Abstract

Worldwide, over half a million women died of breast cancer in 2011 alone. Mammography screening is associated with a reduction of 20 to 35% in breast cancer mortality. The aim of this study was to determine the awareness and practice of mammography screening and predictors of its uptake in Malaysian women attending a primary care clinic. A cross-sectional study was carried out among women aged 40 to 74 years attending a primary care clinic in Selangor, Malaysia. An assisted structured questionnaire included questions on socio-demography, source of information and level of knowledge. An adapted version of the revised Champion Health Belief Model Scale plus other associated factors for mammography screening up-take were also included as part of the questionnaire. Predictors for mammography screening uptake were only determined in those who were aware about mammography screening. Significant predictors were determined by logistic regression. 447 women were recruited for this study; 99.1% of them (n: 411) were aware about breast cancer. Only 50.1% (n: 206) had knowledge about mammography screening. Prevalence of clinical breast-examination (CBE) was 23.3% (n: 104) and mammography screening up-take was 13.2% (n: 59). The predictors for the latter were those who have had clinical breast-examination (aOR=17.58, 95%CI: 7.68-39.82) and those aged between 50 to 59 years (aOR=3.94, 95%CI: 1.61-9.66) as well as those aged 60 years and above (aOR=6.91, 95%CI: 2.28-20.94). Good knowledge and positive beliefs about mammography screening were not associated with mammography screening uptake. Half of our Malaysian women were aware about mammography screening. However, the uptake of mammography was low. Previous CBE and older age were significant predictors of mammography screening uptake. Increasing CBE services may increase compliance with guidelines.

Highlights

  • Breast cancer is the most frequently diagnosed cancer in women worldwide (Globocan, 2008)

  • Only 411 respondents have ever heard about breast cancer and 206 (50.1%) of these subjects have ever heard about mammography screening

  • Only half of the respondents (n=206) were aware about mammography screening; 2) Prevalence of mammography screening was very low at 13.2%; 3) Predictors for mammography screening were those with previous clinical breast-examination (CBE) and older age, and 4) good knowledge and positive beliefs on mammography screening had no effect on mammography screening uptake

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Summary

Introduction

Breast cancer is the most frequently diagnosed cancer in women worldwide (Globocan, 2008). Mammography is a gold standard for breast cancer screening (Ministry of Health Malaysia Management of breast cancer, 2010; Canadian Task Force on Preventive Health Care, 2011). It plays a major role in the early detection of disease and reduces breast cancer mortality by 20 to 35% (Elmore, 2005; Services Task Force, 2011). The aim of this study was to determine the awareness and practice of mammography screening and predictors of its uptake in Malaysian women attending a primary care clinic. Predictors for mammography screening uptake were only determined in those who were aware about mammography screening. Previous CBE and older age were significant predictors of mammography screening uptake.

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