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Endrikat J, Schmidt G, Oak B, Shukla V, Nangia P, Schleyer N, Crocker J, Pijnapppel R. Awareness of Breast Cancer Risk Factors in Women with vs. Without High Breast Density. Patient Prefer Adherence 2024; 18:1577-1588. [PMID: 39100427 PMCID: PMC11298181 DOI: 10.2147/ppa.s466992] [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: 04/03/2024] [Accepted: 07/20/2024] [Indexed: 08/06/2024] Open
Abstract
Purpose Women with high breast density (HBD) carry an increased risk for breast cancer (BC). The aim of the study was to provide data on awareness and knowledge gaps among women with vs w/o HBD about BC risk factors (BCRFs), which is the basis for effective communication about screening. Patients and Methods This was a web-based survey of 3000 women aged ≥30 and ≤70 from six countries. It comprised of 45 questions. T-tests and chi-square tests with False Discovery Rate adjustments were conducted as applicable, with significant differences reported at α=0.05. Results Three-thousand women were included in the analysis, 733 (24.4%) had HBD. Overall, 39% of women were familiar with the concept of HBD in the context of BC. Thirty-one percent of women were aware of HBD as BCRF and for 24% of women HBD was personally applicable. A significantly higher proportion of women with HBD were aware of almost all BCRFs compared to women w/o HBD (p ≤ 0.05). Similarly, a significantly higher proportion of women with HBD have undergone screening procedures compared to women w/o HBD (p ≤ 0.05). Women with HBD were significantly better aware of basic facts about BC (p ≤ 0.05). A total of 1617 women underwent mammography, 904 ultrasound and 150 MRI during their last screening. The most relevant source of information about BC was the health care professional, as reported by 63% of women. Conclusion Overall 39% of women were familiar with HBD as BCRF. Lack of BCRF awareness may contribute to delayed screenings, missed opportunities for early detection, and potentially poorer outcomes for individuals with dense breast tissue. Thus, this information should be communicated more widely.
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Affiliation(s)
- Jan Endrikat
- Radiology, Bayer AG, Berlin, Germany
- Department of Gynecology, Obstetrics and Reproductive Medicine, University Medical School of Saarland, Homburg, Saar, Germany
| | - Gilda Schmidt
- Department of Gynecology, Obstetrics and Reproductive Medicine, University Medical School of Saarland, Homburg, Saar, Germany
| | | | | | | | | | | | - Ruud Pijnapppel
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
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2
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Zhu L, Zhou Q, Huang Z, Yang Y, Yang Y, Du Y, Zhao Y, Yu X, Li T, Chen W. Factors Influencing Breast Cancer Awareness in Rural Southwest China: A Cross-Sectional Study. Int J Womens Health 2024; 16:509-518. [PMID: 38533523 PMCID: PMC10964776 DOI: 10.2147/ijwh.s453857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/25/2024] [Indexed: 03/28/2024] Open
Abstract
Background This study aimed to explore the current knowledge level of breast cancer among rural women in Southwest China and analyze the influencing factors of breast cancer cognition. Methods From May to November 2022, 1468 rural women were invited to participate in this study. Demographic information and the Chinese version of the Breast Cancer Awareness Measure (C-BCAM) were collected through one-on-one investigations. The data were analyzed using descriptive statistics, chi-square tests, and multiple regression analysis in SPSS 26.0. Results The study included a total of 1468 rural women with a median age of 54.0 (IQR, 47.0, 60.0).The average score of breast cancer in the study population was 73.0 (IQR, 66.0, 82.0). Among women in Southwest China, the awareness rates of knowledge on breast cancer symptoms, barriers to seeking medical help, and risk factors were 68.8%, 98.4%, and 62.1%, respectively. The awareness rate was found to increase with higher education levels (P<0.001) and decrease with increasing age (P<0.001). Multivariate logistic regression analysis identified three variables that might influence breast cancer awareness: education level, contraceptive measures, and history of breast disease (all P<0.05). Specifically, history of breast disease (Odds ratio (OR) = 1.907, 95% CI = 1.128 ~ 3.223), middle school education (OR = 2.155, 95% CI = 1.585 ~ 2.928), and junior college education and above (OR = 5.536, 95% CI = 1.898 ~ 16.148) were positive factors for women's breast cancer awareness. Conversely, the use of intrauterine devices (OR = 0.523, 95% CI = 0.384 ~ 0.712) was found to be a negative factor for women's breast cancer awareness. Conclusion This study highlights the insufficient awareness of breast cancer among women in rural area of Southwest China. It emphasizes the necessity of health education to improve female breast cancer awareness.
