Breast Cancer Screening Behaviors Research Articles

Breast cancer screening patterns and associated factors in Iranian women over 40 years

Screening is a key component of breast cancer early detection programs that canconsiderably reduce relevant mortality rates. The purpose of this study was to determinethe breast cancer screening behavioral patterns and associated factors in women over40 years of age. In this descriptive‑analytical cross‑sectional study, 372 over 40 years of agewomen visiting health centers in Tabriz, Iran, in 2023 were enrolled using cluster sampling.The data were collected using the sociodemographic characteristics questionnaire, breastcancer perception scale, health literacy for Iranian adults scale, and the Breast CancerScreening Behavior Checklist. The obtained data were analyzed in SPSS version 16 usingdescriptive statistics (frequency, percentage, mean, and standard deviation) and inferentialstatistics (univariate and multivariate logistic regression analyses). In total, 68.3% of allparticipants performed breast self‑examination (BSE) (9.9% regularly, once per month),60.2% underwent clinical breast examination (CBE) (8.9% regularly, twice per year),51.3% underwent mammography (12.3% regularly, once per year), and 36.2% underwentsonography (3.8% regularly, twice per year). The findings also showed that women withbenign breast diseases were more likely to undergo CBE (OR = 8.49; 95% CI 2.55 to 28.21;P < 0.001), mammography (OR = 8.84; 95% CI 2.98 to 10; P < 0.001), and sonography(OR = 18.84; 95% CI 6.40 to 53.33; P < 0.001) than others. Participants with low and moderatebreast cancer perception scores were more likely to perform BSE than women with highbreast cancer perception scores (OR = 2.20; 95% CI 1.21 to 4.00; P = 0.009) and women whohad a history of benign breast disease were more likely to perform screening behaviors thanothers (OR = 2.47; 95% CI 1.27 to 4.80; P = 0.008). Women between the ages of 50 and 59 weremore likely to undergo mammography (OR = 2.33; 95% CI 1.29 to 4.77; P = 0.008) and CBE(OR = 2.40; 95% CI 1.347 to 4.20; P = 0.003) than those ≥ 60 years. Given the low participationof women in regular breast cancer screening, it is suggested that health care providershighlight the need for screening at the specified intervals in their training programs. Inaddition, health authorities are recommended to use reminder systems to remind women,especially those over 40 years of age, of the best time for breast screening. Moreover, healthcare providers must seek to improve breast cancer knowledge, attitudes, and perceptionsof women who visit health centers, which are the first level of contact with the healthcaresystem for the general population.

Factors influencing breast cancer screening practices among women worldwide: a systematic review of observational and qualitative studies

BackgroundThe variation in breast cancer incidence rates across different regions may reflect disparities in breast cancer screening (BCS) practices. Understanding the factors associated with these screening behaviors is crucial for identifying modifiable elements amenable to intervention. This systematic review aims to identify common factors influencing BCS behaviors among women globally.MethodsRelevant papers were sourced from PubMed, Scopus, Embase, and Google Scholar. The included studies were published in English in peer-reviewed journals from January 2000 to March 2023 and investigated factors associated with BCS behaviors.ResultsFrom an initial pool of 625 articles, 34 studies (comprising 29 observational and 5 qualitative studies) with 36,043 participants were included. Factors influencing BCS behaviors were categorized into nine groups: socio-demographic factors, health status history, knowledge, perceptions, cultural factors, cues to action, motivation, self-efficacy, and social support. The quality appraisal scores of the studies ranged from average to high.ConclusionsThis systematic review highlights factors pivotal for policy-making at various levels of breast cancer prevention and assists health promotion professionals in designing more effective interventions to enhance BCS practices among women.

