Translation, adaptation and validation of the AWACAN tool for breast and cervical cancer awareness among Arabic-speaking women: a study from Libya

Cervical and breast cancer is the most leading cause of death among women globally. Cervical and breast cancer can be cured if detected early. The aim of the study was to compare the knowledge and awareness of cervical and breast cancer among medical and nonmedical students of a private institution in South India. A cross-sectional study was done on 600 female students of a private institution comprising both medical and nonmedical for a period of 6 months. A study was done to assess the awareness and knowledge on cervical and breast cancer by using a standardized questionnaire. The data were statistically analyzed with Mann-Whitney test by using GraphPad prism. Out of the 600 female students, there were each of 300 female students in medical and nonmedical. Majority of the student population was seen in 17-19 years: 143 (47.6%) in medical and 206 (68.6%) in nonmedical. A total of 235 (78.3%) medical students have heard of cervical cancer and its screening (164 [54.6%]). Many nonmedical students have never heard of cervical cancer (248 [82.6%]) and its screening (283 [94.3%]). Nearly 61% of the medical students and 1.1% nonmedical have heard of Pap smear. Both medical students (276 [92%]) and nonmedical students (179 [53.2%]) were aware of the breast cancer but have less awareness about the age of occurrence. Awareness on breast self-examination was poor among medical (137 [45.6%]) and nonmedical (19 [5.6%]) students. The P < 0.0001 (<0.05) showed a statistically significant difference between the medical and nonmedical students. Through the findings of our study, we analyzed that the knowledge and awareness of cervical and breast cancer among medical students was better than that of the nonmedical students.

Introduction: Similar to many countries in the world, breast cancer is the most common cancer among women in the State of Qatar and the incidence rate is rising. Previous findings indicate women in Qatar are often diagnosed with breast cancer at advanced stages and their awareness of breast cancer screening (BCS) services and participation rates in screening activities are low. Previous studies indicate the need to understand the many complex beliefs, values, and attitudes that influence Arabic women's health seeking behavior for the development of culturally-appropriate awareness and effective intervention strategies to address breast cancer in Qatar. This study investigates beliefs and attitudes about breast cancer and BCS activities in Qatar and how it relates to their screening practices. Methods: A multi-center, cross-sectional quantitative survey of 1,063 (87.5% response rate) female Qatari citizens and Qatari Arabic-speaking residents, 35 years of age or older, was conducted in Qatar from March 2011 to July 2011. Results: In addition to low levels of awareness and participation rates in BCS (13.9% of participants reported performing a monthly BSE, 31.3% had a CBE within the last 1-2 years, and 26.9% of participants 40 years of age or older had a mammogram done within the last 1-2 years), less than half of the women interviewed believed breast cancer can be prevented. The majority of women participants want to know if they have breast cancer and would make an appointment for a mammogram if their HCP suggested it. The main reasons for not planning BCS were fear and embarrassment. Other factors related to BCS practice indicate women with self-perceived good and excellent health, who believe cancer can be prevented, and do not believe cancer is due to God's punishment or bad luck, were more likely to practice BCS. Conclusion: A variety of channels (health care providers, media, breast cancer survivors, and religious leaders) should be utilized to create culturally-appropriate intervention programs to raise awareness of breast cancer, BCS, and the benefits of early detection of breast cancer to help reduce mortality rates amongst Arabic-speaking women living in the State of Qatar. Awareness campaigns must emphasize that cancer can be prevented and treated if detected in its early stages. In addition, including religiously and culturally appropriate messages/teachings as part of awareness campaigns is important components to sustaining intervention strategies that address breast cancer amongst Arabic-speaking Muslim women.

90 Use of the Health Belief Model in screening methods for colorectal cancer

In general, refugees have an increased cancer burden because of living in difficult conditions and having low income. Refugee women may have difficulty in accessing healthcare services because of the fear of uncertainty, security concerns, language barriers, cultural differences, and economic problems. For this reason, it is thought that health education given to Syrian refugee women by overcoming the language problem (given in their own language-Arabic) increases the awareness of breast and cervical cancer. The aim of this study is to evaluate the effect of health education given to refugee women in their own language on the awareness of breast and cervical cancer. This is a randomized controlled trial with one control and one intervention group. The research sample consisted of 60 Syrian women (30 experiments, 30 controls), at least 18years old, married, and literate women who were refugees in Hatay/Turkey. The research data were collected via the questionnaire form developed by the researchers. At the beginning of the study, there was no statistically significant difference in terms of age, education, economic status, gravida, and parity among the women in the experimental and control groups (p > 0.05). There was no statistically significant difference between the pre-test mean scores of the experimental and control groups (p > 0.05). However, there was a statistically significant difference between the post-test mean scores of the experimental and control groups (p < 0.005). In this study, it was determined that health education given to refugee women in their own language had a significant effect on breast and cervical cancer awareness. The attitudes and motivations are shaped, not only by personal information but also by the cultural changes within the community.

