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Aga SS, Yasmeen N, Al-Mansour M, Khan MA, Nissar S, Khawaji B, Awadh A, Alasmari MM, Abushouk A. Knowledge, awareness and attitude towards breast cancer: Risk factors, signs and screening among Health and Allied students: A prospective study. J Family Med Prim Care 2024; 13:1804-1824. [PMID: 38948630 PMCID: PMC11213396 DOI: 10.4103/jfmpc.jfmpc_1720_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/04/2023] [Accepted: 12/14/2023] [Indexed: 07/02/2024] Open
Abstract
Introduction Breast cancer (BC) is the second most common cancer in Saudi women. Therefore, understanding BC and its related risk factors, symptoms, and screening is critical for early detection and intervention. The current study was meant to explore the knowledge, awareness, and attitude (KAA) gap in BC: risk factors, symptoms, and screening. Material and Methods This cross-sectional investigation was carried out with Health Professions Students (HPS) using a predesigned and validated study questionnaire to examine HPS knowledge and attitudes concerning BC and associated risk factors, symptoms, and screening. Results A total of 277 female students responded to the survey. The frequency of correct answers for the BC knowledge questions varied from the lowest of 27.8% to the highest of 88.8%, with only 5 out of 15 questions (33.3%) answered correctly by more than 60% of the participants, displaying poor knowledge and awareness of BC. A majority (>60%) of the participants identified only 7 of the 18 risk factors of BC correctly, whereas 11 of the 13 early warning signs of BC were identified correctly by the majority (>60%) of the participants. Among the participants, only 26.4% were aware of the breast cancer screening center, but 94.6% of them agreed that early detection of breast cancer is important and 82.7% agreed to participate in the screening program if offered. Conclusion Participants' knowledge and awareness of BC were found to be relatively low; however, their attitudes towards BC screening were positive. As a result, it is critical to develop effective education programs, curricular activities, and awareness campaigns to address the lack of awareness of BC and to have an appropriate response to screening to reduce disease burden.
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Affiliation(s)
- Syed S. Aga
- Department of Basic Medical Sciences, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
- Molecular Diseases and Diagnostics Division, Infinity Biochemistry Pvt. Ltd, Sajjad Abad, Chattabal, Srinagar, Kashmir, India
| | - Nusrath Yasmeen
- Department of Pharmacy, College of Nursing, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Mubarak Al-Mansour
- Department of Medical Education, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
- Adult Medical Oncology, Princess Noorah Oncology Center, King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Muhammad A. Khan
- Department of Medical Education, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Saniya Nissar
- Molecular Diseases and Diagnostics Division, Infinity Biochemistry Pvt. Ltd, Sajjad Abad, Chattabal, Srinagar, Kashmir, India
| | - Bader Khawaji
- Department of Basic Medical Sciences, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Abdullah Awadh
- Department of Basic Medical Sciences, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
- Department of Medical Education, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Moudi M. Alasmari
- Department of Basic Medical Sciences, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Amir Abushouk
- Department of Basic Medical Sciences, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), King Abdulaziz Medical City, Jeddah, Saudi Arabia
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Kuriakose S, Krishnamurthy A, Vinutha RS, Ramshankar V, Sekhar S, Walia GK, Gupta R, Aggarwal A, Singh R, Rajan S, Kondal D, Grover S, Prabhakaran D, Dhillon PK, Shridhar K, Goodman M. Time intervals and patient-level factors in oral cancer diagnostic pathways: An application of the WHO framework in India. Cancer Epidemiol 2022; 81:102283. [PMID: 36335850 DOI: 10.1016/j.canep.2022.102283] [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] [Revised: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Oral cancer, a leading cancer-site in India, is often detected at advanced stages. We evaluated the time intervals from first symptom to help-seeking and diagnosis among oral cancer patients. METHODOLOGY In this cross-sectional study, we recruited 226 consecutive oral cancer patients (mean age ( ± SD) 51.9 years ( ± 10.9); 81.9% men; 70.3% advanced stage) registered for diagnosis and treatment, between 2019 and 2021 at a cancer care centre in South India. We used WHO framework and previously standardized tools to record time intervals (appraisal, help-seeking and diagnostic) and baseline characteristics. We utilized multivariable logistic regression models to test the associations between 'prolonged (i.e., over 1 month) time intervals') and patient-level factors to estimate odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS Over a half of patients presented with prolonged appraisal (60%) and help-seeking intervals (57%), and a third (34%) reported prolonged diagnostic interval. Patients with no formal education, no routine healthcare visits, no self-reported risk factors, and those who did not perceive initial symptoms to be serious were 2-4 times more likely to have prolonged appraisal and help-seeking than the rest. High travel costs and self-decision for visiting healthcare facility prolonged help-seeking. Diagnostic interval was prolonged only among women OR= 2.7 (95% CI: 1.2-6.1)) and in patients whose first doctor's opinion was 'nothing to worry' OR (=7.3 (95% CI: 2.6-20.5)). 'Correct knowledge of cancer' shortened appraisal and help-seeking intervals and 'incorrect knowledge and negative beliefs' prolonged diagnostic interval. CONCLUSION Our findings highlight that interventions targeting sociocultural and economic determinants, symptom awareness, sensitizing persons at risk (especially women) and primary care providers might reduce overall time to diagnosis. Further, patients without any known risk factors for oral cancer might be at-risk for prolonged appraisal interval. These might help inform 'pull' strategies for cancer control in India and similar settings.