Breast cancer screening motivation and behaviours of women aged over 75 years: a scoping review

BackgroundThis scoping review aimed to identify and present the evidence describing key motivations for breast cancer screening among women aged ≥ 75 years. Few of the internationally available guidelines recommend continued biennial screening for this age group. Some suggest ongoing screening is unnecessary or should be determined on individual health status and life expectancy. Recent research has shown that despite recommendations regarding screening, older women continue to hold positive attitudes to breast screening and participate when the opportunity is available.MethodsAll original research articles that address motivation, intention and/or participation in screening for breast cancer among women aged ≥ 75 years were considered for inclusion. These included articles reporting on women who use public and private breast cancer screening services and those who do not use screening services (i.e., non-screeners).The Joanna Briggs Institute (JBI) methodology for scoping reviews was used to guide this review. A comprehensive search strategy was developed with the assistance of a specialist librarian to access selected databases including: the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Web of Science and PsychInfo. The review was restricted to original research studies published since 2009, available in English and focusing on high-income countries (as defined by the World Bank). Title and abstract screening, followed by an assessment of full-text studies against the inclusion criteria was completed by at least two reviewers. Data relating to key motivations, screening intention and behaviour were extracted, and a thematic analysis of study findings undertaken.ResultsA total of fourteen (14) studies were included in the review. Thematic analysis resulted in identification of three themes from included studies highlighting that decisions about screening were influenced by: knowledge of the benefits and harms of screening and their relationship to age; underlying attitudes to the importance of cancer screening in women's lives; and use of decision aids to improve knowledge and guide decision-making.ConclusionThe results of this review provide a comprehensive overview of current knowledge regarding the motivations and screening behaviour of older women about breast cancer screening which may inform policy development.

Factors Affecting Breast Cancer Screening Behavior Among Women in Saudi Arabia: A Retrospective Cross-Sectional Study.

Background Early detection of breast cancer is crucial for effective treatment and minimizing mortality, requiring effective screening methods like self-examination, clinical examination, and mammography. However, not all women in Saudi Arabia comply with these examinations, and studies examining its practice and barriers of low uptake are scant. The aim of this study is to investigate factors influencing breast cancer screening behavior among women in Saudi Arabia. Methods This cross-sectional study involving 806 women from October to November 2022 used an online questionnaire for the data collection process, including questions about demographic characteristics, awareness assessment, breast cancer screening behavior, symptoms, risk factors, and screening programs. Factors affecting the screening behavior were analyzed using the logistic regression model with adjusted odds ratio (AOR) and 95% confidence interval (CI). Results Among the 806 women who participated in the study, 479 (59.4%) were under 40 years old, and half of them were urban residents (n = 394, 48.9%). Only 134 subjects (16.6%) had a history of breast screening. Social media (n = 519, 64.5%) was the predominant source of screening information. The primary obstacles to breast cancer screening were the absence of tumor symptoms (n = 333, 41.3%), insufficient knowledge about early detection (n = 249, 31%), lack of time (n = 245, 30%), fear of discovering a tumor (n = 187, 23%), and lack of awareness about screening centers (n = 155, 19%).In regression analysis, predictive factors for breast cancer screening behavior were as follows: age over 40 years old (AOR: 2.56; 95% CI: 1.70-3.87), residents of big cities (AOR: 3.57; 95% CI: 1.02-12.56), positive family history of breast cancer (AOR: 2.53; 95% CI: 1.50-4.28), proximity to the screening center (AOR: 2.56; 95% CI: 1.22-5.39), and using contraceptive pills for more than five years (AOR: 1.78; 95% CI: 1.04-3.04), and were statistically significant (all p-values < 0.05). Conclusions In this study, the most perceived barriers to BSE were the absence of tumor symptoms, followed by insufficient knowledge about early detection, lack of time, fear of discovering a tumor, and lack of awareness about screening centers. Additionally, the predictive factors for breast cancer screening behavior were as follows: age over 40 years old, residents of big cities, positive family history of breast cancer, proximity to the screening center, and using contraceptive pills for more than five years. Given the identified factors affecting breast self-examination behavior in this study, public education initiatives are crucial for raising awareness, facilitating self-examination, and ultimately improving health outcomes and reducing breast cancer treatment costs in society.