Breast and cervical cancer are the leading causes of cancer death among women worldwide. Given the growing concern, cervical cancer awareness month (CCAM) in January and Breast cancer awareness month (BCAM) in October occur annually as global health observances to raise public awareness. This infodemiology study aimed to assess trends in public online searches for breast cancer and cervical cancer following the annual BCAM and CCAM from 2008 to 2021. Google Trends (GT) was used to investigate online searches for "breast cancer" and "cervical cancer" from January 1, 2008, to December 31, 2021. (168 months). A joinpoint regression analysis was used to identify statistically significant weekly percentage changes (WPCs) and monthly percentage changes (MPCs) trends over time. Breast cancer searches increased in October (BCAM) every year, while cervical cancer searches increased in January (CCAM) in 2013, 2019, and 2020. Joinpoint regression analysis revealed a significant negative trend in "breast cancer" searches from 2008 to 2021 (MPC: -0.2%, 95% CI: -0.3 to -0.1) and an upward trend in "cervical cancer" searches from May 2017 to December 2021 (MPC: 0.5%, 95% CI: 0.2 to 0.7). Online searches on "breast cancer" remain consistently high only during BCAM, and "cervical cancer" has increased by 0.5% MPC since May 2017. Our findings can inform online interventions like event-based opportunities (BCAM and CCAM) and Google Ads to raise public awareness of breast and cervical cancer.

BACKGROUND:There are no general consensuses on why the lifetime risk of dying from breast and cervical cancer in African is several times higher than that of developed countries. However, a notable window of opportunity for prevention and treatment are often wasted where there are little or no awareness and low level of screening.AIM:To specifically highlight the awareness, knowledge and determinants of participation in the screening exercise for possible prevention or control of the diseases. To also provide insights on the development of contextual and relevant timely detection for effective early interventions.METHODS:A cross-sectional study was conducted in southern and northern geopolitical zones of Nigeria. The respondents, which consisted of 1,023 women aged 15-49 years, completed a 116-item questionnaire assessing the correlation between cancer awareness and participation in screening. Nineteen, In-depth interviews were also conducted for this study. The outcome measured included awareness of breast and cervical cancer, how it can be prevented or detected, and the availability and actual participation in screening exercises.RESULTS:While women are familiar with breast cancer, little is known about cervical cancer, and the awareness of the former is not correlated with participation in screening.The lack of enthusiasm to seek screening exercise is rooted in three key factors:lack of specific information, belief, economic and inadequate screening facilities.CONCLUSION:The study thus recommends that policies and programs aimed at the breast and cervical cancers awareness and early intervention should address the underlying problems.

6 Background: Cervical cancer is causing a burden in sub-Saharan Africa, with human papillomavirus (HPV) identified as the necessary cause of cervical cancer. HPV mainly affects young women, which puts female university students at risk of cervical cancer. Knowledge and awareness of cervical cancer and HPV in sub-Saharan Africa, including Ethiopia, is poor. The aim of this study was to assess the knowledge and awareness of cervical cancer and HPV in University of Gondar medicine and health science female students. Methods: This cross-sectional study was conducted from April 1 to May 30, 2016, at University of Gondar, College of Medicine and Health Sciences, Gondar, Ethiopia. Undergraduate female students from 11 different health-related departments at the College of Medicine and Health Sciences were included in the study. A 14-item, paper-based, self-administered questionnaire was provided to each of the participants to measure her level of knowledge and awareness of cervical cancer and HPV. Results: A total of 267 female students participated in the study, with ages ranging from 18 to 24 years (mean age, 20.58 ± 1.22 years). More than one half of participants (59.6%) stated that they did not know the main cause of cervical cancer, whereas only approximately one fifth (19.5%) identified HPV as the main cause of cervical cancer. As many as 83.9% of participants did not know other causes of cervical cancer. Binary logistic analysis revealed that students from midwifery (adjusted odds ratio [AOR], 14.14; P &lt; .05), anesthesiology (AOR, 9.66; P &lt; .05), and medicine (AOR, 5.84; P &lt; .05) departments were associated with knowledge of the main cause of cervical cancer. Furthermore, fifth-year students (AOR, 16.94; P &lt; .05) and fourth-year students (AOR, 8.32; P &lt; .05) were found to have better knowledge of the main cause of cervical cancer. Only a few students (15%) had been vaccinated for HPV or had had a cervical smear test performed in the past. Conclusion: Cervical cancer mainly affects young women, which puts female university students at risk of cervical cancer. Hence, assessing the knowledge and awareness of these students will be of paramount importance to designing effective measures to increase their knowledge and awareness of the disease. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.