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Affiliation(s)
- Lingling Zhu
- College of Public Health, Chengdu Medical College, Chengdu, Sichuan, 610500, People’s Republic of China
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Qiang Zhou
- College of Public Health, Chengdu Medical College, Chengdu, Sichuan, 610500, People’s Republic of China
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Ziyue Huang
- Mianyang Maternal and Child Health Care Hospital, Mianyang, Sichuan, 621000, People’s Republic of China
| | - Yuan Yang
- School of Public Health, Xiamen University, Xiamen, Fujian, 361102, People’s Republic of China
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People’s Republic of China
| | - Ying Yang
- Yanting County Maternal and Child Health Hospital, Mianyang, Sichuan, 621600, People’s Republic of China
| | - Yao Du
- Yanting County Maternal and Child Health Hospital, Mianyang, Sichuan, 621600, People’s Republic of China
| | - Yuqian Zhao
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Xiaoping Yu
- School of Preclinical Medicine, Chengdu University, Chengdu, Sichuan, 610106, People’s Republic of China
| | - Tingyuan Li
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Wen Chen
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People’s Republic of China
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Elshami M, Qawasmi MA, Ghithan RJ, Al-Slaibi I, Alser M, Shurrab NR, Ismail IO, Mahfouz II, AbdulQader Fannon A, Hawa MR, Giacaman N, Ahmaro M, Okshiya HM, Zaatreh RK, AbuKhalil WA, Usrof FD, Melhim NK, Madbouh RJ, Abu Hziema HJ, Abed-Allateef Lahlooh R, Ubaiat SN, Jaffal NA, Alawna RK, Abed SN, Abuzahra BN, Abu Kwaik AJ, Dodin MH, Taha RO, Alashqar DM, Mobarak RAA, Smerat T, Albarqi SI, Abu-El-Noor N, Bottcher B. Barriers to Timely Seeking of Breast Cancer Care Among Palestinian Women: A Cross-Sectional Study. JCO Glob Oncol 2024; 10:e2300373. [PMID: 38386955 PMCID: PMC10898679 DOI: 10.1200/go.23.00373] [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: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 02/24/2024] Open
Abstract
PURPOSE Examining the association of breast cancer (BC) symptom awareness with time to help seeking and exploring barriers to timely presentation may enhance the effectiveness of BC awareness campaigns and early detection efforts. This study aimed to assess the anticipated time for seeking medical advice when experiencing a potential BC symptom among women in Palestine and to identify their barriers to early presentation. MATERIALS AND METHODS A convenience sampling method was used to recruit adult women from hospitals, primary health care facilities, and public areas across 11 governorates in Palestine. A translated-into-Arabic version of the validated BC Awareness Measure was used. The questionnaire consisted of three sections: sociodemographic information, recognition of 13 BC symptoms and reporting time for seeking medical advice, and barriers to early presentation. RESULTS A total of 5,257 questionnaires were included. The proportion of participants who would seek medical advice immediately varied on the basis of the nature of BC symptoms. For symptoms related to the breast, the proportion ranged from 25.7% for redness of the breast skin to 53.5% for a lump or thickening in the breast. For symptoms related to the nipple, the proportion ranged from 30.7% for nipple rash to 48.0% for discharge or bleeding from the nipple. Exhibiting good BC symptom awareness was associated with a higher likelihood of seeking medical advice within a week for all BC symptoms. Emotional barriers were the most frequently reported barriers. There was no association between increasing levels of BC awareness and reporting fewer or more barriers. CONCLUSION The nature of BC symptoms had an impact on help-seeking behaviors. Participants with good BC symptom awareness were more likely to seek medical advice earlier.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH
- Ministry of Health, Gaza, Palestine
| | - Malak Ayman Qawasmi
- Department of Medical Laboratory Sciences, Hebron University, Hebron, Palestine
| | | | | | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East, Gaza, Palestine
| | | | | | | | | | | | | | - Manar Ahmaro
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | - Faten Darwish Usrof
- Faculty of Health Sciences Master of Medical Laboratory Sciences, Islamic University of Gaza, Gaza, Palestine
| | | | | | | | | | | | - Nour Ali Jaffal
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | | | | | | | - Tasneem Smerat
- Faculty of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
| | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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AlRajhi B, Aljadani FF, Almarwan SR, Alzahrani AA, Sindi MHM, Kano A, Alzahrani RS, Baaqeel R. Breast Cancer Awareness Among Women in Saudi Arabia: A Systematic Review. BREAST CANCER (DOVE MEDICAL PRESS) 2023; 15:913-924. [PMID: 38111500 PMCID: PMC10726713 DOI: 10.2147/bctt.s426079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 11/03/2023] [Indexed: 12/20/2023]
Abstract
Purpose Breast cancer (BC) is the most prevalent cancer worldwide, and second most common cause of cancer-related deaths among women worldwide. Early detection of BC significantly improves prognosis; thus, awareness is an important aspect of BC morbidity and survival as well as the economic burden. This systematic review aimed to explore awareness of BC among women in Saudi Arabia. Patients and Methods A systematic search was performed using Medline, Scopus, the Directory of Open Access Journals (DOAJ), and Google Scholar for all cross-sectional studies conducted in Saudi Arabia, published after the year 2000 and in English. The quality assessment of the included studies was performed using the AXIS tool. Results The total number of included articles after full-text assessment was 13 articles that were conducted between 2005 and 2022. The sample size of all the articles was 7,562 women. All the studies categorized BC awareness into low, moderate, and high groups. The level of low awareness among women reached 66.3% (n=2808), 13.5% (n=570) had moderate awareness levels, and 20.2% (n=858) had high awareness levels. Furthermore, 59.4% (n=1446) of the participants did not perform breast self-examination (BSE) regularly. Conclusion The level of awareness and knowledge regarding BC and BSE was significantly low among women in Saudi Arabia, as all included studies except one have indicated. We highly recommend and urge the implementation of effective special programs and campaigns to raise awareness regarding BC and integrating BSE into school health programs dedicated to women living in Saudi Arabia.
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Affiliation(s)
- Bassam AlRajhi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Faisal F Aljadani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Shahad Rafed Almarwan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Atheer Abdullah Alzahrani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Mostafa Hatim M Sindi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Abdulaziz Kano
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Raghad Saleh Alzahrani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Rasha Baaqeel
- Section of Plastic Surgery, Department of Surgery, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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Igissin N, Toguzbayeva A, Khamidullina Z, Telmanova Z, Bilyalova Z, Kudaibergenova I, Muratbekova S, Igissinova G, Rustemova K, Kulmirzayeva D, Syzdykov N, Taszhanov R, Turebayev D, Orazova G, Kassenova D, Detochkina V, Baibosynov D, Kuandykov Y. Epidemiology of Breast Cancer Mortality in Kazakhstan, trends and Geographic Distribution. Asian Pac J Cancer Prev 2023; 24:3361-3371. [PMID: 37898839 PMCID: PMC10770671 DOI: 10.31557/apjcp.2023.24.10.3361] [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: 09/26/2022] [Accepted: 10/10/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND According to the International Agency for Research on Cancer, ongoing demographic changes will lead to an increase in the number of deaths from breast cancer (BC) per year in the vast majority of regions. In 2040 it is expected that 1.04 million people worldwide will die from this malignancy, including 2,380 women in Kazakhstan. METHODS The retrospective study (2009-2018) was done using descriptive and analytical methods of oncoepidemiology. The extensive, crude and age-specific incidence rates are determined according to the generally accepted methodology used in sanitary statistics. The data were used to calculate the average percentage change (APС) using the Joinpoint regression analysis to determine the trend over the study period. RESULTS During 10 years 12,958 women died from BC. An average age of the death was 61.6 years (95%CI=60.6-62.6) and tended to increase (APC=+0.6%, R2=0.6117). Age-specific rates had a bimodal increase with peak rates at 70-74 years - 76.7±5.5 (APC=+3.4%, R2=0.2656) and 80-84 years - 78.0±9.1 (APC=+3.7%, R2=0.0875). The age-standardized rate was 13.9 per 100,000 of female population, and the trend has decreased. When compiling thematic maps, mortality rates were determined on the basis of standardized indicators: low - up to 12.5, average - from 12.5 to 15.2, high - above 15.2 per 100,000. The results of the spatial analysis showed the regions with a higher levels of BC mortality rate per 100,000: Pavlodar (16.9), Almaty (19.2) and Astana cities (19.3). CONCLUSIONS Age-standardized mortality rates had a strong downward trend (APC=-4.0%, R2=0.9218). The decrease mostly is due to a large coverage of the population by mammography screening and to an improvement in the effectiveness of breast cancer treatment.