Association between sociodemographic factors and health beliefs related to breast cancer screening behavior among Northern Thai women: a hospital-based study

Early diagnosis of breast cancer is crucial for reducing mortality rates. The purpose of this study is to determine the impact of demographics/social determinants of health on beliefs about the practice of self-breast examination, using mammogram and ultrasound in the context of breast cancer screening among Thai women in a hospital-based setting for implying program planning and future research. A cross-sectional study was conducted in two health centers in Chiang Mai Province from August 2021 to December 2021, involving 130 Thai women ages 40 to 70 years. Data were collected by a survey using a questionnaire to gather sociodemographic information, and health beliefs about breast cancer and screening behavior utilizing the modified Thai version of Champion's Health Belief Model Scale (MT-CHBMS). Descriptive statistics, t-tests, ANOVA, and linear regression models were employed for examining association between sociodemographic factors and health beliefs about the practice of self-breast examination (BSE), using mammogram (MG) and ultrasound (UTS). Health insurance schemes were associated with Benefit-MG, Barrier-BSE, Barrier-MG and Barrier-UTS subscales. Additionally, monthly income was associated with Barrier-MG and Barrier-UTS subscales. The most common barriers reported were “embarrassment”, “worry”, and “takes too much time”. To enhance breast cancer screening in Thailand, program planning and future research should focus on health insurance schemes, especially women with social security schemes, as they may be the most appropriate target group for intervention.

Socio-cultural and financial issues against breast cancer screening behaviour among eligible Indian women: evidence for action.

Breast cancer, a common malignancy in Indian women, is preventable and curable upon early diagnosis. Screening is the best control strategy against breast cancer, but its uptake is low in India despite dedicated strategies and programmes. We explored the impact of socio-cultural and financial issues on the uptake of breast cancer screening behaviour among Indian women. Breast cancer screening-uptake and relevant social, cultural, and financial data obtained from the National Family Health Survey (NFHS) round 5 were used for analysis. We studied 399,039 eligible females to assess their breast cancer screening behavior and determine the impact of socio-cultural and financial issues on such behavior using multivariable logistic regression. Most participants were 30-34-year-old (27.8%), educated to the secondary level (38.0%), and 81.5% had bank accounts. A third (35.0%) had health insurance, and anaemia was the most common comorbidity (56.1%). Less than 1.0% had undergone breast cancer screening. Higher age, education, urban residence, employment, less privileged social class, and access to the Internet and mass media were predictors of positive screening-uptake behavior (p < 0.05). Mothers of larger number of children, tobacco- and alcohol-users, the richer and having health insurance had negative uptake behavior (p < 0.05). A clear impact of socio-cultural and financial factors on breast cancer screening behavior is evident among Indian women. Therefore, apart from the ongoing health system strengthening efforts, our findings call for targeted interventions against prevailing misconceptions and taboos along with economic and social empowerment of women for the holistic success of India's cancer screening strategy.

Factors Affecting Breast Screening Behavior of First-Degree Relatives of Breast Cancer Patients in China: A Cross-sectional Study.

Breast cancer is the most common cancer in women, and first-degree relatives (FDRs) of breast cancer patients have a significantly higher risk of developing breast cancer. However, the factors affecting breast cancer screening behavior of FDRs in China remain unclear. The aim of this study was to determine the social cognitive theory factors influencing screening behaviors of FDRs. A cross-sectional survey was conducted, and 430 FDRs were recruited. Data were collected using demographic information and self-reported questionnaire based on the social cognitive theory. The structural equation modeling method was used to analyze the influence of social cognitive factors on breast cancer screening behavior. The model showed a good fit (goodness of fit = 0.462). Goal setting and self-regulation (β = 0.631, P < .001) and positive outcome expectation (β = 0.098, P = .042) were positively related to breast cancer screening behavior. Negative outcome expectation was negatively related to breast cancer screening behavior (β = -0.102, P = .024). In addition, positive outcome expectation, negative outcome expectation, and goal setting and self-regulation are mediators of self-efficacy (β = 0.475, P < .001) to breast cancer screening behavior. Goal setting and self-regulation are important influences on breast cancer screening behavior. The social cognitive theory is both applicable to and effective in explaining and predicting breast cancer screening behavior. Health professionals can develop appropriate intervention strategies based on the social cognitive theory among FDRs. It is necessary to focus on the people who influence women, such as spouses, mothers, or daughters.