Acceptance of cervical and breast cancer screening and cancer awareness among women in Villupuram, Tamil Nadu, India: A cross sectional survey

Background Cervical cancer incidence and mortality are high in Africa. We assessed cervical cancer and screening awareness in two West African countries. Methods We used data from the Demographic and Health Surveys (DHS) in Benin (2017-2018) and Cameroon (2018). Women (n=21322) aged 15-49 were interviewed on awareness of cervical cancer and cervical cancer screening. Descriptive statistics and logistic regression analysis were employed. Results Awareness of cervical cancer was low among women in Cameroon (46.1%) and very low in Benin (9.5%). Among those aware of cervical cancer, 51.4% in Benin and 59.7% in Cameroon were also aware of cervical screening. In the adjusted analysis, women in Cameroon aged 45+ had the highest awareness odds of both cervical cancer (adjusted odds ratio, aOR=2.91, 95% confidence interval, CI=2.36-3.60) and screening (aOR=1.75, 95% CI=1.33-2.29). In Benin, women aged 45+ had the highest cervical cancer awareness (aOR=1.89, 95% CI=1.23-2.91) while screening awareness was highest in women aged 25-34 years (aOR=1.98, 95% CI=1.20-3.27). Women with higher education were six to nine times more aware of cervical cancer and three to four times more aware of cervical screening than women with no education in Benin and Cameroon respectively. Additionally, cervical cancer awareness was approximately four times higher in the richest wealth quintile in Cameroon. In Benin, the odds of awareness of cervical cancer were increased with daily internet use (aOR=3.61, 95% CI=2.45-5.32) and radio listening once a week (aOR=1.73, 95% CI=1.04-2.88) compared to no internet and no radio listening respectively. In Cameroon, both awareness of cervical cancer and screening increased with daily internet use (aOR=1.95, 95% CI=1.61-2.35) and (aOR=1.35, 95% CI=1.10-1.67) respectively. Conclusions There is a need to increase awareness of cervical cancer and screening in Benin and Cameroon and extend to other West African countries. The internet and radio appear to be important potentially effective means for raising awareness.

Cervical cancer remains a significant disease burden and contributes to prominent cancer-related mortality among women. This study aimed to assess awareness and knowledge of cervical cancer and attitude towards HPV vaccination among rural women in Bangladesh. A cross-sectional study was carried outfrom September 2019 to January 2020 involving 600 women selected using multi-stage sampling from six rural areas of Bangladesh. Face-to-face interviews were conducted using a semi-structured questionnaire consisting of socio-demographic information, knowledge (20-items) and, attitudes (5-items). Most of the participants (71.8%) were aware of cervical cancer. Women's awareness was significantly associated with marital status, education level, employment status, and internet/social media use (p < 0.05). Mass media was the main source of information and 2.3% of the women had previously undergone cervical cancer screening. Knowledge regarding symptoms, risk factors, and preventive measures was limited with a mean knowledge score of 8.73 (SD: 2.68). Only 5.3% of women had vaccinated against HPV, but the willingness to receive the HPV vaccine was high (76.6%) among those who were not vaccinated. The cost of the HPV vaccine (40.1%) and lack of adequate knowledge (34.3%) were the main reasons behind women's unwillingness to receive the vaccine. Higher odds of willingness to receive the HPV vaccine were found among women aged 15-29years (aOR: 1.92, CI = 1.21-3.04, p = 0.006), had high education (aOR: 1.93, CI = 1.25-4.42, p = 0.005), and internet/social media users (aOR: 2.32, CI: 1.51-3.56, p < 0.001). These results highlight the urgent need for educational intervention on cervical cancer and the institution of national policies providing HPV vaccination coverage.

Cervical cancer is the leading cause of cancer deaths among women in Haiti. Given this high disease burden, we sought to better understand women's knowledge of its causes and the sociodemographic and health correlates of cervical cancer screening. Participants were 410 adult women presenting at clinics in Léogâne and Port-au-Prince, Haiti. We used bivariate and multivariate logic regression to identify correlates of Pap smear receipt. Only 29% of respondents had heard of human papillomavirus (HPV), whereas 98% were aware of cervical cancer. Of those aware of cervical cancer, 12% believed that sexually transmitted infections (STIs) cause it, and only 4% identified HPV infection as the cause. Women with a previous sexually transmitted infection were more likely to have had Pap smear (34% vs 71%, odds ratio = 3.45; 95% CI = 1.57-7.59). Screening was also more likely among women who were older than the age of 39 years, better educated, and employed (all p < .05). Almost all women (97%) were willing to undergo cervical cancer screening. This sample of Haitian women had limited awareness of HPV and cervical cancer causes; but when provided with health information, they saw the benefits of cancer screening. Future initiatives should provide health education messages, with efforts targeting young and at-risk women.