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Affiliation(s)
- Nurbek Igissin
- Research Institute of Life and Health Sciences, Higher School of Medicine, Kokshetau University named after Sh. Ualikhanov, Kokshetau, Kazakhstan.
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Asian Pacific Organization for Cancer Prevention, Bishkek, Kyrgyzstan.
| | - Assem Toguzbayeva
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.
| | | | - Zhansaya Telmanova
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Asian Pacific Organization for Cancer Prevention, Bishkek, Kyrgyzstan.
| | - Zarina Bilyalova
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Asian Pacific Organization for Cancer Prevention, Bishkek, Kyrgyzstan.
| | - Indira Kudaibergenova
- Asian Pacific Organization for Cancer Prevention, Bishkek, Kyrgyzstan.
- Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan.
| | - Svetlana Muratbekova
- Research Institute of Life and Health Sciences, Higher School of Medicine, Kokshetau University named after Sh. Ualikhanov, Kokshetau, Kazakhstan.
| | - Gulnur Igissinova
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.
| | - Kulsara Rustemova
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Astana Medical University, Astana, Kazakhstan.
| | | | - Nariman Syzdykov
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Health Department of the Akmola region, Kokshetau, Kazakhstan.
| | - Rustem Taszhanov
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Kokshetau Higher Medical College, Kokshetau, Kazakhstan.
| | - Dulat Turebayev
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Astana Medical University, Astana, Kazakhstan.
| | | | - Dinara Kassenova
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Astana Medical University, Astana, Kazakhstan.
| | | | - Daulet Baibosynov
- Central Asian Institute for Medical Research, Astana, Kazakhstan.
- Astana Medical University, Astana, Kazakhstan.
| | - Yerlan Kuandykov
- Khoja Akhmet Yassawi International Kazakh-Turkish University, Shymkent, Kazakhstan.
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Ng B, Puspitaningtyas H, Wiranata JA, Hutajulu SH, Widodo I, Anggorowati N, Sanjaya GY, Lazuardi L, Sripan P. Breast cancer incidence in Yogyakarta, Indonesia from 2008-2019: A cross-sectional study using trend analysis and geographical information system. PLoS One 2023; 18:e0288073. [PMID: 37406000 DOI: 10.1371/journal.pone.0288073] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/17/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Breast cancer is a significant public health concern worldwide, including in Indonesia. Little is known about the spatial and temporal patterns of breast cancer incidence in Indonesia. This study aimed to analyze temporal and spatial variations of breast cancer incidence in Yogyakarta Province, Indonesia. METHODS The study used breast cancer case data from the Yogyakarta Population-Based Cancer Registry (PBCR) from 2008 to 2019. The catchment areas of the PBCR included the 48 subdistricts of 3 districts (Sleman, Yogyakarta City, and Bantul). Age-standardized incidence rates (ASR) were calculated for each subdistrict. Joinpoint regression was used to detect any significant changes in trends over time. Global Moran's and Local Indicators of Spatial Association (LISA) analyses were performed to identify any spatial clusters or outliers. RESULTS The subdistricts had a median ASR of 41.9, with a range of 15.3-70.4. The majority of cases were diagnosed at a late stage, with Yogyakarta City having the highest proportion of diagnoses at stage 4. The study observed a significant increasing trend in breast cancer incidence over the study period the fastest of which is in Yogyakarta City with an average annual percentage change of 18.77%, with Sleman having an 18.21% and Bantul having 8.94% average changes each year (p <0.05). We also found a significant positive spatial autocorrelation of breast cancer incidence rates in the province (I = 0.581, p <0.001). LISA analysis identified 11 subdistricts which were high-high clusters in the central area of Yogyakarta City and six low-low clusters in the southeast region of the catchment area in the Bantul and Sleman Districts. No spatial outliers were identified. CONCLUSIONS We found significant spatial clustering of BC ASR in the Yogyakarta Province, and there was a trend of increasing ASR across the region. These findings can inform resource allocation for public health efforts to high-risk areas and develop targeted prevention and early detection strategies. Further res is needed to understand the factors driving the observed temporal and spatial patterns of breast cancer incidence in Yogyakarta Province, Indonesia.