The effectiveness of educational intervention based on the Health Action Model (HAM) in improving breast cancer screening behaviors

IntroductionBreast cancer disease is known as the most common cancer among women. Lack of knowledge and awareness is a leading cause of breast cancer, and since nearly all women are increasingly susceptible to this disease, training screening behaviors for early detection is proven essential in order to reduce breast cancer mortality. Therefore, the present study was designed to determine the effect of educational intervention based on the Health Action Model in improving breast cancer screening behaviors in women aged 30 to 69 in Kashan, Iran.MethodsThis quasi-experimental study was conducted on 162 women aged 30–69 years old among the clients of Comprehensive health service centers in Kashan, Iran and they were assigned to intervention and control groups. The research instrument included a questionnaire assessed within three phases: baseline, 3-months, and 6-months, containing Health Action Model (HAM) structures and also three screening behaviors. The intervention consisted of a model-based education package and was carried out over 2 months. To evaluate the effect of the intervention, the mean of model structures and proportion screening behaviors in the third and sixth months were compared with the baseline phase. All analyses were carried out using SPSS, version 22.ResultsThe intervention and control groups were homogeneous regarding the structures of the HAM and the proportion of screening behaviors in the baseline phase (p > 0.05). In the 3-month (p < 0.05) and 6-month (p < 0.05) phases, the mean scores of the HAM constructs in the intervention group were found higher compared with the control group. Moreover, the proportion of clinical breast examinations in the intervention group was statistically higher than in the control group in the 3-month (p < 0.001) and 6-month (p < 0.001) phases. In addition, the proportion of mammography performed in the 3-month (p = 0.002) and 6-month (p < 0.001) phases were reported to be higher in the intervention group compared with the control group.ConclusionOverall, these results provide important insight into the effectiveness of the interventions based on the Health Action Model in promoting breast cancer screening behaviors and the determinants of such behaviors.

Breast Cancer Screening Behavior among Working Women in Japan: Characteristics and Factors Inhibiting Screening.

Improving breast cancer screening rates is crucial for early detection. However, factors hindering regular screening among working women remain unclear. This study aimed to clarify screening behavior among working women in Japan and associated discouraging factors. Surveys were conducted from April to May 2019 among women aged 40-60 at public offices and companies in Tottori Prefecture. We used two surveys: the "Basic Attributes Questionnaire" and the "Structural Questionnaire on Rejecting Screening." Data analysis involved chi-squared tests, logistic regression analysis, factor analysis, and nonparametric tests. Completed questionnaires analyzed were 668 out of 825 collected (response rate: 81.0%). Most participants were part-time employees with an average age of 51 years. Over 60% reported undergoing regular screening. Logistic regression analysis identified part-time employment, lack of children, a discouraging workplace atmosphere, and absence of personal connections to breast cancer patients as factors associated with avoiding breast cancer screening. Factor analysis identified five factors and 16 items as reasons for not undergoing regular screening. Women who had no spouse, no children or felt that their workplace was not encouraging breast screening felt difficulty in scheduling screening most strongly. Individuals who had part-time employment and had no children, did not know a breast cancer patient, or considered that their workplace environment was not supportive were more likely to avoid undergoing regular breast cancer screening. Also, women who did not undergo regular screening experienced difficulty in scheduling. In the future, the challenge lies in disseminating accurate knowledge about breast cancer to foster awareness without excessive anxiety.

BREAST CANCER SCREENING AMONG OLDER NON-HISPANIC CARIBBEAN BLACK WOMEN IN THE UNITED STATES

Abstract Breast cancer is one of the most common forms of the second leading cause of death—cancer, which impacts racial and ethnic groups differently. The mortality rate of breast cancer among Black women is 40% higher than that of non-Hispanic White women. Early detection is critical for improving survival rates and reducing health disparities by race and ethnicity over the life course. However, the heterogeneity (i.e., within-group differences) among Black women in the United States is often overlooked, and relatively little is known about specific sub-populations of Black women and breast cancer screening. Of those sub-populations, Afro-Caribbean women in the United States tend to have different demographic and cultural backgrounds (e.g., a higher % of immigrants), for example, from African/African American women. Thus, this study examined factors associated with breast cancer screening among non-Hispanic Caribbean Black women. Using seven waves (2011-2017) of the National Health Interview Surveys data, we analyzed a sample of non-Hispanic Caribbean Black women living in the United States (age 40-75 years; n = 552). The results of the binary logistic regression indicated that the years in the United States were positively associated with breast cancer screening in the past 12 months among non-Hispanic Caribbean Black women (odds-ratio = 1.39, standard-error = 0.15, p &amp;lt; 0.05), after adjusting for the selected covariates. However, age was not associated with breast cancer screening behaviors. Our findings support breast cancer prevention efforts specifically targeting middle-aged and older non-Hispanic Caribbean Black women who have newly immigrated to the United States.

