees in South Khorasan. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:102. [PMID: 34084849 PMCID: PMC8150083 DOI: 10.4103/jehp.jehp_750_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/09/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Breast cancer is a preventable disease, using three secondary preventive methods of mammography, clinical breast examination (CBE), and breast self-examination (BSE) that can lead to early detection of breast cancer. This study was designed to assess breast cancer screening behavior and its associated factors in females employed in South Khorasan. MATERIALS AND METHODS In this analytic-descriptive study, 2256 female personnel of governmental organizations were investigated in Birjand city in 2016-2017. The data collection tool was a three-part questionnaire: sociodemographic characteristics, knowledge about breast cancer screening methods plus women's performance, and stage of change regarding screening behaviors of mammography, CBE, and BSE. The data were analyzed by SPSS 16 and one-way analysis variance, Tukey's post hoc, and multiple logistic regression model statistical tests. RESULTS The mean ± standard deviation score of knowledge of the women was 3.45 ± 1.5. There was a significant difference of the mean score of knowledge between the single and married (P = 0.03) and age group (P = 0.04). The stage action of mammography, CBE, and BSE was 6.8%, 12.3%, and 16.8%, respectively. Logistic regression model showed that variables such as age and family history of breast cancer were highly significant related to mammography and also CBE. Knowledge was also highly significant in mammography, CBE, and BSE. Education level in CBE, marital status in BSE and mammography, and job in BSE were also significant (P < 0.001). CONCLUSIONS This study reveals insufficient knowledge of female workers about breast cancer and the negative influence of low knowledge on the practice of breast cancer screening behavior. Therefore, the establishment and maintenance of regular educational courses for female employees is essential.
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Affiliation(s)
- Zoya Tahergorabi
- Medical Toxicology and Drug Abuse Research Center, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Mahyar Mohammadifard
- Department of Radiology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Fatemeh Salmani
- Social Determinants of Health Research Center, Departments of Epidemiology and Biostatistics, School of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Mitra Moodi
- Social Determinants of Health Research Center, Department of Health Promotion and Education, School of Health, Birjand University of Medical Sciences, Birjand, Iran
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22
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McKeague B, Maguire R. "The effects of cancer on a family are way beyond the person who's had it": The experience and effect of a familial cancer diagnosis on the health behaviours of family members. Eur J Oncol Nurs 2021; 51:101905. [PMID: 33601195 DOI: 10.1016/j.ejon.2021.101905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE People who are first-degree relatives of cancer patients are at an increased risk of developing cancer themselves. Despite this, relatives of cancer patients do not always make beneficial changes to their health behaviours. This study aimed to answer the following questions: (1) do the health behaviours of people who are first-degree relatives of cancer survivors change following cancer diagnosis, and if so, how, and why, (2) what motivations/barriers exist for first-degree relatives when seeking to engage with health promoting behaviours, and (3) what do first-degree relatives believe healthcare organisations can do to improve uptake of healthy lifestyle changes. METHOD Nine biological first-degree relatives of cancer survivors living in Ireland (6 children, 2 siblings, 1 parent) participated in semi-structured interviews which were later thematically analysed. RESULTS Findings revealed four superordinate themes: Being Conscious/Aware, Limited Lifestyle Changes, Psychosocial Consequences of Experience, and Unmet Needs, with each of these themes having two to three subordinate themes. Patient and public involvement emphasised Unmet Needs, including needs for information and family support, as the theme that was most reflective of participants' lived experience. CONCLUSIONS Results suggest that while family members tend not to change their lifestyle behaviours following cancer diagnosis, they do seem to make changes to their medical behaviours. Additionally, they can be negatively impacted by the experience in several other ways. Identifying means of support will allow relatives to cope better post diagnosis.
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Affiliation(s)
- Beth McKeague
- Department of Psychology, Maynooth University, Maynooth, County Kildare, Ireland.
| | - Rebecca Maguire
- Department of Psychology, Maynooth University, Maynooth, County Kildare, Ireland.
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Bhandari D, Shibanuma A, Kiriya J, Hirachan S, Ong KIC, Jimba M. Factors associated with breast cancer screening intention in Kathmandu Valley, Nepal. PLoS One 2021; 16:e0245856. [PMID: 33481894 PMCID: PMC7822561 DOI: 10.1371/journal.pone.0245856] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 01/10/2021] [Indexed: 12/24/2022] Open
Abstract
Background Breast cancer burden is increasing in low-income countries (LICs). Increasing incidence and delayed presentation of breast cancer are mainly responsible for this burden. Many women do not participate in breast cancer screening despite its effectiveness. Moreover, studies are limited on the barriers associated with low utilization of breast cancer screening in LICs. This study identified breast cancer screening behavior and factors associated with breast cancer screening intention among women in Kathmandu Valley, Nepal. Methods A cross-sectional study was conducted among 500 women living in five municipalities of Kathmandu Valley, Nepal. Data were collected from July to September 2018, using a structured questionnaire. Interviews were conducted among women selected through proportionate random household sampling. This study was conceptualized using the theory of planned behavior, fatalism, perceived susceptibility, and perceived severity. The outcome variables included: the intention to have mammography (MMG) biennially, the intention to have clinical breast examination (CBE) annually, and the intention to perform breast self-examination (BSE) monthly. Analysis was conducted separately for each outcome variable using partial proportional odds model. Results Out of 500 women, 3.4% had undergone MMG biennially, 7.2% CBE annually, and 14.4% BSE monthly. Women with a positive attitude, high subjective norms, and high perceived behavioral control were more likely to have the intention to undergo all three screening methods. Similarly, women were more likely to have intention to undergo CBE and MMG when they perceived themselves susceptible to breast cancer. Conversely, women were less likely to have intention to undergo CBE when they had high fatalistic beliefs towards breast cancer. Conclusion Women in this study had poor screening behavior. The practice of breast self-examination was comparatively higher than clinical breast examination and mammography. Multidimensional culturally sensitive interventions are needed to enhance screening intentions. Efforts should be directed to improve attitude, family support, and fatalistic belief towards cancer. Furthermore, the proper availability of screening methods should be ensured while encouraging women to screen before the appearance of symptoms.