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Affiliation(s)
- Bryant Ng
- Faculty of Medicine, Medicine Study Program, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Herindita Puspitaningtyas
- Faculty of Medicine, Doctorate Program of Health and Medical Science, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Juan Adrian Wiranata
- Academic Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Faculty of Medicine, Master Program in Clinical Epidemiology, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Susanna Hilda Hutajulu
- Faculty of Medicine, Department of Internal Medicine, Division of Hematology and Medical Oncology, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Irianiwati Widodo
- Faculty of Medicine, Department of Anatomical Pathology, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Nungki Anggorowati
- Faculty of Medicine, Department of Anatomical Pathology, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Guardian Yoki Sanjaya
- Faculty of Medicine, Department of Health Policy and Management, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Lutfan Lazuardi
- Faculty of Medicine, Department of Health Policy and Management, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Patumrat Sripan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
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Pillai D, Narayan J, Gentry-Maharaj A, Deo S, Vijaykumar DK, Mukherjee P, Wadhwa N, Bhasin A, Mishra A, Rajanbabu A, Kannan R, Husain Z, Kumar A, Antoniou AC, Manchanda R, Menon U. Co-Creation of Breast Cancer Risk Communication Tools and an Assessment of Risk Factor Awareness: A Qualitative Study of Patients and the Public in India. Cancers (Basel) 2023; 15:2973. [PMID: 37296935 PMCID: PMC10252022 DOI: 10.3390/cancers15112973] [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: 03/23/2023] [Revised: 05/16/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Low awareness of BC and its associated risk factors causes delays in diagnosis and impacts survival. It is critical to communicate BC risk to patients in a format that they are easily able to understand. Our study aim was to develop easy-to-follow transmedia prototypes to communicate BC risk and evaluate user preferences, alongside exploring awareness of BC and its risk factors. METHODS Prototypes of transmedia tools for risk communication were developed with multidisciplinary input. A qualitative in-depth online interview study was undertaken using a pre-defined topic guide of BC patients (7), their relatives (6), the general public (6), and health professionals (6). Interviews were analyzed using a thematic approach. FINDINGS Most participants preferred pictographic representations (frequency format) of lifetime risk and risk factors and storytelling using short animations and comic strips (infographics) for communicating genetic risk and testing: "In a short time, they explained it very well, and I liked it". Suggestions included minimizing technical terminology, decreasing the delivery speed, "two-way dialogue", and using local "language for different locations". There was low awareness of BC, with some understanding of age and hereditary risk factors but limited knowledge of reproductive factors. INTERPRETATION Our findings support use of multiple context-specific multimedia tools in communicating cancer risk in an easy-to-understand way. The preference for storytelling using animations and infographics is a novel finding and should be more widely explored.
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Affiliation(s)
- Divya Pillai
- Translational Health Science & Technology Institute, NCR Biotech Science Cluster, Faridabad—Gurgaon Expressway, Faridabad 121001, India
| | | | - Aleksandra Gentry-Maharaj
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, Faculty of Population Health Sciences, University College London, London WC1V 6LJ, UK
| | | | | | - Poulome Mukherjee
- Cachar Cancer Hospital & Research Centre, Meherpur, Silchar 788015, India
| | - Nitya Wadhwa
- Translational Health Science & Technology Institute, NCR Biotech Science Cluster, Faridabad—Gurgaon Expressway, Faridabad 121001, India
| | | | - Ashutosh Mishra
- All India Institute of Medical Sciences, New Delhi 110029, India
| | - Anupama Rajanbabu
- Amrita Institute of Medical Sciences & Research Centre, Kochi 682041, India
| | - Ravi Kannan
- Cachar Cancer Hospital & Research Centre, Meherpur, Silchar 788015, India
| | - Zakir Husain
- 86/1 College Street, Economics Department, Presidency University Kolkata, Kolkata 700073, India
| | | | - Antonis C. Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Ranjit Manchanda
- Wolfson Institute of Population Health, Barts CRUK Cancer Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Department of Gynaecological Oncology, Barts Health NH Trust, London EC1A 7BE, UK
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | - Usha Menon
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, Faculty of Population Health Sciences, University College London, London WC1V 6LJ, UK
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8
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Bohsas H, Alibrahim H, Swed S, Khan U, Al Ibrahim M, Nashwan AJ, Hodaifah S, AlAli A, Alhalaky N, Sawaf B, Habib MB, Fathey S, Rashid G, Hafez W. Assessing Syrian women's knowledge of breast cancer risk factors, warning signs, and barriers to preventive measures: A cross-sectional study. Cancer Treat Res Commun 2023; 36:100717. [PMID: 37159973 DOI: 10.1016/j.ctarc.2023.100717] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/20/2023] [Accepted: 05/01/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND This study aims to investigate the knowledge of Syrian women about breast cancer risk factors, warning signals, and barriers. Breast cancer is the most common cancer worldwide and the leading cause of cancer death among women. It develops when cells in the breast tissue grow uncontrollably, forming a tumor that can spread to other parts of the body. MATERIALS AND METHODS This survey was conducted online from September 3 to September 27, 2022, and focused on Syrian women over the age of 18. It was divided into two sections, one focusing on sociodemographic characteristics and the other on breast cancer risk factors, warning signals, and barriers. RESULTS This study found that the majority of the 1305 participants had inadequate knowledge of breast cancer risk factors, warning signs, and barriers. Those with higher levels of education, such as Ph.D. students, had the highest overall scores. The sample was mostly made up of housewives, married women, and women with moderate monthly incomes. CONCLUSION This research found that Syrian women have inadequate knowledge about breast cancer, including risk factors, warning signs, and barriers. To reduce mortality rates, increase survival rates, and improve early diagnosis, local health organizations should provide awareness courses to emphasize the importance of annual breast exams.
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Affiliation(s)
| | | | - Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria
| | - Ubaid Khan
- King Edward Medical University, Lahore, Pakistan
| | - Mohamad Al Ibrahim
- Department of Biotechnology Engineering, Faculty of Technical Engineering, University of Aleppo, Aleppo, Syria
| | | | | | - Aya AlAli
- Faculty of Medicine, Al-Furat University, Damascus, Syria
| | - Najwa Alhalaky
- Faculty of Medicine, Damascus University, Damascus, Syria.
| | - Bisher Sawaf
- Department of Internal Medicine, Hamad Medical Coropetation, Doha, Qatar.
| | - Mhd Baraa Habib
- Department of Internal Medicine, Hamad Medical Coropetation, Doha, Qatar.
