Knowledge, attitudes, and practices related to breast cancer screening among female Jordanian university employees: A cross-sectional study

INTRODUCTION

To improve participation in breast screening programs, the level of knowledge about BC, attitudes, and practices of women in different sections of society must be understood. This study aimed to measure the level of knowledge of BC risk factors, signs and symptoms and determine current mammography practices among female employees at Jordanian universities.

METHODS

A cross-sectional descriptive study was conducted on female employees at Jordanian government universities. Data was collected using a structured questionnaire that included: sociodemographic characteristics, knowledge of BC risk factors, knowledge of BC symptoms and knowledge, attitude and practice of mammography as an early detection method.

RESULTS

A total of 362 participants completed the questionnaire. Overall, 174 scored ≥50% correct answers regarding BC risk factors, while 231 scored ≥50% correct answers regarding BC signs and symptoms. Half of the participants (n = 184, 50.8%) understood mammography to be an early BC detection method. Among those participants, 95 (51.6%) were eligible for screening and 39 (21.2%) had had a previous mammogram. The main reason for not engaging in mammography was the absence of BC signs and symptoms (37.2%). Profession, educational level and family history of BC were associated with increased knowledge of BC risk factors, signs and symptoms (p = 0.01). Lecturers in medical faculties exhibited the highest level of knowledge about mammography compared to participants in other professions (p = 0.02).

CONCLUSION

Only 79 participants had good to excellent knowledge about BC. Participants' profession was the major indicator for awareness of BC and mammography as an early detection method.

IMPLICATIONS FOR PRACTICE

The findings of this study reinforce the importance of providing BC educational programs for university employees in Jordan to increase awareness of BC and mammography.

Breast Cancer Knowledge, Attitudes and Practices amongst Women in Qatar

This cross-sectional study examines knowledge, attitudes, and practices surrounding breast cancer awareness and screening among women residents in Qatar. Females, >18 years old, registered with the Primary Health Care Corporation were invited to complete an Arabic or English online survey using a modified version of the Breast Cancer Awareness Module. Of the 9008 participants, 69% report awareness of breast cancer warning signs, but the results did not substantiate these claims. There remains a disconnect between participants’ perceived awareness of their ability to detect breast cancer and their actual recognition of individual signs and symptoms. Nearly half (45.4%) report rarely or never checking their breasts for abnormalities (44.6%). Breast self-examination (BSE) and Breast Cancer Screening (BCS) uptake is low and many are unaware of the starting age for invitation to Qatar’s BCS program. While only 18% of women report receiving an invitation, 94% attended, indicating that the BCS invitation is a remarkably effective means of improving screening uptake. Policymakers should capitalize on early recognition, which is possible in the youthful population. Broadening awareness campaigns and interventions targeting a broader audience including males, community and religious leaders and healthcare professionals may prove more effective in Arab communities.

Women's Breast Cancer Knowledge and Health Communication in the United Arab Emirates

In the United Arab Emirates (UAE), women’s participation in breast cancer screening is low, and women are commonly diagnosed in advanced stages. This study investigated women’s attitudes towards breast cancer screening, their use of health services in the UAE emirate of Ras Al Khaimah, and their preferred medium for breast cancer information. In this qualitative study, six focus groups were conducted with Emirati (n = 28) and non-Emirati (n = 26) women as Ras Al Khaimah is a highly multi-cultural region. Women were separated into different age groups (25–34, 30–44, 44+) so as to obtain perspectives of young (n = 16), middle (n = 19), and older women (n = 19). The focus group transcripts were analysed using thematic analysis. Women recognised that any breast change should be checked by a doctor, and that women with symptoms or those at higher risk may need to have breast screening earlier than the recommended starting age. However, participants wanted more information from doctors or other health personnel. Women had observed breast cancer information and campaigns advertisements in multiple media but recommended greater use of social media and WhatsApp to disseminate information. Overall, women had positive attitudes towards breast cancer screening but wanted more breast cancer awareness campaigns year-round and better access to screening.

Psychosocial Aspects of Female Breast Cancer in the Middle East and North Africa

Breast cancer, the most common cancer among women in the Middle East and North Africa (MENA) region, is associated with social and psychological implications deriving from women's socio-cultural contexts. Examining 74 articles published between 2007 and 2019, this literature/narrative review explores the psychosocial aspects of female breast cancer in the MENA region. It highlights socio-cultural barriers to seeking help and socio-political factors influencing women's experience with the disease. In 17 of 22 Arab countries, common findings emerge which derive from shared cultural values. Findings indicate that women lack knowledge of breast cancer screening (BCS) and breast cancer self-examination (BSE) benefits/techniques due to a lack of physicians' recommendations, fear, embarrassment, cultural beliefs, and a lack of formal and informal support systems. Women in rural areas or with low socioeconomic status further lack access to health services. Women with breast cancer, report low self-esteem due to gender dynamics and a tendency towards fatalism. Collaboration between mass media, health and education systems, and leading social-religious figures plays a major role in overcoming psychological and cultural barriers, including beliefs surrounding pain, fear, embarrassment, and modesty, particularly for women of lower socioeconomic status and women living in crises and conflict zones.