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Affiliation(s)
- Divya Bhandari
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo, Japan
| | - Akira Shibanuma
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo, Japan
| | - Junko Kiriya
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo, Japan
| | | | - Ken Ing Cherng Ong
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo, Japan
- * E-mail:
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo, Japan
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Maschke A, Paasche-Orlow MK, Kressin NR, Schonberg MA, Battaglia TA, Gunn CM. Discussions of Potential Mammography Benefits and Harms among Patients with Limited Health Literacy and Providers: "Oh, There are Harms?". JOURNAL OF HEALTH COMMUNICATION 2020; 25:951-961. [PMID: 33455518 PMCID: PMC8062298 DOI: 10.1080/10810730.2020.1845256] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Starting breast cancer screening at age 40 versus 50 may increase potential harms frequency with a small mortality benefit. Younger women's screening decisions, therefore, may be complex. Shared decision-making (SDM) is recommended for women under 50 and may support women under 55 for whom guidelines vary. How women with limited health literacy (LHL) approach breast cancer screening decision-making is less understood, and most SDM tools are not designed with their input. This phenomenological study sought to characterize mammography counseling experiences among women with LHL and primary care providers (PCPs). Women ages 40-54 with LHL who had no history of breast cancer or mammogram within 9 months were approached before a primary care visit at a safety-net hospital. PCPs at this site were invited to participate. Qualitative interviews explored mammography counseling experiences. Patients also reviewed sample information materials. A constant comparison technique generated four themes salient to 25 patients and 20 PCPs: addressing family history versus comprehensive risk assessment; potential mammography harms discussions; information delivery preferences; and integrating pre-visit information tools. Findings suggest that current counseling techniques may not be responsive to patient-identified needs. Opportunities exist to improve how mammography information is shared and increase accessibility across the health literacy spectrum.
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Affiliation(s)
- Ariel Maschke
- Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA, USA
| | - Michael K Paasche-Orlow
- Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Nancy R Kressin
- Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Mara A Schonberg
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Tracy A Battaglia
- Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA, USA
| | - Christine M Gunn
- Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA, USA
- Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, MA, USA
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
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Ustaoğlu G, Göller Bulut D, Üyetürk Ü, Uysal Ö. Evaluation of periodontal health in breast cancer patients undergoing tamoxifen or aromatase inhibitors drugs therapy: A cross-sectional study. SPECIAL CARE IN DENTISTRY 2020; 41:41-48. [PMID: 33156573 DOI: 10.1111/scd.12538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/28/2020] [Accepted: 10/21/2020] [Indexed: 11/27/2022]
Abstract
AIM To study the dental and periodontal status of women with breast cancer (BCa) having tamoxifen or aromatase inhibitors (AIs) treatment in comparison with control healthy women. METHODS Fifty-one women on tamoxifen therapy, 52 women on AIs therapy and 52 systemically healthy controls were included in the study. The total number of teeth, the number of teeth indicated for extraction, the number of decayed teeth, and the duration of medication were recorded. Periodontal status was evaluated with gingival index (GI); plaque index (PI); bleeding on probing (BOP); probing depth (PD) and clinical attachment loss (CAL). RESULTS The lowest number of teeth and decayed teeth was found in AIs users (P < .001 and P = .003 respectively). The highest CAL value was seen in AIs users (P = .042) whereas no significant difference was found between the groups in terms of PI, GI, and PD (P = .102, P = .233, and P = .306, respectively). Lower PI was observed in patients using AIs for less than 2 years (P = .048). CONCLUSIONS While tamoxifen did not affect the dental and periodontal condition, AIs medication adversely affected the dental and periodontal condition by more tooth loss and higher CAL.
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Affiliation(s)
- Gülbahar Ustaoğlu
- Department of Periodontology, Faculty of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkey
| | - Duygu Göller Bulut
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkey
| | - Ümmügül Üyetürk
- Department of Medical Oncology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Özge Uysal
- Department of Periodontology, Faculty of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkey
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Biological Aging Marker p16 INK4a in T Cells and Breast Cancer Risk. Cancers (Basel) 2020; 12:cancers12113122. [PMID: 33114473 PMCID: PMC7692397 DOI: 10.3390/cancers12113122] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/13/2020] [Accepted: 10/19/2020] [Indexed: 12/27/2022] Open
Abstract
Simple Summary The association between cellular senescence, a hallmark of biological aging, and cancer risk has not been examined in population-based studies. To fill the gap, in this study, we assessed the relationship between p16INK4a mRNA expression in T cells, a marker of cellular senescence, with breast cancer risk and selected sociodemographic and lifestyle variables. Overall, we discovered that higher p16INK4a mRNA expression in T cells was associated with an increased risk of breast cancer. Also, we found that p16INK4a mRNA expression in T differed by age, race, family history of cancer, marital status, annual income, and smoking status. The results of this study provide evidence that cellular senescence plays a role in breast cancer development. Furthermore, our results also suggest that social demographics may modify cellular senescence and biological aging. Abstract Prior research has demonstrated that altered telomere length, a well-known marker for biological aging, is associated with various types of human cancer. However, whether such association extends to additional hallmarks of biological aging, including cellular senescence, has not been determined yet. In this two-stage study, we assessed the association between p16INK4a mRNA expression in T cells, a marker of cellular senescence, and breast cancer risk. The discovery stage included 352 breast cancer patients and 324 healthy controls. p16INK4a mRNA expression was significantly higher in individuals who were older, Black, and had family history of cancer than their counterparts in both cases and controls. p16INK4a mRNA expression also differed by marital status, annual income, and smoking status in cases. In the discovery stage, we found that increased p16INK4a mRNA expression was associated with 1.40-fold increased risk of breast cancer (OR = 1.40; 95%CI: 1.21, 1.68; p < 0.001). A marginally significant association was further observed in the validation stage with 47 cases and 48 controls using pre-diagnostic samples (OR = 1.28; 95%CI: 0.98, 2.97; p = 0.053). In addition, we found that p16INK4a mRNA expression was higher in tumors with selected aggressive characteristics (e.g., poorly differentiated and large tumors) than their counterparts. In summary, our results demonstrate that higher p16INK4a mRNA expression in T cells is a risk factor for breast cancer and further support the role of biological aging in the etiology of breast cancer development. Novelty and Impact Statements: The results from this study provide evidence that cellular senescence, a process of biological aging, plays a role in breast cancer etiology. In addition, our results also support that social demographics may modify cellular senescence and biological aging.