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Affiliation(s)
- Steena Kuriakose
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India.
| | | | - R S Vinutha
- Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Vijayalakshmi Ramshankar
- Department of Preventive Oncology and Molecular Testing Laboratory, Cancer Institute WIA, Adyar, Chennai 600020, India.
| | | | - Gagandeep Kaur Walia
- Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Ruby Gupta
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India; Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Aastha Aggarwal
- Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Ranjana Singh
- Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Sheril Rajan
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India.
| | - Dimple Kondal
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India; Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Surbhi Grover
- Hospital of the University of Pennsylvania, Department of Radiation Oncology, 3400 Civic Center Blvd., Philadelphia, PA 19104, United States.
| | - D Prabhakaran
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India; Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Preet K Dhillon
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India; Department of Real World Data, PD Data Sciences, Genentech Inc., South San Francisco, CA, USA.
| | - Krithiga Shridhar
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India; Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Michael Goodman
- Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, United States.
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Öztürk R, Bakir S, Kazankaya F, Paker S, Ertem G. Awareness about Gynecologic Cancers and Related Factors among Healthy Women: A Cross-Sectional Study. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:847-856. [PMID: 34433370 DOI: 10.1080/19371918.2021.1965936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The risk of cancer-related mortality and morbidity decreases when women are aware of the risk factors for gynecologic cancers and implement strategies such as attending relevant early screening programs. This cross-sectional study conducted between August 2017 and August 2018 at a public hospital in Turkey aimed to determine the awareness about gynecologic cancers among healthy women by utilized the Krieger's ecosocial theory as a framework for the study. The study included 554 Turkish women aged 18-65 years. Data were collected using the Gynecological Cancer Awareness Scale (GCAS) and a questionnaire designed in this study. Significant differences were noted between the average GCAS score and variables such as the amount of menstrual bleeding, entering menopause, a history of reproductive system disease, regular gynecological examination (including Pap test), regular vaginal self-examination, sexually transmitted infections (STIs), genital hygiene behavior, the fear of having cancer, having knowledge about cancer, and requiring information about cancer (p < .05). Despite the high level of awareness about gynecologic cancer among these women, the lack of proper knowledge and preventive measures was high. Having knowledge about gynecologic cancers results in increased awareness; however, the level of knowledge is not sufficient to prevent gynecologic cancers, which shows the need for sufficient and effective cancer screening and education programs.