| | | | - Gowhar Rashid
- Amity Medical School, Amity University Gurugram Haryana, India
| | - Wael Hafez
- NMC Royal Hospital, 16th Street, Khalifa City, Abu Dhabi, UAE; Medical Research Division, Department of Internal Medicine, The National Research Centre, Cairo, Egypt
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9
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Álvarez-Pardo S, De Paz JA, Montserrat Romero-Pérez E, Portilla-Cueto KM, Horta-Gim MA, González-Bernal JJ, Fernández-Solana J, Mielgo-Ayuso J, García-Valverde A, González-Santos J. Factors Associated with Body Image and Self-Esteem in Mastectomized Breast Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5154. [PMID: 36982062 PMCID: PMC10048946 DOI: 10.3390/ijerph20065154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/04/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
Body image (BI) and self-esteem (SE) are two fundamental aspects in the evolution of breast cancer (BC), mainly due to surgery, treatment, and the patient's conception of BI. A dissatisfaction with BI and low SE decreases the subject's quality of life and increases the risk of recurrence and mortality by BC. The aim of this study is to find out if there is any degree of association between the sociodemographic data of the sample and their BI and SE. A cross-sectional, descriptive study was conducted with 198 women diagnosed with BC, aged 30-80 years, in Mexico. Women's BI and SE were assessed using two questionnaires, Hopwood Body Image Scale (S-BIS) and Rosenberg Self-Esteem Scale (RSES). The results show significant differences in several items when the variable sense of humor is taken into account, indicating that women with a sense of humor report higher satisfaction with their BI and higher SE. The age also indicates a significantly better BI in women over 50 years of age, as well as the education level variable, where those women who had studied up to secondary reported higher satisfaction with their BI; the family history shows that those women without a family history report better SE. All these data are supported by stepwise regression, which shows that educational level and sense of humor are predictors of BI, and family history along with breast reconstruction and sense of humor are predictors as of SE. In conclusion, it is important to take into account the characteristics of women with BC, particularly age and sense of humor, in order to reduce the impact of the disease on their BI and SE with the help of a multidisciplinary team.
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Affiliation(s)
| | | | | | | | - Mario A. Horta-Gim
- Division of Biological Sciences and Health, University of Sonora, Hermosillo 83000, Mexico
| | | | | | - Juan Mielgo-Ayuso
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain
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10
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Florez-Garcia VA, Guevara-Romero EC, Hawkins MM, Bautista LE, Jenson TE, Yu J, Kalkbrenner AE. Cadmium exposure and risk of breast cancer: A meta-analysis. ENVIRONMENTAL RESEARCH 2023; 219:115109. [PMID: 36563983 PMCID: PMC9957608 DOI: 10.1016/j.envres.2022.115109] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/28/2022] [Accepted: 12/17/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Cadmium is a heavy metal with carcinogenic properties, highly prevalent in industrialized areas worldwide. Prior reviews evaluating whether cadmium influences breast cancer have been inconclusive and not reflected several recent studies. OBJECTIVE To evaluate the association between cadmium exposure and female breast cancer incidence, with an emphasis on separately estimating dietary vs. airborne vs. biomarker measures of cadmium and studies published until October 2022. METHODS We evaluated risk of bias using set criteria and excluded one study judged to have high risk based on self-report of breast cancer and insufficient adjustment. We conducted a random effects meta-analysis of epidemiological studies, including subgroups by exposure route and by menopausal status. RESULTS A total of 17 studies were eligible for our meta-analysis. Only 2 studies addressed airborne cadmium directly. Breast cancer risk was elevated in women exposed to higher levels of cadmium across all studies - pooled odds ratio: 1.13 (95% confidence interval: 1.00, 1.28), with notable heterogeneity between studies (I2 = 77%). When examining separately by exposure route, dietary cadmium was not linked with an elevated risk - (OR: 1.05; 95%CI: 0.91, 1.21; I2 = 69%), consistent with prior reviews, but biomarker-based studies showed an elevated but non-significant pooled measure (OR: 1.37; 95%CI: 0.96, 1.94; I2 = 84%). We did not observe any clear patterns of different risk by menopausal status. CONCLUSION Findings from our meta-analysis suggest that exposure to higher cadmium increases the risk of breast cancer in women, but with remaining questions about whether non-dietary exposure may be more risky or whether residual confounding by constituents of tobacco smoke may be at play.
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Affiliation(s)
- V A Florez-Garcia
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, 5321, USA; Department of Public Health. Universidad Del Norte, Barranquilla. Colombia.
| | - E C Guevara-Romero
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, 5321, USA
| | - M M Hawkins
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, 5321, USA; Public Health. Carroll University College of Health Sciences. 100 N East Ave, Waukesha, WI, 53186, USA
| | - L E Bautista
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, 610 Walnut Street, WARF 703, Madison, WI, 53726-2397, USA
| | - T E Jenson
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, 5321, USA
| | - J Yu
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, 5321, USA
| | - A E Kalkbrenner
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, 5321, USA
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11
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Perceptions and knowledge of breast cancer and breast self-examination among young adult women in southwest Ethiopia: Application of the health belief model. PLoS One 2022; 17:e0274935. [PMID: 36129946 PMCID: PMC9491534 DOI: 10.1371/journal.pone.0274935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 09/08/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Breast cancer is still a recognized public health issue in Ethiopia. Despite this, the viewpoints and comprehensions of young women about the situation are unknown. Therefore, this study was carried out to assess the knowledge and perceptions of young adult women in Southwest Ethiopia about breast cancer and breast self-examination (BSE).
Methods
A community-based cross-sectional study was carried out in the Gurage zone, southwest Ethiopia, in 2021. A total of 392 young adult women were randomly selected from both urban and rural strata using a three-stage stratified sampling process. A pretested questionnaire was used to collect the data. For data entry, Epi-data 4.6 with a double-entry approach was used, and for analysis, SPSS 26 was used. Bivariate and multivariable logistic regression analyses were performed to identify variables associated with BSE behavior. A p-value of 0.05 or below was considered statistically significant with a 95% CI.
Results
The respondents’ ages ranged from 20 to 24, with a mean of 21.25 (±1.32) years. Breast cancer and BSE were unknown to more than 80% of the study participants. A large proportion of young adult women had low perceived susceptibility (97.6%), low threat of breast cancer (96%), and low self-efficacy to perform BSE (91.4%). BSE was conducted by 23.1% of the participants occasionally. Being married (AOR = 5.31, 95% CI = 2.19–12.90), having good outcome expectations of BSE (AOR = 2.05, 95% CI = 1.16–3.61), having good BSE knowledge (AOR = 1.22, 95% CI = 1.04–1.45), having high perceived susceptibility (AOR = 1.12, 95% CI = 1.05–1.20), high perceived severity (AOR = 1.78, 95% CI = 1.02–3.09), and having high self-efficacy to do BSE (AOR = 1.05, 95% CI = 1.01–1.09) were all significant predictors of BSE practice.