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Donley T, Tshiswaka DI, Blanc J, Seixas A, Okafor A, Mbizo J. Differences in Breast and Cervical Cancer Screening Among U.S. Women by Nativity and Family History. Am J Prev Med 2020; 59:578-587. [PMID: 32828585 DOI: 10.1016/j.amepre.2020.05.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 05/13/2020] [Accepted: 05/17/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION System-level factors such as poor access to health services can help explain differential uptake in breast and cervical cancer screening between U.S.- and foreign-born women. However, few studies have explored the roles of family history and perceived risk of these cancers on screening rates. To address these gaps, this study investigates whether a family history of cancer, perceived risk, and system-level factors independently and additively predict differential screening rates of breast and cervical cancer between U.S.-born and foreign-born women living in the U.S. METHODS Data were analyzed in 2019 from the 2015 National Health Interview Survey. Descriptive and multivariable logistic regression modeling was performed to test whether there were differences in breast and cervical cancer screening within and between the 2 groups and whether family history of cancer and perceived risk of breast cancer were predictors of uptake. RESULTS The sample comprised women aged 21-74 years (n=14,047). The mean age of the sample was 45.5 (SD=14.8 years). The majority of the women were U.S.-born (77.5%). U.S.- and foreign-born women had more mammograms and Pap tests with a usual source of care (p<0.001) and insurance (p<0.001). Healthcare access and utilization factors were also predictive for both groups of women. Data analyses were conducted in 2019. CONCLUSIONS These findings are consistent with previous work. Access and healthcare utilization were associated with screening uptake. However, differences in risk perception, family history of breast and cervical cancers, and screening uptake were found between U.S.- and foreign-born women.
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Affiliation(s)
- Tiffany Donley
- Department of Population Health, NYU Langone Health, New York, New York.
| | | | - Judite Blanc
- Department of Population Health, NYU Langone Health, New York, New York
| | - Azizi Seixas
- Department of Population Health, NYU Langone Health, New York, New York
| | - Anthony Okafor
- Department of Mathematics, University of West Florida, Pensacola, Florida
| | - Justice Mbizo
- Department of Public Health, University of West Florida, Pensacola, Florida
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Açucena Vieira Alves S, Weller M. Breast Cancer Risk Perception and Mammography Screening Behavior of Women in Northeast Brazil. WOMEN'S HEALTH REPORTS 2020; 1:150-158. [PMID: 33786479 PMCID: PMC7784808 DOI: 10.1089/whr.2019.0026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Previous studies suggest that education and income affect Brazilian women's breast cancer prevention behavior. The present study focused on the impact of perceived and estimated risk on mammography screening (MS) behavior. Materials and Methods: Information regarding socioeconomic variables and risk perception was obtained from 396 healthy women aged 40-79 years. Perceived comparative risk was measured on a seven-point Likert scale. A Breast Cancer Risk Assessment Tool of 5-year risk to develop breast cancer was used to determine objective risk. Estimated comparative risk was determined as categories of perceived risk relative to the objective risk. Regression analysis was applied to determine odds ratios (ORs) and confidence intervals (95% CIs) of variables. Results: Asked about the potential of MS to lower risk of death because of breast cancer, 215 (54.29%) responded that it does not lower risk. Women with low perceived comparative risk had a twofold (OR = 0.493; 95% CI: 0.24-1.00) decreased chance to participate in MS annually, compared with women with high-perceived comparative risk (p = 0.020). Women without family history had a 7.6-fold (OR = 0.132; 95% CI: 0.07-0.25) decreased chance of having a high-perceived comparative risk (p = 0.000). If compared with underestimation, the overestimation and accurate estimation of comparative risk tended to be associated with a decreased chance of MS attendance (p = 0.017). Regression modeling indicated that low educational level, no occupation, and no family history decreased the chance of women having MS (p = 0.040; p = 0.010; p = 0.022). Conclusions: Risk perception depended on family history. Present data did not indicate that overestimation, or accurate estimation of comparative risk, increased chance of MS attendance. Educational level, occupation status, and family history, instead, determined MS performance.
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Affiliation(s)
| | - Mathias Weller
- Post Graduate Program in Public Health, State University of Paraíba (UEPB), Campina Grande, Paraíba, Brazil
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Kanaya N, Bernal L, Chang G, Yamamoto T, Nguyen D, Wang YZ, Park JS, Warden C, Wang J, Wu X, Synold T, Rakoff M, Neuhausen SL, Chen S. Molecular Mechanisms of Polybrominated Diphenyl Ethers (BDE-47, BDE-100, and BDE-153) in Human Breast Cancer Cells and Patient-Derived Xenografts. Toxicol Sci 2020; 169:380-398. [PMID: 30796839 DOI: 10.1093/toxsci/kfz054] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Polybrominated diphenyl ethers (PBDEs) have been used as flame retardants in household materials. Their environmental persistence has led to continuous human exposure and significant tissue levels. Three PBDE congeners (BDE-47, BDE-100, and BDE-153) have been frequently detected in human serum. Although these compounds appear to possess endocrine disrupting activity, studies are largely missing to determine the biological mechanisms of PBDEs in breast cancer cells. Here, we assessed PBDE bioactivities with three complementary strategies: receptor binding/activity assays; nonbiased RNA-sequencing analysis using an estrogen-dependent breast cancer cell line MCF-7aroERE; and in vivo assessments using patient-derived xenograft (PDX) models of human breast cancer. According to the results from in vitro experiments, the PBDE congeners regulate distinct nuclear receptor signaling pathways. BDE-47 acts as a weak agonist of both estrogen receptor α (ERα) and estrogen-related receptor α (ERRα); it could stimulate proliferation of MCF-7aroERE and induced expression of ER-regulated genes (including cell cycle genes). BDE-153 was found to act as a weak antagonist of ERα. BDE-100 could act as (1) an agonist of aryl hydrocarbon receptor (AhR), inducing expression of CYP1A1 and CYP1B1 and (2) as a very weak agonist/antagonist of ERα. In vivo, a mixture of the three congeners with ratios detected in human serum was tested in an ER+ PDX model. The mixture exhibited estrogenic activity through apoptosis/cell cycle regulation and increased the expression of a proliferation marker, Ki-67. These results advance our understanding of the mechanisms of PBDE exposure in breast cancer cells.
