Abstract
BackgroundBreast cancer is the most common form of cancer in women and second most common cancer after lung cancer. The prognosis of breast cancer depends on early detection and intervention which in turn relies upon awareness. Health workers in all communities are responsible for educating the population at risk. This study evaluates the knowledge regarding breast cancer, personal judgment of confidence, perceived barriers to help seeking and breast self-examination practices among Pakistani female medical students and studies the impact of clinical training on the studied variables.MethodsDescriptive cross-sectional study design using self-administered validated questionnaires (BCAM-Breast Cancer Awareness Measure designed by Cancer Research UK) was employed. Female medical students enrolled in clinical and pre-clinical classes of King Edward Medical University, Lahore were targeted and questioned regarding symptoms, risk factors and their practices regarding breast cancer. Possible barriers to seeking help were also studied.ResultThe mean number of symptoms correctly identified was 6.7 ± 3.2 (5.5 ± 3.2 for pre-clinical and 7.8 ± 2.9 for clinical students) and for risk factors it was 4.3 ± 2.1 (3.7 ± 2.1 for pre-clinical and 4.7 ± 2.2 for clinical students). The difference in the level of perception of two groups was found to be significant (p < 0.001 for symptoms and p < 0.001 for risk factors). 38.7% of the subjects responded that they check their breasts rarely, 33.1% were fairly confident while 8.6% were very confident about detecting a change in their breast, 50.0% never noticed a change in their breast, and 77.4% will contact a doctor within a week or less of finding a change in their breast. Confidence about detecting a change significantly improved (p < 0.001) after the start of clinical training.ConclusionThis study suggests that clinical training may have improved knowledge of female medical students regarding breast cancer; yet the knowledge related to the symptoms and risk factors of breast cancer and frequency of breast self-examination of female medical students is less than anticipated.
Highlights
Breast cancer is the most common form of cancer in women and second most common cancer after lung cancer
This study suggests that clinical training may have improved knowledge of female medical students regarding breast cancer; yet the knowledge related to the symptoms and risk factors of breast cancer and frequency of breast self-examination of female medical students is less than anticipated
According to the teaching system and curriculum as per the requirements of Pakistan Medical and Dental Council (PMDC), the basic theoretical section on breast cancer is included in the curriculum of first year along with thorax in anatomy; second year only contains the embryological development of mammary glands, the history, examination and clinical aspects of breast cancer are taught in wards during clinical rotations, fourth year syllabus contains pathological types and risk factors, while final year includes staging and treatment details (PMDC revised curriculum 2018) [13]
Summary
Breast cancer is the most common form of cancer in women and second most common cancer after lung cancer. The prognosis of breast cancer depends on early detection and intervention which in turn relies upon awareness. According to GLOBOCAN 2012, 1.67 million cases of breast cancer were diagnosed in 2012. It was responsible for 522,000 deaths that year and the most frequent cause of cancer death in women in less developed regions [1]. Pakistan has the highest prevalence of breast cancer in Asia with one in every nine women suffering from the disease [2, 3]. A study on the incidence and mortality of breast cancer demonstrated that the highest age standardized death rate (2.52) in Asia due to breast cancer was observed in Pakistan [4]. The frequency of breast cancer in Karachi was reported to be 69.1 per 100,000 from 1998 to 2002 [5]
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