Breast cancer screening motivation and behaviours of women aged over 75years.

In Australia, breast screening is offered free every two years to women aged 50-74years. Women aged ≥75 are eligible to receive a free mammogram but do not receive an invitation. This study aimed to explore the motivations and behaviours of women living in Australia aged ≥75years regarding ongoing breast cancer screening given the public health guidance. Sixty women aged ≥75 were recruited from metropolitan, regional, and rural areas across Australia to participate in a descriptive qualitative study. Semi-structured interviews were used to seek reflection on women's experience of screening, any advice they had received about screening beyond 75, their understanding of the value of screening and their intention to participate in the future. Thematic analysis of transcripts led to the development of themes. Themes resulting from the study included: reasons to continue and discontinue screening, importance of inclusivity in the health system and availability of information. Regular screeners overwhelmingly wished to continue screening and had strong beliefs in the benefits of screening. Women received limited information about the benefits or harms of screening beyond age 75 and very few had discussed screening with their Primary Healthcare Provider. No longer receiving an invitation to attend screening impacted many women's decision-making. More information via structured discussion with health professionals is required to inform women about the risks and benefits of ongoing screening. No longer being invited to attend screening left many women feeling confused and for some this led to feelings of discrimination.

Predictive factors of breast cancer mammography screening among Iranian women.

Understanding the factors that influence women's cancer screening behavior is crucial in reducing cancer mortality through early detection. Therefore, the objective of this study was to examine the status of mammography and related factors among women who presented to the health centers of Khorasan Razavi province, Iran. For this study, a sample of 251,011 women who visited healthcare centers affiliated with Mashhad University of Medical Sciences was selected. The study examined several variables, including sociodemographic information, current smoking, nutrition status, and physical exercise. All analyses were performed using Python programming language and SPSS software. Furthermore, to handle imbalanced data, we used SMOTE balancing method that is an oversampling method and produce synthetic samples from the minority class. The factors of age, education, being employed, having children, family history of cancer, physical activity, smoking status, and diet were all predictors of mammography screening. Moreover, findings showed that age and family history of breast cancer were most important variables to predict mammography status, respectively. By examining various variables such as dietary habits, exercise, smoking, and demographic properties, it sheds light on the relationships between these factors and mammography screening. This provides valuable insights into the associations between breast cancer screening behavior and preventive lifestyle behaviors. By targeting both preventive lifestyle choices and breast cancer screening behaviors, interventions can effectively promote positive changes in behavior and ultimately reduce the incidence and impact of breast cancer.

Breast cancer screening attitudes, beliefs, and behaviors of Zuni Pueblo women: identifying cornerstones for building effective mammogram screening intervention programs

PurposeBreast cancer is the leading form of cancer and has the second highest mortality rate of cancers for American Indian/Alaska Native (AI/AN) women. Early screening is critical. This study examines the breast cancer-related knowledge, beliefs, and behaviors of Zuni women in the Southwest United States (U.S.).MethodsIn 2020 and 2021, a survey was administered to better understand cancer screening patterns in Zuni Pueblo; 110 women from 50 to 75 years of age were recruited to respond to the breast cancer screening portion. Inclusion criteria included self-identifying as AI, a member of the Zuni tribe, or married to a Zuni tribal member, and meeting the age and gender requirements. Descriptive statistics and bivariate analyses were conducted examining the associations between measures of breast cancer knowledge, beliefs, and behaviors and breast cancer screening status (never, ever/non-compliant, and ever/compliant).ResultsOf survey participants, 47.3% have had a breast cancer screening and are up-to-date, 39.1% have had a screening in the past but are not up-to-date, and 13.6% have never been screened. Age was the only statistically significant socioeconomic predictor of breast cancer screening; the median (interquartile range) ages of each group are 62 (54, 68) ever/compliant, 56 (54, 68) ever/non-compliant, and 53 (51, 55) never (p-value < 0.001). Significant differences by health status and access to medical care include having a regular health care provider and going to see a provider for routine check-ups. The survey also shows differences in knowledge about breast cancer risk factors, beliefs, and behaviors. Women across all three screening statuses reported that they would get screened if encouraged by a health care provider.ConclusionWhile survey respondents report a relatively high rate of ever having had a breast cancer screening, less than half are compliant with screening guidelines, which shows there is an opportunity to improve breast cancer screening rates. With culturally tailored interventions, providers have the potential to improve breast cancer screening for Zuni women.