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Affiliation(s)
- Noriko Kanaya
- Department of Cancer Biology, Beckman Research Institute of City of Hope, Duarte, California 91010
| | - Lauren Bernal
- Department of Cancer Biology, Beckman Research Institute of City of Hope, Duarte, California 91010
| | - Gregory Chang
- Department of Cancer Biology, Beckman Research Institute of City of Hope, Duarte, California 91010
| | - Takuro Yamamoto
- Department of Cancer Biology, Beckman Research Institute of City of Hope, Duarte, California 91010
| | - Duc Nguyen
- Department of Cancer Biology, Beckman Research Institute of City of Hope, Duarte, California 91010
| | - Yuan-Zhong Wang
- Department of Cancer Biology, Beckman Research Institute of City of Hope, Duarte, California 91010
| | - June-Soo Park
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, Berkeley, California 94710
| | - Charles Warden
- Integrative Genomics Core, Beckman Research Institute of City of Hope, Duarte, California 91010
| | - Jinhui Wang
- Integrative Genomics Core, Beckman Research Institute of City of Hope, Duarte, California 91010
| | - Xiwei Wu
- Integrative Genomics Core, Beckman Research Institute of City of Hope, Duarte, California 91010
| | - Timothy Synold
- Department of Cancer Biology, Beckman Research Institute of City of Hope, Duarte, California 91010
| | - Michele Rakoff
- Breast Cancer Care & Research Fund, Los Angeles, California 90036
| | - Susan L Neuhausen
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, California 91010
| | - Shiuan Chen
- Department of Cancer Biology, Beckman Research Institute of City of Hope, Duarte, California 91010
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Narayan AK, Lehman CD. Mammography Screening Guideline Controversies: Opportunities to Improve Patient Engagement in Screening. J Am Coll Radiol 2020; 17:633-636. [PMID: 32027838 DOI: 10.1016/j.jacr.2020.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 12/31/2019] [Accepted: 01/06/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Anand K Narayan
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Constance D Lehman
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Exploring factors that impact uptake of risk-reducing bilateral salpingo-oophorectomy (RRBSO) in high-risk women. ACTA ACUST UNITED AC 2020; 27:26-32. [DOI: 10.1097/gme.0000000000001422] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Karvinen KH, Brunet J, Carr LJ. Family history of cancer as a cue to action for physical activity behaviour and beliefs. Psychol Health 2019; 35:933-945. [DOI: 10.1080/08870446.2019.1693570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Kristina H. Karvinen
- School of Physical and Health Education, Nipissing University, North Bay, ON, Canada
| | - Jennifer Brunet
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Institut du Savoir de L’Hôpital Montfort (IRHM), Ottawa, ON, Canada
- Centre for Cancer Therapeutics, Ottawa Hospital Research Institute (OHRI), Ottawa, ON, Canada
| | - Lucas J. Carr
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
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Correlation of MLH1 polymorphisms, survival statistics, in silico assessment and gene downregulation with clinical outcomes among breast cancer cases. Mol Biol Rep 2019; 47:683-692. [DOI: 10.1007/s11033-019-05175-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 10/30/2019] [Indexed: 02/07/2023]
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Salinas JJ, Roy R, Dwivedi AK, Shokar NK. Hereditary Breast Cancer Risk Analysis in Uninsured Mexican-Origin Women Living in the U.S.–Mexico Border Region. HISPANIC HEALTH CARE INTERNATIONAL 2019; 17:118-124. [DOI: 10.1177/1540415319837850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
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.
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Affiliation(s)
| | - Renet Roy
- Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| | - Alok K. Dwivedi
- Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
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Aldemir K, Gürkan A, Taskın Yılmaz F, Demirel G. Participation of First-Degree Relatives of Women with Breast Cancer in
Screening Programs. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2019. [DOI: 10.29252/pcnm.9.2.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Genton MC, Carretier J, Gafni A, Medina P, Charles C, Moumjid N. ‘There’s a before and an after’: effects of a personal history of cancer on perception of cancer risks and adoption of behaviours. HEALTH, RISK & SOCIETY 2019. [DOI: 10.1080/13698575.2019.1652729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Marine Cécile Genton
- Univ. Lyon, Université Claude Bernard Lyon 1, GATE-LSE UMR CNRS 5824, F-69100, Villeurbanne, France
- Univ. Lyon, Université Claude Bernard Lyon 1, Université Jean Monnet Saint Etienne, EA7425 Health Services and Performance Research (HESPER), F-69100, F-42000, Villeurbanne, Saint Etienne, France
| | - Julien Carretier
- Univ. Lyon, Université Claude Bernard Lyon 1, Université Jean Monnet Saint Etienne, EA7425 Health Services and Performance Research (HESPER), F-69100, F-42000, Villeurbanne, Saint Etienne, France
- Department Cancer and Environment, Cancer Centre Léon Bérard, F-69008 Lyon, France
| | - Amiram Gafni
- Department of Health Research Methods Evaluation and Impact, Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
| | - Patricia Medina
- Obervatoire Régional de la Santé Auvergne-RhÔne-Alpes, F-69001 Lyon, France
| | - Cathy Charles
- Department of Health Research Methods Evaluation and Impact, Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
| | - Nora Moumjid
- Univ. Lyon, Université Claude Bernard Lyon 1, Université Jean Monnet Saint Etienne, EA7425 Health Services and Performance Research (HESPER), F-69100, F-42000, Villeurbanne, Saint Etienne, France
- Department Cancer and Environment, Cancer Centre Léon Bérard, F-69008 Lyon, France
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Hwang M, Zhang HS, Park B. Association Between Health Behaviors and Family History of Cancer According to Sex in the General Population. Am J Prev Med 2019; 56:393-403. [PMID: 30642691 DOI: 10.1016/j.amepre.2018.10.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 10/09/2018] [Accepted: 10/10/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Family history of cancer and modifiable risk factors are each associated with cancer development, but no studies have assessed their association with each other by sex. This study aimed to examine modifiable risk factors in individuals with a family history of cancer compared with those without a family history of cancer, according to sex. METHODS This study recruited 166,810 participants aged 40-79 years from Korea's Health Examinee Study cohort between 2004 and 2014. Results were calculated as AORs and 95% CIs to determine the relationship between family history of cancer in first-degree relatives and modifiable risk factors. Data analyses were performed in 2018. RESULTS The prevalence of modifiable cancer risk factors, including current smoking, drinking alcohol, physical inactivity, obesity, and abdominal obesity, were different according to the presence of a family history of cancer, cancer type of such a family history, and sex. Male participants with a family history of cancer were less likely to be current smokers or obese (AOR=0.95, 95% CI=0.91, 0.99 and AOR=0.95, 95% CI=0.92, 0.99, respectively) than those without a family history of cancer, whereas female participants with a family history of cancer were more likely to be current smokers but less likely to be physically inactive (AOR=1.13, 95% CI=1.03, 1.23 and AOR=0.96, 95% CI=0.93, 0.98, respectively) than those without a family history of cancer. CONCLUSIONS This study's findings suggest that, in general, males with a family history of cancer show better health behaviors, whereas females with a family history of cancer demonstrate worse health behaviors.