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Affiliation(s)
- Ruşen Öztürk
- Department of Women Health and Diseases Nursing, Ege University Faculty of Nursing, Izmir, Turkey
| | - Sümeyye Bakir
- Department of Women Health and Diseases Nursing, Ege University Faculty of Nursing, Izmir, Turkey
| | - Figen Kazankaya
- Department of Women Health and Diseases Nursing, Ege University Faculty of Nursing, Izmir, Turkey
| | - Selin Paker
- Department of Women Health and Diseases Nursing, Ege University Faculty of Nursing, Izmir, Turkey
| | - Gül Ertem
- Department of Women Health and Diseases Nursing, Ege University Faculty of Nursing, Izmir, Turkey
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Li YL, Qin YC, Tang LY, Liao YH, Zhang W, Xie XM, Liu Q, Lin Y, Ren ZF. Patient and Care Delays of Breast Cancer in China. Cancer Res Treat 2018; 51:1098-1106. [PMID: 30428639 PMCID: PMC6639234 DOI: 10.4143/crt.2018.386] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 11/03/2018] [Indexed: 12/12/2022] Open
Abstract
Purpose This study differentiates patient and care delays of breast cancer and explores the related factors as well as the associations with the prognosis in Guangzhou, a southern city of China. Methods A cohort of female incident breast cancer patients (n=1,551) was recruited from October 2008 to March 2012 and followed up until January 1, 2016 (n=1,374) in the affiliated hospitals of Sun Yat-sen University. The factors associated with patient and care delays were analyzed with multivariable logistic models. Cox proportional hazards regression models were constructed to estimate the impacts of the delays on the prognosis. Results There were 40.4% patient delay (≥3 months) and 15.5% care delay (≥1 month). The patient delay, but not the care delay, was significantly related to the clinical stage and consequently worsened the prognosis of breast cancer (hazard ratio, 1.45; 95% confidence interval, 1.09 to 1.91 for progression-free survival). The factors related to an increased patient delay included premenopausal status, history of benign breast disease, and less physical examination. Conclusion Patient delay was the main type of delay in Guangzhou and resulted in higher clinical stage and poor prognosis of breast cancer. Screening for breast cancer among premenopausal women may be an effective way to reduce this delay.
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Affiliation(s)
- Yue-Lin Li
- Department of Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ya-Chao Qin
- Department of Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lu-Ying Tang
- Department of Pathology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yu-Huang Liao
- Department of Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wei Zhang
- Department of Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiao-Ming Xie
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Qiang Liu
- Breast Tumor Center, Second Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ying Lin
- Department of Breast and Thyroid Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ze-Fang Ren
- Department of Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Okuhara T, Ishikawa H, Goto E, Okada M, Kato M, Kiuchi T. Processing fluency effect of a leaflet for breast and cervical cancer screening: a randomized controlled study in Japan. PSYCHOL HEALTH MED 2018; 23:1250-1260. [PMID: 30101600 DOI: 10.1080/13548506.2018.1492732] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Processing fluency (the inferred subjective ease with which people process information) has been a topic of increasing research attention in the field of psychology over the past decade. We examined the effect of improving written materials in terms of processing fluency with regard to encouragement for obtaining breast and cervical cancer screening. We randomly assigned 670 women to intervention or control conditions; the 215 who mailed back distributed questionnaires were the study participants. A standard leaflet for cancer screening was mailed to the control group, while the materials mailed to the intervention group were improved in terms of perceptual fluency (e.g., legibility), linguistic fluency (e.g., readability), retrieval fluency (e.g., reducing amount of information) and imagery fluency (having recipients imagine future behavior and events). The screening rate of the intervention group was significantly higher than that of the control group (29.4% vs. 14.2%, χ2 = 7.275, df = 1, p = .007, φ = .184). Improving the processing fluency of written materials may be useful for encouraging individuals to obtain breast and cervical cancer screening.
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Affiliation(s)
- Tsuyoshi Okuhara
- a Department of Health Communication , Graduate School of Medicine, The University of Tokyo , Tokyo , Japan
| | - Hirono Ishikawa
- a Department of Health Communication , Graduate School of Medicine, The University of Tokyo , Tokyo , Japan
| | - Eiko Goto
- a Department of Health Communication , Graduate School of Medicine, The University of Tokyo , Tokyo , Japan
| | - Masahumi Okada
- a Department of Health Communication , Graduate School of Medicine, The University of Tokyo , Tokyo , Japan
| | - Mio Kato
- a Department of Health Communication , Graduate School of Medicine, The University of Tokyo , Tokyo , Japan
| | - Takahiro Kiuchi