An Intersectional Approach to Examining Breast Cancer Screening among Subpopulations of Black Women in the United States.

This study examines breast cancer screening behavior among subpopulations of Black women in the United States. Binary logistic regression was used to analyze breast cancer screening among a nationally-representative sample (n = 9,783) of Black women-US-born, non-US-born Caribbean, and non-US-born African-from the 2011-2017 National Health Interview Survey dataset. Non-US-born African Black women were less likely to have breast cancer screening, compared to US-born Black women. Among non-US-born Black women, non-US-born Caribbean Black women were more likely to have had breast cancer screening. Differential healthcare access associated with nativity differences among Black women can be informing their breast cancer screening behaviors. Efforts to improve breast cancer outcomes among Black women can benefit from interventions that account for differential access to healthcare and breast cancer screening behaviors among subgroups of Black women.

Breast Cancer Knowledge and Mammography Use Among Asian American Women Aged 40 and Older: Using the Transtheoretical Model Approach.

Mammography screening rates remain low among Asian American women (AAW). The aims of our study were to: (a) assess breast cancer knowledge and mammography screening behaviors, and (b) identify the factors related to the transtheoretical model (TTM) stages of change in relation to mammography utilization among AAW aged 40 and older. Using a cross-sectional design, a convenience sample of 714 AAW completed a structured questionnaire in 2021. Participants demonstrated a moderate level of knowledge regarding breast cancer and mammography. Only 34.2% of the participants reported obtaining regular mammograms. The ordinal logistic regression indicated that age, birthplace, health perception, breast biopsy history, breast cancer knowledge, self-efficacy, and perceived barriers were correlated with TTM stages of change. Our results highlight the need for implementing effective interventions aimed at increasing knowledge and screening rates for breast cancer among AAW. Additional TTM studies with AAW are needed to determine the relationships among TTM constructs and develop theory-based programs to improve adherence to screening guidelines. Future research using a mixed-method design may provide opportunities to explore complex phenomena associated with breast cancer screening behaviors. Finally, further assessments of the Breast Cancer Knowledge Scale's psychometric properties are necessary to improve this instrument.

Factors Influencing Iranian Women's Participation in Breast Cancer Screening Programs: A Systematic Review

Background: Breast cancer screening programs are one of the most important methods for the early detection of breast cancer in women. Several studies have been conducted to identify factors affecting breast cancer screening behaviors among Iranian women. This study is conducted to systematically review the factors influencing women’s participation in breast cancer screening programs in Iran.&#x0D; Methods: Papers were collected by using the keywords breast, mammary, screening, early detection, diagnosis*, examination, testing, and Iran from various English-language databases, including PubMed, Scopus, Web of Science, and databases in Persian language including SID and Magiran. The search was limited to the title and abstract of papers published between January 1, 2000, and May 1, 2021. A narrative synthesis was performed to summarize findings of the obtained papers.&#x0D; Results: In this study, 1345 papers were initially found and, after screening the title, abstract, and full-text, 39 papers were selected. Most of them were cross-sectional (n= 28). Results indicated that socioeconomic factors, individual characteristics, recommendation of health workers, knowledge, Islamic beliefs, support by family, and activities of the Iranian government are frequently mentioned as contributing factors and can be applied to increase participation of Iranian women in breast cancer screening.&#x0D; Conclusion: The results demonstrate that lack of knowledge and a positive attitude towards breast cancer screening is a major problem regarding Iranian women's non-participation in the screening programs. Therefore, the need for regular implementation of the national screening program in the country, providing appropriate educational methods to increase women's awareness, removing barriers and improving women's access to health care providers should be the priorities of the Iranian health system to prevent breast cancer.