Conclusions
Young adult women were less concerned about breast cancer and had insufficient knowledge of breast cancer and breast self-examination. They have little knowledge of, confidence in, or experience with BSE. The practice of BSE was associated with increased perceived susceptibility, self-efficacy, severity, outcome expectations, and BSE knowledge. Therefore, these variables should be considered when developing educational interventions for young women.
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12
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Wang YJ, Wang F, Yu LX, Xiang YJ, Zhou F, Huang SY, Zheng C, Fu QY, Li L, Gao DZ, Zhang Q, Ma ZB, Yu ZG, Liu LY. Worldwide review with meta-analysis of women's awareness about breast cancer. PATIENT EDUCATION AND COUNSELING 2022; 105:1818-1827. [PMID: 34952749 DOI: 10.1016/j.pec.2021.12.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 12/11/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To summarize the awareness levels of breast cancer (BC) worldwide and investigate factors associated with BC awareness to determine differences in awareness between China and other countries. METHODS This systematic review followed the PRISMA guidelines and included 92 articles up to July, 2021. We calculated percentages for BC awareness levels and conducted subgroup analysis and cumulative meta-analysis. RESULTS A total 84% (95% confidence interval [95%CI]: 78-90%) of women knew about BC; however, only 51% (95%CI: 37-66%) and 40% (95%CI: 24-56%) of women were aware of BC symptoms and BC risk factors, respectively. The most commonly known BC symptom was breast lump (71%, 95%CI: 62-80%), and BC family history was the most well-known BC risk factor (61%, 95%CI: 54-69%). Subgroup analysis showed lower awareness levels among Chinese and Asian women than women from other countries. Cumulative meta-analysis showed no obvious progress in BC awareness levels over time. We investigated 15 awareness-related factors, the most frequent of which were education level (61.8%), occupation (29.4%), and age (26.5%). CONCLUSION BC awareness levels remain low. Improving BC awareness is critical, especially in developing countries. PRACTICE IMPLICATIONS Effective education programs are urgently needed to improve women's BC awareness.
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Affiliation(s)
- Yong-Jiu Wang
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Fei Wang
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Li-Xiang Yu
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Yu-Juan Xiang
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Fei Zhou
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Shu-Ya Huang
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Chao Zheng
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Qin-Ye Fu
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Liang Li
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - De-Zong Gao
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Qiang Zhang
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Zhong-Bing Ma
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Zhi-Gang Yu
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Li-Yuan Liu
- Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China.
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13
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Šantrić Milićević M, Djurin A, Terzić-Šupić Z, Todorović J, Nikolić D, Soldatović I. Knowledge and barriers to early detection of breast cancer among female primary care patients in Serbia. Cent Eur J Public Health 2022; 30:119-130. [PMID: 35876601 DOI: 10.21101/cejph.a6305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 05/16/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Breast cancer is the leading cause of cancer mortality among women in Serbia and accounts for 22.8% of total cancer mortality in 2018. This study assessed the knowledge and barriers to early detection of breast cancer in women. METHODS In March 2019, at the Primary Healthcare Centre Kikinda, Serbia, a 22-item questionnaire was distributed to a series of patients (N = 403, response rate 91.8%) to assess the odds ratio (OR) and 95% confidence interval (CI) between variables explaining knowledge of breast cancer symptoms and risk factors and barriers to screening, and four types of early detection of breast cancer. RESULTS The majority of patients (85.4%) know that a lump in a breast is a common symptom of breast cancer and that a family history of breast cancer is a risk factor (80.1%); 63.8% of respondents aged ≥ 30 years self-examined their breasts in the past month, 39.1% of patients aged ≥ 40 years had clinical, while 34.4% had ultrasound breast examination in the past year, and 51.1% of patients aged ≥ 50 years had mammography once in the past two years. Patients aged ≥ 40 years retired and those with a positive family history were 84% and 63% less likely not to undergo a clinical breast examination in the past year. Participants over 40 years of age who reported a lack of funds were 2.46 times more likely to miss a clinical breast examination than those who did not have that barrier. Among participants aged 50-69 years, the likelihood of not receiving the mammography increases by 2.82 with an increase in wealth status and it was 65% lower for those who lack information about the available treatment. CONCLUSION Women under the age of 50 rarely practice breast cancer screening. Study findings can be used to improve breast cancer screening at the primary level.
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Affiliation(s)
| | - Ana Djurin
- Primary Healthcare Centre of Kikinda, Kikinda, Serbia
| | - Zorica Terzić-Šupić
- Faculty of Medicine, Institute of Social Medicine, University of Belgrade, Belgrade, Serbia
| | - Jovana Todorović
- Faculty of Medicine, Institute of Social Medicine, University of Belgrade, Belgrade, Serbia
| | - Dejan Nikolić
- University Children's Hospital, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivan Soldatović
- Faculty of Medicine, Institute for Statistics and Medical Informatics, University of Belgrade, Belgrade, Serbia
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14
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Dewi TK, Ruiter RA, Ardi R, Massar K. The role of psychosocial variables in breast self‐examination practice: Results from focus group discussions in Surabaya, Indonesia. Psychooncology 2022; 31:1169-1177. [PMID: 35184356 PMCID: PMC9543474 DOI: 10.1002/pon.5905] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/19/2022] [Accepted: 02/09/2022] [Indexed: 11/08/2022]
Abstract
Introduction Method Results Conclusion
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Affiliation(s)
- Triana Kesuma Dewi
- Department of Work and Social Psychology Faculty of Psychology and Neuroscience Maastricht University
- Department of Psychology Faculty of Psychology Universitas Airlangga
| | - Robert A.C. Ruiter
- Department of Work and Social Psychology Faculty of Psychology and Neuroscience Maastricht University
| | - Rahkman Ardi
- Department of Psychology Faculty of Psychology Universitas Airlangga
| | - Karlijn Massar
- Department of Work and Social Psychology Faculty of Psychology and Neuroscience Maastricht University
- Department of Psychology Faculty of Psychology Universitas Airlangga
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15
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Hutajulu SH, Prabandari YS, Bintoro BS, Wiranata JA, Widiastuti M, Suryani ND, Saptari RG, Taroeno-Hariadi KW, Kurnianda J, Purwanto I, Hardianti MS, Allsop MJ. Delays in the presentation and diagnosis of women with breast cancer in Yogyakarta, Indonesia: A retrospective observational study. PLoS One 2022; 17:e0262468. [PMID: 35025941 PMCID: PMC8757982 DOI: 10.1371/journal.pone.0262468] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 12/23/2021] [Indexed: 11/19/2022] Open
Abstract
Purpose
To investigate factors associated with delays in presentation and diagnosis of women with confirmed breast cancer (BC).