- a Department of Health Communication , Graduate School of Medicine, The University of Tokyo , Tokyo , Japan
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Khandelwal R. Health worker led breast examination in rural India using electro-mechanical hand-held breast palpation device. ACTA ACUST UNITED AC 2018. [DOI: 10.15406/jcpcr.2018.09.00337] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Somashekhar SP, Agarwal G, Deo SVS, Chintamani, Raghu Ram P, Sarkar D, Parmar V. Indian Solutions for Indian Problems-Association of Breast Surgeons of India (ABSI) Practical Consensus Statement, Recommendations, and Guidelines for the Treatment of Breast Cancer in India. Indian J Surg 2017; 79:275-285. [PMID: 28827899 PMCID: PMC5549057 DOI: 10.1007/s12262-017-1666-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 06/13/2017] [Indexed: 12/14/2022] Open
Affiliation(s)
| | | | | | - Chintamani
- Vardhaman Mahavir Medical College, Safdarjung Hospital, New Delhi, India
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Madhukumar S, Thambiran UR, Basavaraju B, Bedadala MR. A study on awareness about breast carcinoma and practice of breast self-examination among basic sciences' college students, Bengaluru. J Family Med Prim Care 2017; 6:487-490. [PMID: 29416994 PMCID: PMC5787941 DOI: 10.4103/2249-4863.222026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND In India, the number of new breast cancer cases is about 115,000 per year and this is expected to rise to 250,000 new cases per year by 2015. It needs to be noted that breast cancer is leading in the age groups of 15-34 years which is a cause of concern as this denotes the need for educative and awareness programs targeting younger members of the society, to implement early practices of breast examination. This study was carried out with the intention of assessing the level of knowledge and awareness of carcinoma breast and breast self-examination (BSE) in female college students. MATERIALS AND METHODS This cross-sectional study was carried out in a well-known basic sciences college. After the pretest questionnaire was given, an awareness talk was given about breast cancer and BSE. A posttest questionnaire was administered. The data of pre- and post-test were collected and analyzed using SPSS. RESULTS Pretest and posttest were collected from 1030 students. The age of the study participants was ranged between 18 and 23 years. Most of them were aware of breast carcinoma, but half of them thought breast cancer affects the elderly. Regarding different aspects studied, 58% had a knowledge of at least one of the symptoms and 59% knew at least one of the risk factors for breast carcinoma. Only 185 (18%) women knew about BSE and 107 women practice it. CONCLUSIONS This study concluded that the awareness of the breast cancer was good but the knowledge of signs and BSE was poor, which is utmost important for early detection and in reduction of mortality.
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Affiliation(s)
- Suwarna Madhukumar
- Department of Community Medicine, MVJ Medical College and Research Hospital, Bengaluru, Karnataka, India
| | - Uthraa R. Thambiran
- Department of Community Medicine, MVJ Medical College and Research Hospital, Bengaluru, Karnataka, India
| | - Bhavya Basavaraju
- Department of Community Medicine, MVJ Medical College and Research Hospital, Bengaluru, Karnataka, India
| | - Mayur R. Bedadala
- Department of Community Medicine, MVJ Medical College and Research Hospital, Bengaluru, Karnataka, India
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Gupta A, Shridhar K, Dhillon PK. A review of breast cancer awareness among women in India: Cancer literate or awareness deficit? Eur J Cancer 2015; 51:2058-66. [PMID: 26232859 PMCID: PMC4571924 DOI: 10.1016/j.ejca.2015.07.008] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 07/07/2015] [Accepted: 07/10/2015] [Indexed: 12/29/2022]
Abstract
Background Breast cancer is the most common female cancer worldwide including India, where advanced stages at diagnosis, and rising incidence and mortality rates, make it essential to understand cancer literacy in women. We conducted a literature review to evaluate the awareness levels of risk factors for breast cancer among Indian women and health professionals. Methods A structured literature search using combined keywords was undertaken on bibliographic databases including MEDLINE, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health (CINAHL) and SCOPUS. Searches were restricted to research published in English language peer-reviewed journals through December, 2014 in India. Results A total of 7066 women aged 15–70 years showed varied levels of awareness on risk factors such as family history (13–58%), reproductive history (1–88%) and obesity (11–51%). Literacy levels on risk factors did not improve over the 8-year period (2005–2013). On average, nurses reported higher, though still varied, awareness levels for risk factors such as family history (40.8–98%), reproductive history (21–90%) and obesity (34–6%). Awareness levels were not consistently higher for the stronger determinants of risk. Conclusion Our review revealed low cancer literacy of breast cancer risk factors among Indian women, irrespective of their socio-economic and educational background. There is an urgent need for nation- and state-wide awareness programmes, engaging multiple stakeholders of society and the health system, to help improve cancer literacy in India.