Cervical cancer and breast cancer are two types of cancer that often occur in women and contribute to a high mortality rate. However, there are still many people who do not know about the early detection of cervical cancer and breast cancer to prevent diseases. This community service aims to make people aware of the dangers of breast and cervical cancer. The subjects of this community service program assistance were women in Arjasa sub-district, Kangean Islands, Sumenep Regency. The method used in community service is Community-based Research (CBR) to develop early detection programs for non-communicable diseases of breast cancer and cervical cancer. Research findings showed 91.1% of respondents did not know about early detection of IVA test. The results of the IVA screening test on 90 respondents, there is one respondent with a definite IVA pre-cancerous lesion. SRIKANDI (Sadar Kanker Sejak Dini) Cadre was formed to increase public awareness. Srikandi's cadre provisioned with knowledge about cervical and breast cancer, equipped with pocketbooks and given training on breast self-examination (BSE). They invited the public to increase awareness of cervical and breast cancer by conducting IVA tests and being able to do breast self-examinations to reduce the incidence of cervical and breast cancer.

BackgroundMeasuring factors influencing time to presentation is important in developing and evaluating interventions to promote timely cancer diagnosis, yet there is a lack of validated, culturally relevant measurement tools. This study aimed to develop and validate the African Women Awareness of CANcer (AWACAN) tool to measure awareness of breast and cervical cancer in Sub-Saharan Africa (SSA).MethodsDevelopment of the AWACAN tool followed 4 steps: 1) Item generation based on existing measures and relevant literature. 2) Refinement of items via assessment of content and face validity using cancer experts’ ratings and think aloud interviews with community participants in Uganda and South Africa. 3) Administration of the tool to community participants, university staff and cancer experts for assessment of validity using test-retest reliability (using Intra-Class Correlation (ICC) and adjusted Kappa coefficients), construct validity (comparing expert and community participant responses using t-tests) and internal reliability (using the Kuder-Richarson (KR-20) coefficient). 4) Translation of the final AWACAN tool into isiXhosa and Acholi.ResultsICC scores indicated good test-retest reliability (≥ 0.7) for all breast cancer knowledge domains and cervical cancer risk factor and lay belief domains. Experts had higher knowledge of breast cancer risk factors (p < 0.001), and cervical cancer risk factors (p = 0.003) and symptoms (p = 0.001) than community participants, but similar knowledge of breast cancer symptoms (p = 0.066). Internal reliability for breast cancer risk factors, lay beliefs and symptom and cervical cancer symptom subscales was good with KR-20 values > 0.7, and lower (0.6) for the cervical cancer risk subscale.ConclusionThe final AWACAN tool includes items on socio-demographic details; breast and cervical cancer symptom awareness, risk factor awareness, lay beliefs, anticipated help-seeking behaviour; and barriers to seeking care. The tools showed evidence of content, face, construct and internal validity and test-retrest reliability and are available for use in SSA in three languages.

Breast and cervical cancers are the most common types of cancer in women worldwide. Previous studies in Asia have shown that related knowledge and awareness is low among female university students. The goal of this study was to assess breast and cervical cancer knowledge, practices, and awareness among female university students in Samsun,Turkey. This research was a cross-sectional survey of female university students using a self-administered. questionnaire to investigate participant awareness and knowledge of breast and cervical cancer. A total of 301 female university students participated. Descriptive statistics and chi square tests were used for data analysis. The mean age of the participants in this study was 22.0 ± 5.91 years. Regarding family history, 89.7 % of the students had no known familial history of breast cancer. Students (65.4%) had knowledge about breast self examination and 52.2 % of them had performed breast self examinationm while 55.1% of them had knowledge about prevention of cervical cancer. Although the results are preliminary, the study points to an insufficient knowledge of university students in Samsun about breast and cervical cancer.

One of the leading cause of death in the entire world is cancer. More than 10 millions of people die from cancer every year but with early identification and leading to prompt treatment could relieve people from suffering and death. There are several types of cancer among which 30% are preventable. Mostly women suffer from breast cancer and cervical cancer which are preventable with early diagnosis. This research was conducted to identify the opportunities and barriers in using current screening services for the early detection of cervical and breast cancer among rural women in tertiary care centre in Sitapur, U.P.: The systemic study was planned to perform at the Hind institute of medical sciences Sitapur. At the centre the research was performed through systemic sampling procedure and with the help of academic research and industry professionals. A statistical analysis was conducted to determine the comparison of factors associated with awareness of breast and cervical cancer among study population.: We observed and concluded that breast cancer is more common than cervical cancer in India. The knowledge about cervical cancer is relatively low among women which is revealed in this research.: This study is concluded by stating that the women in this study population have less knowledge about cervical cancer than breast cancer due to lack of education.Therefore, promoting awareness among people about cervical and breast cancer would lead to early identification and diagnosis which would help women with less suffering and cost effective treatment.