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Affiliation(s)
- Minji Hwang
- Industry-University Cooperation Foundation, Hanyang University, Seoul, Republic of Korea
| | - Hyun-Soo Zhang
- Industry-University Cooperation Foundation, Hanyang University, Seoul, Republic of Korea; Department of Biomedical Systems Informatics, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Boyoung Park
- Department of Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea.
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Malik SS, Mubarik S, Masood N, Khadim MT. An insight into clinical outcome of XPG polymorphisms in breast cancer. Mol Biol Rep 2018; 45:2369-2375. [PMID: 30255276 DOI: 10.1007/s11033-018-4401-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Accepted: 09/21/2018] [Indexed: 12/16/2022]
Abstract
XPG polymorphisms are associated with varied clinical outcomes in different cancers but up-till now no study has been reported on breast cancer. Therefore, current study was aimed to explore the association of breast cancer risk factors and XPG polymorphisms (rs2296147 and rs1047768). It also investigated impact of XPG variants on overall survival and progression free survival among breast cancer cases. A total of 493 histopathologically identified breast cancer cases and 387 healthy females were genotyped by ARMS-PCR. Relationship between general characteristics, XPG polymorphisms and breast cancer risk was accessed by conditional logistic regression and illustrated by OR and 95% CI. Kaplan Meier test was applied to estimate survival distributions whereas log rank test demonstrated survival differences. Association of XPG variants with OS and PFS in breast cancer was illustrated by HR and 95% CI. Early onset of menopause, consanguinity and family history contributed (P < 0.05) towards breast cancer development. Both rs2296147 and rs1047768 SNPs were found to be associated (P < 0.05) with the risk of breast cancer. XPG rs1047768 was significantly associated with decreased PFS (HR 1.72; 95% CI 1.0-2.8) in breast cancer cases (P = 0.013) which was demonstrated by median time of 26 months for T > C variant when compared with median time of 37 months for TT genotype. No association was found between XPG rs2296147 polymorphism and survival analysis among breast cancer cases. XPG (rs1047768 T > C) variant may play a significant role in terms of decreased PFS and could be used as a predictor of unfavourable prognosis among breast cancer.
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Affiliation(s)
- Saima Shakil Malik
- Fatima Jinnah Women University, The Mall, Rawalpindi, 46000, Pakistan.
- Armed Forces Institute of Pathology, Rawalpindi, Pakistan.
| | - Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, China
| | - Nosheen Masood
- Fatima Jinnah Women University, The Mall, Rawalpindi, 46000, Pakistan
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Seven M, Bağcivan G, Akyuz A, Bölükbaş F. Women with Family History of Breast Cancer: How Much Are They Aware of Their Risk? JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:915-921. [PMID: 28474221 DOI: 10.1007/s13187-017-1226-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The aims of this study are to assess knowledge of inheritance characteristics of breast cancer and risk reduction strategies and to determine risk perception and the factors affecting risk perception of women with family history. There is a gap in our understanding of risk perception and knowledge of genetic aspect of breast cancer and risk reduction strategies in women with a family history of breast cancer. The study design is descriptive cross-sectional study. Between January 2015 and 2016 at a training and research hospital in Turkey, 117 women who were the first- and second-degree relatives of breast cancer patients were included in the study. Perceived risk scale, cancer worry chart, and a knowledge assessment form were used to collect data. Of the women, 34.1% were first-degree relatives of a breast cancer patient, and knowledge score was 6.9 ± 2.19 out of 11. Almost half of the women (41.9%) moderately worry about the chances of getting breast cancer, and half of the women (51.3%) ranked their perceived risk as moderate (26-50% out of 100%). There is a significant difference between the perceived risk and educational level, having genetic testing, and a significant relationship between the perceived risk and worry level of women. However, breast cancer screening behavior was not affected by risk perception. The knowledge of women regarding inheritance characteristics of breast cancer and risk reduction strategies was moderate, but still majority of women have moderate or higher level of risk perception and are worried about getting breast cancer. Therefore, interventions should be planned to reduce worry and to increase risk reduction strategies such as screening and other health behaviors in women at risk for breast-ovarian cancer.
