Breast Cancer Screening Practices Research Articles

Breaking barriers: improving mammography screening accessibility and quality of care for breast cancer women with disabilities in Saudi Arabia

IntroductionBreast cancer screening remains pivotal in early detection and intervention. However, disparities persist, particularly among women with disabilities, necessitating a comprehensive understanding of their screening practices. This study aims to investigate breast cancer screening behaviours in Saudi women with disabilities.MethodsA cross-sectional study conducted in Saudi Arabia surveyed 307 women with disabilities, evaluating their screening frequency, knowledge of mammography, disability types, and duration. The Statistical Package for the Social Sciences (SPSS) was employed for data analysis.ResultsThe study found that 70.4% of participants had irregular breast cancer screenings, and 92.5% lacked tailored information on breast cancer screening. The primary sources of information were support groups (59.3%) and healthcare professionals (25.4%). Significant associations were observed between education levels and awareness of the importance of mammography and the increased risk of breast cancer in individuals with disabilities. Notably, participants with higher education levels demonstrated greater awareness.ConclusionThe findings highlight substantial gaps in breast cancer screening practices and knowledge among Saudi women with disabilities. There is a critical need for tailored educational programs, accessible information, and targeted awareness campaigns to address these disparities. Enhancing the accessibility of screening services and information for this demographic is essential for improving healthcare equity and outcomes.

Determinants of breast cancer screening behavior amongst Nigerian women using the transtheoretical model

Breast cancer is a leading cause of morbidity and mortality amongst women in developing and developed countries. Breast Self-Examination (BSE), mammography and clinical examination are amongst the most effective methods of early detection, however uptake remains low. The Transtheoretical Model (TTM) has been used in many other countries to characterize behavioral shifts related to enable the adoption of more focused tactics for improving breast cancer screening behaviors among Nigerian women. A cross-sectional research study was conducted to assess the level of knowledge and uptake of breast cancer screening practice based on the various stages of readiness and change predictors using the Transtheoretical Model (TTM). The model was applied to identify and characterise key behavioural determinants such as decision balance, stage of change, and process of change (POC) for breast cancer screening through breast self-examination and mammography. A total of 265 adult female respondents in Kaduna State, Northwest, Nigeria was sampled out of which ninety-one (91%) had no family history of breast cancer. Although 80.3% had knowledge of breast cancer disease, 68% of respondents knew how to conduct BSE and only 55% practiced it. In terms of BSE behaviour staging, 29.4% and 26.7% respondents are in the preparation and maintenance stages respectively. In terms of mammography adoption, most respondents (34%) are in the preparation stage. Review of process of change determinants show that breast cancer screening behaviour are driven more by experiential determinants as compared to behaviour determinants. Addressing the complex factors influencing BSE and mammography practice requires a comprehensive social behaviour change approach that may sustaining positive behaviour-driving factors and minimise inhibitive factors that can promote breast cancer screening.

Mammography screening among women attending primary healthcare centers in Monastir, Tunisia

Abstract Background Breast cancer is the leading cancer among women worldwide. Early detection through mammography screening improves prognosis and enhances survival rate for this disease. The aim of this study was to identify the factors associated with mammography screening utilization among women attending primary healthcare centers. Methods A cross-sectional study was conducted in four primary healthcare centers in Monastir governorate in October 2023 using a pre-tested questionnaire. Women aged over 45 years-old were included as they were the target group in the breast cancer screening strategy. Univariate then multivariate analyses were performed in order to identify the factors associated with mammography screening utilization. Data was analyzed by SPSS 21.0. Results A total of 192 women were included in the study with a mean age of 56.7±8.8 years-old. Among them, 79.7 % (n = 153) were married and 51.6% (n = 98) had three children and less. A total of 55.3 % (n = 94) had a primary education level. Regarding participants’ practices of breast cancer screening, 35% of our participants have had mammogram. Univariate analysis showed that the knowledge about breast cancer symptoms (p = 0.015), practicing Breast self-examination (BSE) (p = 0.002), being aware about mammography (p = 0.001) and the recommended age of the screening at 45 years-old (p = 0.001) were significantly associated with adherence to breast cancer screening. Multivariate analysis revealed that practicing BSE (ORa=2.60 [95%CI: 1.22-5.55] and knowing the recommended age of mammography screening (ORa=2.28 [95%CI: 1.17-4.45] were significant (P < 0.05) predictors of mammography screening utilization. Conclusions Mammography screening rate is low. This study had provided some informations about factors influencing mammography screening. Policymakers and public health practitioners should consider the identified factors when developing intervention programs to improve breast cancer screening. Key messages • There is a need to conduct education sessions in schools to raise awareness about breast cancer screening at an early age. • Social media can be a tool for health education on mammography screening.

Breast Cancer Screening in Transgender Population: Review of literature.