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Affiliation(s)
- A Gupta
- South Asia Network for Chronic Disease (SANCD), Public Health Foundation of India, 4th Floor, Plot No. 47, Sector 44, Gurgaon 122002, India
| | - K Shridhar
- South Asia Network for Chronic Disease (SANCD), Public Health Foundation of India, 4th Floor, Plot No. 47, Sector 44, Gurgaon 122002, India; Centre for Chronic Conditions & Injuries, Public Health Foundation of India, 4th Floor, Plot No. 47, Sector 44, Gurgaon 122002, India
| | - P K Dhillon
- South Asia Network for Chronic Disease (SANCD), Public Health Foundation of India, 4th Floor, Plot No. 47, Sector 44, Gurgaon 122002, India; Centre for Chronic Conditions & Injuries, Public Health Foundation of India, 4th Floor, Plot No. 47, Sector 44, Gurgaon 122002, India.
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Bellinger JD, Millegan W, Abdalla AE. “I'm Not Ashamed to Talk on It!”: African-American Women's Decisions About Cervical Cancer Prevention and Control in South Carolina. Womens Health Issues 2015; 25:120-7. [DOI: 10.1016/j.whi.2014.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 10/23/2014] [Accepted: 10/27/2014] [Indexed: 10/24/2022]
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Rametta S, Grosso G, Galvano F, Mistretta A, Marventano S, Nolfo F, Buscemi S, Gangi S, Basile F, Biondi A. Social disparities, health risk behaviors, and cancer. BMC Surg 2013; 13 Suppl 2:S17. [PMID: 24267900 PMCID: PMC3851246 DOI: 10.1186/1471-2482-13-s2-s17] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Overall cancer incidence rates decreased in the most recent time period in both men and women, largely due to improvements in surgical therapeutic approaches (tertiary prevention) and screening programs (secondary prevention), but differences in cancer incidence and survival according to socioeconomic status are documented worldwide. Health risk behaviors, defined as habits or practices that increase an individual's likelihood of harmful health outcomes, are thought to mediate such inequalities. DISCUSSION Obesity has been related with increased cancer incidence and mortality due to imbalance of leptin and adiponectin which are connected to activation of PI3K, MAPK, and STAT3 pathways and decreasing insulin/insulin-like growth factor (IGF)-1 and mTOR signaling via activation of 5 AMP-activated protein kinase (AMPK), respectively. Physical activity has been associated to prevent cancer by the aforementioned obesity-related mechanisms, but also increasing level of circulating vitamin D, which has been related to lower risk of several cancers, and increasing prostaglandin F2a and reducing prostaglandin E2, which are both related with cancer prevention and promotion, respectively. A large number of different substances may induce themselves a direct cytotoxicity and mutagenic action on cells by smoking, whereas alcohol promote immune suppression, the delay of DNA repair, inhibition of the detoxification of carcinogens, the production of acetaldehyde, and the contribution to abnormal DNA methylation. The combined smoking and alcohol drinking habits have been shown to increase cancer risk by smoke action of increasing the acetaldehyde burden following alcohol consumption and alcohol action of enhancing the activation of various procarcinogens contained in tobacco smoke. CONCLUSIONS Interventions at the social level may be done to increase awareness about cancer risks and promote changing in unhealthy behaviors.
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Affiliation(s)
- Stefania Rametta
- Department “G. F. Ingrassia” Section of Hygiene and Public Health, University of Catania, Catania, Italy
| | - Giuseppe Grosso
- Department of Drug Sciences, Section of Biochemistry, University of Catania, Catania, Italy
| | - Fabio Galvano
- Department of Drug Sciences, Section of Biochemistry, University of Catania, Catania, Italy
| | - Antonio Mistretta
- Department “G. F. Ingrassia” Section of Hygiene and Public Health, University of Catania, Catania, Italy
| | - Stefano Marventano
- Department “G. F. Ingrassia” Section of Hygiene and Public Health, University of Catania, Catania, Italy
| | - Francesca Nolfo
- Department “G. F. Ingrassia” Section of Hygiene and Public Health, University of Catania, Catania, Italy
| | - Silvio Buscemi
- Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - Santi Gangi
- Department of General Surgery, Section of General Surgery and Oncology, University Medical School of Catania, Italy
| | - Francesco Basile
- Department of General Surgery, Section of General Surgery and Oncology, University Medical School of Catania, Italy
| | - Antonio Biondi
- Department of General Surgery, Section of General Surgery and Oncology, University Medical School of Catania, Italy
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Abstract
Ruby Singhrao and colleagues propose four arguments for why cervical cancer screening and treatment should be prioritized. Please see later in the article for the Editors' Summary
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Affiliation(s)
- Ruby Singhrao
- Global Health Sciences, University of California San Francisco, San Francisco, California, USA.
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