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Affiliation(s)
- Memnun Seven
- School of Nursing, Koç University, Davutpasa caddesi No:4, Topkapi, 34010, Istanbul, Turkey.
| | | | - Aygul Akyuz
- School of Nursing, Koç University, Davutpasa caddesi No:4, Topkapi, 34010, Istanbul, Turkey
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Arnold M, Quante AS. Personalized Mammography Screening and Screening Adherence-A Simulation and Economic Evaluation. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2018; 21:799-808. [PMID: 30005752 DOI: 10.1016/j.jval.2017.12.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 11/23/2017] [Accepted: 12/13/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Personalized breast cancer screening has so far been economically evaluated under the assumption of full screening adherence. This is the first study to evaluate the effects of nonadherence on the evaluation and selection of personalized screening strategies. METHODS Different adherence scenarios were established on the basis of findings from the literature. A Markov microsimulation model was adapted to evaluate the effects of these adherence scenarios on three different personalized strategies. RESULTS First, three adherence scenarios describing the relationship between risk and adherence were identified: 1) a positive association between risk and screening adherence, 2) a negative association, or 3) a curvilinear relationship. Second, these three adherence scenarios were evaluated in three personalized strategies. Our results show that it is more the absolute adherence rate than the nature of the risk-adherence relationship that is important to determine which strategy is the most cost-effective. Furthermore, probabilistic sensitivity analyses showed that there are risk-stratified screening strategies that are more cost-effective than routine screening if the willingness-to-pay threshold for screening is below US $60,000. CONCLUSIONS Our results show that "nonadherence" affects the relative performance of screening strategies. Thus, it is necessary to include the true adherence level to evaluate personalized screening strategies and to select the best strategy.
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Affiliation(s)
- Matthias Arnold
- Munich Center of Health Sciences, Ludwig-Maximilians-Universität, Munich, Germany; Institute of Health Economics and Health Care Management, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.
| | - Anne S Quante
- Chair of Genetic Epidemiology, IBE, Faculty of Medicine, LMU Munich, Germany; Institute of Genetic Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Department of Gynecology and Obstetrics, University Hospital rechts der Isar, Technical University Munich, Munich, Germany
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An S, Choi YJ, Lee HY, Yoon YJ, Platt M. Predictors of Breast Cancer Screening Among Korean American Women: Is Having an Annual Checkup Critical? Asian Pac J Cancer Prev 2018; 19:1281-1286. [PMID: 29802037 PMCID: PMC6031831 DOI: 10.22034/apjcp.2018.19.5.1281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 03/29/2018] [Indexed: 11/27/2022] Open
Abstract
Objective: Korean American (KA) immigrant women underutilize breast cancer screening. This study examined factors predicting breast cancer screening behavior among KA women in the United States. Methods: 233 KA women aged 19 to 85 were recruited in the metro area of Atlanta, Georgia. Andersen’s behavioral model theoretically guided the study. Result: Of the predisposing factors, age (OR=1.043, p<.01, 95% CI [1.017, 1.069]) and marital status (OR=2.154, p<.05, 95% CI [1.022, 4.539]) were significantly associated with clinical breast exam (CBE), while income (OR=2.289, p<.05, 95% CI [1.060, 4.945]) and annual checkup (OR=2.725, p<.01, 95% CI [1.342, 5.533]) were linked to CBE as enabling factors. For the receipt of mammographic screening, annual checkup was only significantly associated among enabling factors (OR=4.509, p<.05, 95% CI [1.263, 16.102]), while family cancer history was identified as the only significant need factor (OR=.112, p<.01, 95% CI [.023, .552]). Conclusion: Differing factors explained the receipt of CBEs and mammographic use among KA women. Specifically, the findings shed light on the importance of having an annual checkup for the uptake of both CBEs and mammographic use. Intervention strategies should focus on promoting health accessibility for KA women to adhere to recommended breast cancer screening.
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Affiliation(s)
- Soonok An
- Department of Social Work and Sociology, North Carolina A&T State University, Greensboro, NC, USA.
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Al-Wassia RK, Farsi NJ, Merdad LA, Hagi SK. Patterns, knowledge, and barriers of mammography use among women in Saudi Arabia. Saudi Med J 2018; 38:913-921. [PMID: 28889149 PMCID: PMC5654025 DOI: 10.15537/smj.2017.9.20842] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
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.
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Affiliation(s)
- Rolina K Al-Wassia
- Department of Radiology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. E-mail.
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Braithwaite D, Miglioretti DL, Zhu W, Demb J, Trentham-Dietz A, Sprague B, Tice JA, Onega T, Henderson LM, Buist DSM, Ziv E, Walter LC, Kerlikowske K. Family History and Breast Cancer Risk Among Older Women in the Breast Cancer Surveillance Consortium Cohort. JAMA Intern Med 2018; 178:494-501. [PMID: 29435563 PMCID: PMC5876845 DOI: 10.1001/jamainternmed.2017.8642] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
IMPORTANCE First-degree family history is a strong risk factor for breast cancer, but controversy exists about the magnitude of the association among older women. OBJECTIVE To determine whether first-degree family history is associated with increased risk of breast cancer among older women, and identify whether the association varies by breast density. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study between 1996 and 2012 from 7 Breast Cancer Surveillance Consortium (BCSC) registries located in New Hampshire, North Carolina, San Francisco Bay area, western Washington state, New Mexico, Colorado, and Vermont. During a mean (SD) follow-up of 6.3 (3.2) years, 10 929 invasive breast cancers were diagnosed in a cohort of 403 268 women 65 years and older with data from 472 220 mammography examinations. We estimated the 5-year cumulative incidence of invasive breast cancer by first-degree family history, breast density, and age groups. Cox proportional hazards models were fit to estimate the association of first-degree family history with risk of invasive breast cancer (after adjustment for breast density, BCSC registry, race/ethnicity, body mass index, postmenopausal hormone therapy use, and benign breast disease for age groups 65 to 74 years and 75 years and older, separately). Data analyses were performed between June 2016 and June 2017. EXPOSURE First-degree family history of breast cancer. MAIN OUTCOMES AND MEASURES Incident breast cancer. RESULTS In 403 268 women 65 years and older, first-degree family history was associated with an increased risk of breast cancer among women ages 65 to 74 years (hazard ratio [HR], 1.48; 95% CI, 1.35-1.61) and 75 years and older (HR, 1.44; 95% CI, 1.28-1.62). Estimates were similar for women 65 to 74 years with first-degree relative's diagnosis age younger than 50 years (HR, 1.47; 95% CI, 1.25-1.73) vs 50 years and older (HR, 1.33; 95% CI, 1.17-1.51) and for women ages 75 years and older with the relative's diagnosis age younger than 50 years (HR, 1.31; 95% CI, 1.05-1.63) vs 50 years and older (HR, 1.55; 95% CI, 1.33-1.81). Among women ages 65 to 74 years, the risk associated with first-degree family history was highest among those with fatty breasts (HR, 1.67; 95% CI, 1.27-2.21), whereas in women 75 years and older the risk associated with family history was highest among those with dense breasts (HR, 1.55; 95% CI, 1.29-1.87). CONCLUSIONS AND RELEVANCE First-degree family history was associated with increased risk of invasive breast cancer in all subgroups of older women irrespective of a relative's age at diagnosis.
