Factors Associated with Breast Cancer Awareness in Thai Women.

Cameron Paul Hurst,Nitchamon Rakkapao,Supannee Promthet

doi:10.31557/apjcp.2019.20.6.1825

Abstract

Background:Breast cancer is the most common cancer in women worldwide. In south-east Asia, both the incidence and mortality rates of breast cancer are on the rise, and the latter is likely due to the limited access to large-scale community screening program in these resource-limited countries. Breast cancer awareness is an important tool which may, through increasing breast self-examination and the seeking of clinical examination, reduce breast cancer mortality. Investigating factors associated with breast cancer awareness of women is likely to help identify those at risk, and provide insights into developing effective health promotion interventions. Objective:To investigate factors associated with breast cancer awareness in Thai women. Methods:A cross-sectional sample of Thai women aged 20-64 years was collected during August to October, 2015 from two provinces of southern Thailand (Surat Thani and Songkla). A questionnaire including the Breast Cancer Awareness Scale along with demographic characteristics was administered and Proportional Odds Logistic regression was then used to investigate factors associated with breast cancer awareness. Results:In total, 660 Thai women participated in this study. Factors most often associated with the various breast cancer awareness domains were age and rurality. While rural women had poorer knowledge of breast cancer signs and symptoms, they also had lower levels of perceived barriers and considerably better breast cancer awareness behaviors. Conclusion:Despite lower knowledge of breast cancer risk factors and no evidence of better knowledge of signs and symptoms, we found rural Thai women had considerably better breast cancer awareness behavior. This may be due to these women’s lower levels of perceived barriers to breast cancer screening services. Indeed this suggests, at least in Thai women, that interventions aimed at lowering perceived barriers rather than enhancing disease knowledge may be more successful in engaging women with breast cancer screening services and increasing breast self-examination.

Highlights

Despite a considerably higher breast cancer incidence in western populations such as those in Australia and New Zealand, North America and Western Europe when compared with Asian populations (GLOBOCAN, 2018), early diagnosis and improvements in treatment have led to a considerable fall in breast cancer case fatality rates in these western populations
The adjusted odds ratios of Breast Cancer Awareness scale and Breast Cancer Awareness Scale (B-CAS) subscales are provided in Tables 2 and 3
After adjusting for other potential associated factors, rural living environment had a substantial effect of overall B-CAS (Table 2) with rural women having considerably lower odds of better awareness relative to urban women (OR adjusted=0.43; 95%CI: 0.29,0.62; p

Summary

Introduction

Despite a considerably higher breast cancer incidence in western populations such as those in Australia and New Zealand, North America and Western Europe when compared with Asian populations (GLOBOCAN, 2018), early diagnosis and improvements in treatment have led to a considerable fall in breast cancer case fatality rates in these western populations. While the cumulative risk of breast cancer incidence in south-east Asian countries is about half that of North American countries (4.17% vs 9.32%), the cumulative risk of breast cancer mortality is higher (1.61% vs 1.38%; GLOBOCAN, 2018) This higher mortality rate is likely to be due to the poorer screening and treatment practices associated with resource-limited health care systems in many of these countries. Conclusion: Despite lower knowledge of breast cancer risk factors and no evidence of better knowledge of signs and symptoms, we found rural Thai women had considerably better breast cancer awareness behavior. This may be due to these women’s lower levels of perceived barriers to breast cancer screening services. At least in Thai women, that interventions aimed at lowering perceived barriers rather than enhancing disease knowledge may be more successful in engaging women with breast cancer screening services and increasing breast self-examination

Objectives

Methods

Results

Conclusion