Uptake of breast and cervical cancer screening in four Gulf Cooperation Council countries

In Gulf Cooperation Council States, there is limited information on national levels of mammography and Pap smear screening uptake. The aim of this study is to provide a baseline for national estimates for mammography and Pap smear screening and to explore associations between screening uptake and socioeconomic factors. The nationally representative World Health Survey Plus, implemented in 2008/2009 in Kuwait, Oman, Saudi Arabia and United Arab Emirates (UAE), was used. Uptake of mammography and Pap smear was estimated for each country, followed by the examination of associations between screening and a range of socioeconomic variables. Levels of breast and cervical cancer screening uptake within recommended intervals in all countries were low. The percentages of women aged 40-75 years who had a mammogram were 4.9% in Saudi Arabia, 8.9% in Oman, 13.9% in the UAE and 14.6% in Kuwait. The percentages of women aged 25-49 years who had a Pap smear test were 7.6% in Saudi Arabia, 10.6% in Oman, 17.7% in Kuwait and 28.0% in the UAE. Marital status, wealth, education, nationality and place of residence are associated with screening uptake, with the lower educated, poor and unmarried having the lowest percentages of uptake. The four Gulf Cooperation Council countries need to set clear targets and increase the proportion of women who have regular breast and cervical cancer screening examinations. Health education campaigns and awareness programmes that are fully integrated into the health system are required to ensure women use services that are available to prevent breast and cervical cancers.

Breast cancer screening interventions for Arabic women: a literature review

Similar to other Middle Eastern countries, breast cancer is the most common cancer among women in Qatar with increasing incidence and mortality rates. High mortality rates of breast cancer in the Middle Eastern countries are primarily due to delayed diagnosis of the disease. Thus screening and early detection of breast cancer are important in reducing cancer morbidity and mortality. With the aim of updating knowledge on existing interventions and developing effective intervention programs to promote breast cancer screening in Arabic populations in Qatar, this review addresses the question: What interventions are effective in increasing breast cancer knowledge and breast cancer screening rates in Arabic populations in Arabic countries and North America? Systematic literature review was performed to answer the proposed question. As the result of the search, six research studies were identified and appraised. From the findings, we infer several insights: (a) a language-appropriate and culturally sensitive educational program is the most important component of a successful intervention regardless of the study setting, (b) multi-level interventions that target both women, men, health care professionals, and/or larger health care system are more likely to be successful than single educational interventions or public awareness campaigns, and (c) more vigorous, personal and cognitive interventions that address psychosocial factors are likely to be more effective than less personal and informative interventions. This review has important implications for health care providers, intervention planners, and researchers.

Do socioeconomic factors influence breast cancer screening practices among Arab women in Qatar?

OBJECTIVES

Breast cancer incidence rates are rising in Qatar. Although the Qatari government provides subsidised healthcare and screening programmes that reduce cost barriers for residents, breast cancer screening (BCS) practices among women remain low. This study explores the influence of socioeconomic status on BCS among Arab women in Qatar.

SETTING

A multicentre, cross-sectional quantitative survey was conducted with 1063 Arab women (87.5% response rate) in Qatar from March 2011 to July 2011. Women who were 35 years or older and had lived in Qatar for at least 10 years were recruited from seven primary healthcare centres and women's health clinics in urban and semiurban regions of Qatar. Associations between socioeconomic factors and BCS practice were estimated using χ(2) tests and multivariate logistic regression analyses.

RESULTS

Findings indicate that less than one-third of the participants practised BCS appropriately, whereas less than half of the participants were familiar with recent BCS guidelines. Married women and women with higher education and income levels were significantly more likely to be aware of and to practise BCS than women who had lower education and income levels.

CONCLUSIONS

Findings indicate low levels of awareness and low participation rates in BCS among Arab women in Qatar. Socioeconomic factors influence these women's participation in BCS activities. The strongest predictors for BCS practice are higher education and higher income levels.

RECOMMENDATIONS

Additional research is needed to explore the impact of economic factors on healthcare seeking behaviours in the Middle Eastern countries that have a high national gross domestic product where healthcare services are free or heavily subsidised by the government; promotion of BCS and intervention strategies in these countries should focus on raising awareness about breast cancer, the cost and benefit of early screening for this disease, particularly among low-income women.