Health Literacy and Breast and Cervical Cancer Screening Behaviors in Women

Background: Breast cancer and cervical cancer, the most common forms of cancer in women worldwide, are on a fast and steady rise. Cancer screening tests are an important tool to combat cancer-related morbidity and mortality. Considering the importance of health literacy in promoting community health, this study aimed to investigate the relationship between health literacy and the history of screening behaviors of common cancers in women referred to Bushehr healthcare centers in 2019. Methods: This cross-sectional study was carried out on 380 women referred to urban health centers in Bushehr in 2019. Data were collected by using a questionnaire consisting of three parts: demographic characteristics, breast and cervical cancer screening behavior, and health literacy (HELIA) questionnaire. Data were analyzed via SPSS 21 software using the Chi-square test, an independent t-test, and descriptive statistical methods. Furthermore, P&lt;0.05 was considered statistically significant. Results: The mean age of the subjects was 34.88±9.15 years. Moreover, 3.2% of subjects had inadequate health literacy, 13.9% had health literacy at a border level, and 82.9% had sufficient health literacy. In this study, 46.8% and 88.2% of the women did not undergo Pap tests and mammography, respectively, and 73.9% were never referred to the health centers for clinical examination of breasts. In addition, health literacy had a significant relationship with monthly breast examination and undergoing Pap smear (P&lt;0.001), but health literacy had no significant relationship with undergoing mammography and clinical breast examination (P&gt;0.05). Conclusion: The results of this study indicated that women with higher levels of health literacy are more likely to get in the habit of doing monthly breast self-examination and undergoing the Pap test. Thus, it is suggested that this result be considered in prevention programs (primary and secondary) to increase women’s health.

Influence of distance to health facilities on clinical breast cancer screening behaviour among women in five sub-Saharan African countries

BackgroundRegular breast screening is one of the most effective ways to detect early signs of breast cancer but travel distance to cancer-diagnostic facilities can affect breast screening attendance. Yet, limited studies have examined the impact of distance to cancer-diagnostic facilities on clinical breast screening behaviour among women in sub-Saharan Africa (SSA). This study examined the influence of travel distance to a health facility on clinical breast screening behaviour in five SSA countries: Namibia, Burkina Faso, Cote D’Ivoire, Kenya, and Lesotho. The study further assessed variations in clinical breast screening behaviour across diverse socio-demographic characteristics of women.MethodsA sample of 45,945 women was drawn from the most recent Demographic and Health Surveys (DHS) for the included countries. The DHS uses 2-stage stratified cluster sampling to select nationally representative samples of women (15–49) and men (15–64) via a cross-sectional design. Proportions and binary logistic regression were used to examine associations between the women’s socio-demographic characteristics and breast screening attendance.ResultsThe overall proportion of survey participants who underwent clinical breast cancer screening was 16.3%. Travel distance to a health facility had a significant (p < 0.001) impact on clinical breast screening behaviour as 18.5% of participants who self-reported distance as “not a big problem” attended clinical breast screening compared to 10.8% who self-reported distance as “a big problem”. The study further found that various socio-demographic factors were significantly associated with breast cancer screening uptake, including age, education level, media exposure, wealth status, parity, contraceptive use, health insurance coverage, and marital status. The multivariate analysis controlling for other factors confirmed the strong association between distance to health facilities and screening uptake.ConclusionsThe study found that travel distance is a significant factor affecting clinical breast screening attendance among women in the selected SSA countries. Furthermore, the likelihood of breast screening attendance varied depending on different women’s characteristics. It is crucial to prioritise breast screening interventions, particularly among the disadvantaged women identified in this study, to achieve maximum public health benefits.