Methods
A cross-sectional study nested in an ongoing prospective cohort study of breast cancer patients at Dr Sardjito Hospital, Yogyakarta, Indonesia, was employed. Participants (n = 150) from the main study were recruited, with secondary information on demographic, clinical, and tumor variables collected from the study database. A questionnaire was used to gather data on other socioeconomic variables, herbal consumption, number of healthcare visits, knowledge-attitude-practice of BC, and open-ended questions relating to initial presentation. Presentation delay (time between initial symptom and first consultation) was defined as ≥3 months. Diagnosis delay was defined as ≥1 month between presentation and diagnosis confirmation. Impact on disease stage and determinants of both delays were examined. A Kruskal-Wallis test was used to assess the length and distribution of delays by disease stage. A multivariable logistic regression analysis was conducted to explore the association between delays, cancer stage and factors.
Results
Sixty-five (43.3%) patients had a ≥3-month presentation delay and 97 (64.7%) had a diagnosis confirmation by ≥1 month. Both presentation and diagnosis delays increased the risk of being diagnosed with cancer stage III-IV (odds ratio/OR 2.21, 95% CI 0.97–5.01, p = 0.059 and OR 3.03, 95% CI 1.28–7.19, p = 0.012). Visit to providers ≤3 times was significantly attributed to a reduced diagnosis delay (OR 0.15, 95% CI 0.06–0.37, p <0.001), while having a family history of cancer was significantly associated with increased diagnosis delay (OR 2.28, 95% CI 1.03–5.04, p = 0.042). The most frequent reasons for delaying presentation were lack of awareness of the cause of symptoms (41.5%), low perceived severity (27.7%) and fear of surgery intervention (26.2%).
Conclusions
Almost half of BC patients in our setting had a delay in presentation and 64.7% experienced a delay in diagnosis. These delays increased the likelihood of presentation with a more advanced stage of disease. Future research is required in Indonesia to explore the feasibility of evidence-based approaches to reducing delays at both levels, including educational interventions to increase awareness of BC symptoms and reducing existing complex and convoluted referral pathways for patients suspected of having cancer.
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Affiliation(s)
- Susanna Hilda Hutajulu
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia
- * E-mail:
| | - Yayi Suryo Prabandari
- Department of Health Behaviour, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Center of Health Behaviour and Promotion, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Bagas Suryo Bintoro
- Department of Health Behaviour, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Center of Health Behaviour and Promotion, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Juan Adrian Wiranata
- Medical Internship Program, Academic Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Mentari Widiastuti
- Center of Health Behaviour and Promotion, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Norma Dewi Suryani
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Dr Sardjito Hospital, Yogyakarta, Indonesia
| | - Rorenz Geraldi Saptari
- Medicine Study Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Kartika Widayati Taroeno-Hariadi
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Johan Kurnianda
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ibnu Purwanto
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Mardiah Suci Hardianti
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Matthew John Allsop
- Leeds Institute of Health Sciences, School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
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16
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Almomen A, Arafah M, Alwhaibi M, Alsaigh N, Alshememry A, Alsaleh NB, Alrabeeah D, Al Saleh K, Alshamsan A, Alkholief M. Ceramide expression in relation to breast cancer molecular subtypes in Saudi women. Saudi Pharm J 2021; 29:609-615. [PMID: 34194268 PMCID: PMC8233535 DOI: 10.1016/j.jsps.2021.04.022] [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: 02/04/2021] [Accepted: 04/18/2021] [Indexed: 11/15/2022] Open
Abstract
Background/Introduction Despite advances in the diagnosis and management of breast cancer (BC), it is still associated with high mortality rates. New biomarkers are being developed for the diagnosis, treatment, and prediction of responses of BC. Ceramide (CER), a bioactive sphingolipid, has emerged recently as a useful diagnostic tool in several types of tumors. In this study, we evaluated CER expression in invasive BC and assessed its relation to the molecular subtypes of BC. Materials and methods The clinical data and histopathological slides of 50 patients with invasive ductal carcinoma were retrieved and reviewed. The cases were then stained with a mouse monoclonal anti-ceramide antibody. Pearson correlation was used to assess the correlation between CER percentage and intensity and other clinical and pathological variables. Results CER expression showed a direct relationship with estrogen and progesterone receptors Allred scores. However, it showed an inverse relation with tumor grade, HER2/neu status and Ki-67 index. Conclusions CER expression is likely to be associated with luminal BC molecular subtypes. However, more research is needed to confirm these results and to explore its relation to the different clinical outcomes, including response to treatment and prognosis.