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Affiliation(s)
- Dejana Braithwaite
- Department of Oncology, Georgetown University Medical Center, Washington, DC
| | - Diana L Miglioretti
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, California.,Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Weiwei Zhu
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Joshua Demb
- Department of Oncology, Georgetown University Medical Center, Washington, DC
| | - Amy Trentham-Dietz
- Department of Population Health Sciences, Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison
| | - Brian Sprague
- Department of Surgery, University of Vermont College of Medicine, Burlington
| | - Jeffrey A Tice
- Department of Medicine, University of California, San Francisco
| | - Tracy Onega
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Louise M Henderson
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill
| | - Diana S M Buist
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Elad Ziv
- Department of Medicine, University of California, San Francisco
| | - Louise C Walter
- Department of Medicine, University of California, San Francisco
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Kiely D. Transgender Patient Screening: Breast Cancer Risk Assessment and Screening Recommendations. Clin J Oncol Nurs 2017; 21:E67-E70. [DOI: 10.1188/17.cjon.e67-e70] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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45
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YÜKSEL S, ALTUN UĞRAŞ G, ÇAVDAR İ, BOZDOĞAN A, ÖZKAN GÜRDAL S, AKYOLCU N, ESENCAN E, VAROL SARAÇOĞLU G, ÖZMEN V. A Risk Assessment Comparison of Breast Cancer and Factors Affected to Risk Perception of Women in Turkey: A Cross-sectional Study. IRANIAN JOURNAL OF PUBLIC HEALTH 2017; 46:308-317. [PMID: 28435816 PMCID: PMC5395526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The increase in breast cancer incidence has enhanced attention towards breast cancer risk. The aim of this study was to determine the risk of breast cancer and risk perception of women, factors that affect risk perception, and to determine differences between absolute risk and the perception of risk. METHODS This cross-sectional study was carried out among 346 women whose score in the Gail Risk Model (GRM) was ≥ 1.67% and/or had a 1st degree relative with breast cancer in Bahçeşehir town in Istanbul, Turkey between Jul 2012 and Dec 2012. Data were collected through face-to-face interviews. The level of risk for breast cancer has been calculated using GRM and the Breast Cancer Risk Assessment Form (BCRAF). Breast cancer risk perception (BCRP), has been evaluated by visual analogue 100-cm-long scale. RESULTS Even though 39.6% of the women considered themselves as high-risk carriers, according to the GRM and the BCRAF, only 11.6% and 9.8% of women were in the "high risk" category, respectively. There was a positive significant correlation between the GRM and the BCRAF scores (P<0.001), and the BCRAF and BCRP scores (P<0.001). Factors related to high-risk perception were age (40-59 yr), post-menopausal phase, high-very high economic income level, existence of breast cancer in the family, having regular breast self-examination and clinical breast examination (P<0.05). CONCLUSION In women with high risk of breast, cancer there is a significant difference between the women's risk perception and their absolute risk level.
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Affiliation(s)
- Serpil YÜKSEL
- Dept. of Surgical Nursing, Division of Nursing, Faculty of Health Sciences, Necmettin Erbakan University, Konya, Turkey,Corresponding Author:
| | - Gülay ALTUN UĞRAŞ
- Dept. of Surgical Nursing, Division of Nursing, School of Health, Mersin University, Mersin, Turkey
| | - İkbal ÇAVDAR
- Dept. of Surgical Nursing, Florence Nightingale Faculty of Nursing, İstanbul University, İstanbul, Turkey
| | - Atilla BOZDOĞAN
- Dept. of General Surgery, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Sibel ÖZKAN GÜRDAL
- Dept. of General Surgery, Faculty of Medicine, Namık Kemal University, Tekirdağ, Turkey
| | - Neriman AKYOLCU
- Dept. of Surgical Nursing, Florence Nightingale Faculty of Nursing, İstanbul University, İstanbul, Turkey
| | - Ecem ESENCAN
- School of Medicine, Koç University, İstanbul, Turkey
| | - Gamze VAROL SARAÇOĞLU
- Dept. of Public Health, Faculty of Medicine, Namık Kemal University, Tekirdağ, Turkey
| | - Vahit ÖZMEN
- Dept. of General Surgery, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
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Rutherford EJ, Kelly J, Lehane EA, Livingstone V, Cotter B, Butt A, O'Sullivan MJ, O Connell F, Redmond HP, Corrigan MA. Health literacy and the perception of risk in a breast cancer family history clinic. Surgeon 2016; 16:82-88. [PMID: 27908542 DOI: 10.1016/j.surge.2016.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 05/23/2016] [Accepted: 06/02/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Informed consent is an essential component of medical practice, and especially so in procedural based specialties which entail varying degrees of risk. Breast cancer is one of the most common cancers in women, and as such is the focus of extensive research and significant media attention. Despite this, considerable misperception exists regarding the risk of developing breast cancer. AIMS This study aims to examine the accuracy of risk perception of women attending a breast cancer family history clinic, and to explore the relationship between risk perception accuracy and health literacy. METHODS A cross-sectional study of women attending a breast cancer family history clinic (n = 86) was carried out, consisting of a patient survey and a validated health literacy assessment. Patients' perception of personal and population breast cancer risk was compared to actual risk as calculated by a validated risk assessment tool. RESULTS Significant discordance between real and perceived risks was observed. The majority (83.7%) of women overestimated their personal lifetime risk of developing breast cancer, as well as that of other women of the same age (89.5%). Health literacy was considered potentially inadequate in 37.2% of patients; there was a correlation between low health literacy and increased risk perception inaccuracy across both personal ten-year (rs = 0.224, p = 0.039) and general ten-year population estimations. (rs = 0.267, p = 0.013). CONCLUSION Inaccuracy in risk perception is highly prevalent in women attending a breast cancer family history clinic. Health literacy inadequacy is significantly associated with this inaccuracy.