Abstract P5-04-05: Predictors of guideline-incongruent breast cancer screening in an urban comprehensive cancer center

Abstract Background: Guideline-congruent breast cancer (BC) screening is imperative to systematically curb BC mortality. This study was conducted to identify predictors of BC screening behaviors congruent with guidelines from various nationally recognized organizations (e.g, American Cancer Society, National Comprehensive Cancer Network, American College of Radiology) among high- and average-risk women, and to elucidate the alternative screening behaviors of women who were incongruently screened. Methods: Medical records of 6,090 women who received at least two screening mammograms from January 2016 to March 2018 at the Karmanos Cancer Institute were reviewed to determine breast cancer risk status (classified by the Tyrer-Cuzick model) and breast density status to determine whether breast cancer screening was concordant with risk-driven screening guidelines. Breast density was determined by BI-RADS density scoring, with non-dense breasts defined by a score of A or B, and dense breasts as C or D. For women at average-risk of breast cancer, incongruent screening was defined as receiving supplemental imaging in the interval between screening mammograms. For high-risk women, incongruent screening was defined as not having a recommended supplemental image in the interval between screening mammograms. Further, we examined BC risk, breast density, age, and race as predictors for guideline-concordant screening. Results: The screening cohort included 73.3% Black and 26.7% White women of whom 86.5% were classified as average-risk, 7.7% intermediate risk and 5.8% high risk. Further analyses focused on women with average and high-risk of breast cancer. Among both average- and high-risk women, 390 (6.9%) were incongruently screened, however the rate of incongruent screening was much higher among high-risk vs. average risk women (97.7 vs. 0.9%, p&amp;lt; 0.01). Among average-risk women, incongruent screening was more likely among women with dense vs. non-dense breasts (2.0% vs 0.1%, p&amp;lt; .01). High-risk women were more likely to be incongruently screened if they had non-dense compared to dense breasts (99.5% vs 95.2%, p &amp;lt; .01). Younger women more likely to be incongruently screened among average-risk women (55.11 [SD = 10.24] vs 62.20 [SD = 9.73]; t5267 = 4.87, p &amp;lt; .01, d = 0.73), whereas older women were more likely to be incongruently screened among high-risk women, although this difference was not statistically significant (52.38 [SD = 7.27] vs 47.50 [SD = 8.57]; t351 = 1.87, p = .06, d = 0.67).There was no significant impact of race and incongruent screening for individual risk-level categories. With the exception of rendering the age effect non-significant, preliminary multivariable analyses did not significantly change the results. Further analyses will be conducted to assess the relationship between predictive factors and incongruent screening. Conclusions: An apparent lack of adherence to evidence-based screening guidelines for BC has led to underutilization of supplementary breast imaging for women at high-risk for BC. Further interventions are needed to promote increased supplemental imaging for this group of women. Citation Format: Alexandra Wehbe, Madeleine Gonte, Suzanne O’Neill, Alit Amit-Yousif, Kristen Purrington, Mark Manning, Michael Simon. Predictors of guideline-incongruent breast cancer screening in an urban comprehensive cancer center [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-04-05.

Breast Cancer Beliefs and Screening Practices among Syrian Refugee Women and Jordanian Women.

Despite significant declines in breast cancer (BC) incidence in the West, this disease is widespread in Jordan, where cancer detection occurs at much advanced stages. This is particularly concerning for Syrian refugee women resettled in Jordan, who are less likely to undergo cancer preventative procedures because of poor health literacy and lack of health services access. The present work assesses and compares breast cancer awareness and breast cancer screening behaviors among Syrian refugee women and Jordanian women residing close to the Syrian-Jordanian border city of Ar-Ramtha. A cross-sectional survey was conducted using a validated Arabic version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ). A total of 138 Syrian refugee women and 160 Jordanian women participated in the study. Results indicate that 93.6% of Syrian refugee women and Jordanian women ≥ 40 years of age reported never having undergone a mammogram. Syrian refugee women and Jordanian women reported low attitudes toward general health checkup (mean score for Syrian refugees 45.6 vs. 42.04 among Jordan women; p = 0.150). Barriers for BC screening were higher among Syrian refugees (mean score = 56.43) than Jordanian women (mean score = 61.99, p = 0.006). Women with higher education were more likely to report fewer barriers to screening (p = 0.027). The study documents a significant lack of BC screening awareness among Syrian refugee women and Jordanian women, indicating that future work is needed to alter current attitudes towards mammograms and early detection measures especially for Syrian refugee women and Jordanian women residing in rural areas of Jordan.