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Affiliation(s)
- Aliyah Almomen
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh 11495, Saudi Arabia.,Nanobiotechnology Unit, College of Pharmacy, King Saud University, Riyadh 11495, Saudi Arabia
| | - Maria Arafah
- Department of Pathology, College of Medicine, King Saud University, Riyadh 11495, Saudi Arabia
| | - Monira Alwhaibi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 11149, Saudi Arabia
| | - Norah Alsaigh
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh 11495, Saudi Arabia
| | - Abdullah Alshememry
- Nanobiotechnology Unit, College of Pharmacy, King Saud University, Riyadh 11495, Saudi Arabia.,Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11495, Saudi Arabia
| | - Nasser B Alsaleh
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Danah Alrabeeah
- Departmnet of Pharmaceutical Services, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia
| | - Khalid Al Saleh
- Division of Hematology-Oncology, Oncology Center, King Saud University Medical City, Riyadh 11495, Saudi Arabia
| | - Aws Alshamsan
- Nanobiotechnology Unit, College of Pharmacy, King Saud University, Riyadh 11495, Saudi Arabia.,Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11495, Saudi Arabia
| | - Musaed Alkholief
- Nanobiotechnology Unit, College of Pharmacy, King Saud University, Riyadh 11495, Saudi Arabia.,Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11495, Saudi Arabia
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17
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Abdel-Salam DM, Mohamed RA, Alyousef HY, Almasoud WA, Alanzi MB, Mubarak AZ, Osman DM. Perceived Barriers and Awareness of Mammography Screening Among Saudi Women Attending Primary Health Centers. Risk Manag Healthc Policy 2020; 13:2553-2561. [PMID: 33209065 PMCID: PMC7670172 DOI: 10.2147/rmhp.s277375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/28/2020] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Mammography screening (MS) is an underutilized screening tool; although it is provided free of charge to the Saudi community. The present study aimed at assessing knowledge and barriers of mammography screening among women attending primary health centers in Aljouf region, Saudi Arabia. MATERIALS AND METHODS A cross-sectional study was carried out among 423 women aged 41-75 years attending ten primary health centers in Aljouf region, Saudi Arabia. Structured interviewing questionnaires were used for data collection. SPSS program, version 24 was used for data analysis. RESULTS The least reported risk factors of BC in this study were early menarche (14.9%), first pregnancy after the age of 30 years (18%), and late menopause (18.7%). Concerning knowledge of MS, 50.8% of the women correctly identified that mammogram is the ideal method for detecting BC. The most encountered personal barriers towards MS were lack of information about mammogram (69.5%), fear of exposure to radiation (67.4%), fear of discovery of BC (62.9%), being busy all the time (62.2%), and fear of cancer treatment (61.9%). Regarding economic barriers, 40% of the participants reported that taking sick leave from work is difficult while 37.8% revealed that mammogram is costly. Concerning health system barriers, the most common barriers were fear of error in diagnosis (62.6%), long time to take medical appointment (57%), and preferring not to have a mammogram except after a doctor recommendation (52.7%). The present study showed that women's education and residence significantly predicted their knowledge. Furthermore, women's education and income significantly predicted their barriers towards MS. CONCLUSION Many barriers toward mammography screening were encountered in the present study. Addressing these barriers and raising awareness about MS may be of great value to increase its uptake by Saudi women.
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Affiliation(s)
- Doaa M Abdel-Salam
- Family and Community Medicine Department, College of Medicine, Jouf University, Aljouf 42421, Saudi Arabia.,Public Health and Community Medicine Department, Faculty of Medicine, Assiut University, Assiut 71526, Egypt
| | - Rehab A Mohamed
- Family Medicine Department, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Hind Y Alyousef
- College of Medicine, Jouf University, Aljouf 42421, Saudi Arabia
| | - Wahaj A Almasoud
- College of Medicine, Jouf University, Aljouf 42421, Saudi Arabia
| | - Mashael B Alanzi
- College of Medicine, Jouf University, Aljouf 42421, Saudi Arabia
| | - Atheer Z Mubarak
- College of Medicine, Jouf University, Aljouf 42421, Saudi Arabia
| | - Doaa M Osman
- Public Health and Community Medicine Department, Faculty of Medicine, Assiut University, Assiut 71526, Egypt
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Napitupulu D, Puspitaningtyas H, Mualim K, Kusumanto A, Lazuardi L, Hutajulu SH. Factors that Affected Women Undergoing Cryotherapy Following Cancer Screening with Visual Inspection of the Cervix Using Acetic Acid Method. Asian Pac J Cancer Prev 2020; 21:1423-1429. [PMID: 32458651 PMCID: PMC7541857 DOI: 10.31557/apjcp.2020.21.5.1423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 05/01/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The Indonesian government has applied the cancer "see and treat" method which involves a visual inspection using acetic acid (VIA), followed by a cryotherapy procedure, to reduce the incidence of cervical cancer. However, compliance with the program is still low in the targeted population. This study aims to see what factors influence women to receive cryotherapy treatment if they have positive VIA result. METHODS This cross-sectional study was conducted among 356 VIA positive women, aged 30-50 years old, registered at Temanggung District Health Office, Central Java, Indonesia between March 29 and April 31, 2018. Data on whether subjects underwent cryotherapy, their demographic profile, education, knowledge about cryotherapy, and family support were collected in a direct interview using a structured questionnaire. A statistical analysis was carried out to observe the influence of all the variables on subjects' decisions on cryotherapy. RESULTS In our study, 217 women (60.69%) received cryotherapy, while 139 women (39.04%) did not. Among all the variables analyzed, the factors affecting the subjects' likelihood to undergo cryotherapy are their knowledge about cervical cancer and screening (PR=0.776;95%CI=0.660-0.913;p=0.003), their residences distance from health centre (PR=0.795;95%CI=0.650-0.971;p=0.016), permission from their family (PR=0.675;95%CI=0.556-0.820;p=0.018), and being accompanied by their family (PR=0.824;95%CI=0.700-0.970;p=0.026). Age, marital status, occupation, and education background did not show a significant correlation with the women's decisions to receive cryotherapy. CONCLUSIONS Interestingly, the result of our study indicates that women are less willing to undergo the cryotherapy procedure if they have good knowledge about the cryotherapy procedure and its importance in cervical cancer's prevention. Providing higher quality and more accessible health facilities with cryotherapy services are important in influencing women's willingness to receive cryotherapy. Family support, in the form of permission given by spouses, and if they accompanied the patient to seek cryotherapy care are observed as factors influencing women's willingness to have the procedure. .
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Affiliation(s)
- Dahlan Napitupulu
- Field Epidemiology Training Program, Master of Public Health Postgraduate Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
- Port Health Office Class II, Jayapura, Papua, Indonesia.
| | - Herindita Puspitaningtyas
- Clinical Epidemiology Program, Master of Clinical Medicine Postgraduate Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Khabib Mualim
- Temanggung District Health Office, Central Java, Indonesia.
| | - Ardhanu Kusumanto
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia.
| | - Lutfan Lazuardi
- Department of Public Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Susanna Hilda Hutajulu
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia.
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