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Affiliation(s)
- E J Rutherford
- Cork Breast Research Centre, Cork University Hospital, Cork, Ireland; School of Medicine, University College Cork, Cork, Ireland
| | - J Kelly
- Cork Breast Research Centre, Cork University Hospital, Cork, Ireland
| | - E A Lehane
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - V Livingstone
- Cork Breast Research Centre, Cork University Hospital, Cork, Ireland
| | - B Cotter
- Cork Breast Research Centre, Cork University Hospital, Cork, Ireland
| | - A Butt
- Cork Breast Research Centre, Cork University Hospital, Cork, Ireland
| | - M J O'Sullivan
- Cork Breast Research Centre, Cork University Hospital, Cork, Ireland
| | - F O Connell
- Cork Breast Research Centre, Cork University Hospital, Cork, Ireland
| | - H P Redmond
- Cork Breast Research Centre, Cork University Hospital, Cork, Ireland; School of Medicine, University College Cork, Cork, Ireland
| | - M A Corrigan
- Cork Breast Research Centre, Cork University Hospital, Cork, Ireland.
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Paalosalo-Harris K, Skirton H. Mixed method systematic review: the relationship between breast cancer risk perception and health-protective behaviour in women with family history of breast cancer. J Adv Nurs 2016; 73:760-774. [DOI: 10.1111/jan.13158] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2016] [Indexed: 12/18/2022]
Affiliation(s)
| | - Heather Skirton
- School of Nursing and Midwifery; Faculty of Health and Human Sciences; Plymouth University; Plymouth UK
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Kelly KM, Chopra I, Dolly B. Breastfeeding: An Unknown Factor to Reduce Heart Disease Risk Among Breastfeeding Women. Breastfeed Med 2015; 10:442-7. [PMID: 26436588 DOI: 10.1089/bfm.2015.0082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Breastfeeding confers many health benefits not only to babies but also to their lactating mothers. Breastfeeding is a notable protective factor in the Gail model for breast cancer and is protective for heart disease. Although individuals in the Appalachian region have lower risk of developing breast cancer, their risk of heart disease is elevated compared with the national value for the United States. SUBJECTS AND METHODS We surveyed 155 predominantly breastfeeding mothers of toddlers under 3 years old, recruited through parenting groups, daycares, and county extension in Appalachian West Virginia. Participants were asked their perceived comparative risks for breast cancer and heart disease and why they felt their risk was higher, same, or lower than that of the general population. RESULTS For breast cancer, 29.7% felt their risk was lower than the general population. For heart disease, 26.5% felt their risk was lower than the general population. Although these risks were highly correlated (p=0.006), there was considerable variability in responses (p<0.03). Qualitative responses for breast cancer risk frequently included breastfeeding (30.3%) and family history (30.3%). Qualitative responses for heart disease noted family history (36.1%) but did not include breastfeeding. A regression analysis found that greater family history, shorter duration of breastfeeding, and fewer pregnancies were associated with greater breast cancer risk perceptions. Family history, lower household income, and current smoking were associated with greater heart disease risk perceptions. CONCLUSIONS These well-educated, predominantly lactating women did not know the protective effects of breastfeeding for heart disease. Increased educational efforts about heart disease may be helpful to encourage more women to breastfeed.
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Affiliation(s)
- Kimberly M Kelly
- School of Pharmacy, West Virginia University , Morgantown, West Virginia
| | - Ishveen Chopra
- School of Pharmacy, West Virginia University , Morgantown, West Virginia
| | - Brandon Dolly
- School of Pharmacy, West Virginia University , Morgantown, West Virginia
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Farhadifar F, Taymoori P, Bahrami M, Zarea S. The relationship of social support concept and repeat mammography among Iranian women. BMC WOMENS HEALTH 2015; 15:92. [PMID: 26497048 PMCID: PMC4620002 DOI: 10.1186/s12905-015-0253-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 10/13/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND Breast cancer ranks as the first most common cancer among the Iranian women. The regular repeat of mammography with 1-2 year intervals leads to the increased efficiency of early detection of breast cancer. The present study examined the predictors of repeat mammography. It was hypothesized that higher social support is connected with mammography repeat. METHODS A cross-sectional study was carried out among 400 women 50 years and older in Sanandaj, Iran. Data was collected by the questionnaire including information on socio demographical variables and measuring social support level. Data was analyzed by SPSS16 software. Multiple logistic regression was used to determine the predictive power of demographic variables and dimensions of social support for repeat mammography. RESULTS Women aged 50-55 years had three times odds of repeat mammography compared to women aged 56-60 years) OR, 3.02). Married women had greater odds of repeat mammography compared to single women (P < 0.006). The probability of repeat mammography in women with higher social support was 0.93 times greater than the women with lower social support (OR, 0.93; 95 % CI, 0.91-0.95; P < 0.0001). CONCLUSIONS Iranian women are less likely repeat mammography than other Asian women. Identifying the associations between perceived social support and repeat mammography may offer detailed information to allow for future study and guide the development of interventions not only for Iranian women but also for similar cultural that received pay too little attention to date in the breast cancer literature.
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Affiliation(s)
- Fariba Farhadifar
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Parvaneh Taymoori
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, PO Box 66177-13391, Pasdaran Street, Sanandaj, Iran.
| | - Mitra Bahrami
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, PO Box 66177-13391, Pasdaran Street, Sanandaj, Iran.
| | - Shamsy Zarea
- Department of Genicology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Abstract
Individuals who are given a preventive exam by a primary care provider are more likely to agree to cancer screening. The provider recommendation has been identified as the strongest factor associated with screening utilization. This article provides a framework for breast cancer risk assessment for an advanced practice registered nurse working in primary care practice.
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