This literature review explores breast cancer screening practices among transgender individuals globally, emphasizing the overlooked population in Pakistan. With an overview of intersex and transgender terminology, the study delves into screening guidelines for transfeminine and transmasculine patients, considering hormone therapy and surgery. Worldwide statistics on transgender and intersex populations are provided, highlighting the unique challenges they face, particularly in Pakistan, where societal discrimination and healthcare barriers persist. Databases searched included PubMed, Scopus, and Google Scholar from the Year 2000 till todate.The review synthesizes breast cancer screening recommendations in transgender population from ACR, WPATH, UCSF, and the Canadian Cancer Society, revealing variations in guidelines. It concludes with a call for tailored screening protocols for Pakistan's transgender community and recommends a comprehensive study due to the absence of data in Southeast Asia. The unstructured abstract underscores the need for nuanced, personalized screening strategies and emphasizes the critical gap in knowledge specific to breast cancer in this marginalized population.

Uptake of Breast Cancer Screening Practices in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis.

Breast cancer is the most prevalent cancer worldwide and the leading cause of cancer mortality in women. Uptake of breast cancer screening and early-detection practices in low- and middle-income countries (LMICs) has not been synthesized. We aimed to systematically quantify uptake of breast cancer screening in LMICs. We performed a systematic review and meta-analysis of observational population-based studies that reported the uptake of screening or early-detection practices. We searched PubMed, Scopus, Embase, and Web of Knowledge databases to January 2024. We pooled data using random-effects meta-analysis, and explored heterogeneity using subgroup analyses. 174 population-based studies encompassing >78 million women were included. Pooled prevalence of self-reported uptake of screening mammography, self-reported having had clinical breast examination for screening, and self-reported regular breast self-examination (relevant for breast awareness in LMICs) were 22.7% (95% CI: 18.6-27.2), 23.1% (95% CI: 19.5-27.0), and 14.6% (95% CI: 11.6-17.9) respectively. Uptake of breast cancer screening practices was lowest in Africa and low and lower-middle income countries. Uptake of breast cancer screening practices remained stable over time or slightly decreased. Women who lived in rural area, were single, had lower income level, had low educational attainment, were unemployed, were uninsured and had no family history of breast cancer were generally least likely to self-report uptake of breast cancer screening. This meta-analysis identified concerningly low uptake of breast cancer screening practices in LMICs. Governments should prioritize developing context-appropriate strategies to address this low uptake to support population-level stage-shifting of breast cancer in LMICs.

Understanding Breast Cancer Awareness, Perceptions, and Screening Practices Among the Population of Jazan, Saudi Arabia: A Cross-Sectional Study.

Breast cancer represents a significant global health challenge, with Saudi Arabia experiencing high incidence rates, particularly among females. Early detection through screening methods such as mammography and breast self-examination offers promise in reducing mortality rates. However, participation in screening remains suboptimal, posing a barrier to effective cancer control. In regions like Jazan, situated in southwestern Saudi Arabia, comprehensive studies on breast cancer awareness and screening practices are lacking. This cross-sectionalstudyconducted in Jazan, Saudi Arabia, aimed to comprehensively assess breast cancer awareness, perceptions, and screening practices among the local population.An online survey platform was utilizedto reach individuals aged 18yearsor older residing in Jazan. Recruitment effortsutilizedsocial media platforms, community networks, and local organizations to ensure diverse representation across socioeconomic backgrounds, education levels, and geographical locations.A meticulously designed questionnaire captured demographic information, breast cancer awareness, knowledge, health-seeking behaviors, screening practices, and barriers to mammogram screening.Participants provided electronic informed consent before self-administering the questionnaire. The study conducted in Jazan, Saudi Arabia, encompassed 533 participants, predominantly young to middle-aged individuals. Most participants were Saudi nationals (97.6%), employed in the government sector (55.7%), and resided in urban areas (61.0%). Awareness of breast cancer was high, with 98.1% having heard of the disease. However, perceptions of age of onset and prevalence varied. While participants showed varied awareness of breast cancer warning signs and risk factors, family history was a commonly agreed-upon risk factor (54.4%). Health-seeking behavior for breast cancer symptoms varied, with nipple changes prompting the most immediate medical attention (36.4%). Although most participants were aware of self-breast examination (84.6%) and mammograms (56.7%), utilization rates were suboptimal, with barriers including fear (79.7%) and embarrassment (71.5%) hindering mammogram screening uptake. This study provides insights into breast cancer awareness and screening practices among participants in Saudi Arabia. While awareness of breast self-examination and mammography is high, disparities in screening service access persist due to barriers like fear and embarrassment. Addressing these barriers through culturally sensitive interventions and collaborative efforts is crucial for enhancing screening uptake and promoting health equity.

Incidence and survival of primary metastatic breast cancer in Denmark; implication of breast cancer screening, classification, and staging practice.

Primary metastatic breast cancer (pMBC) accounts for 5-10% of annual breast cancers with a median survival of 3-4 years, varying among subtypes. In Denmark, the incidence of breast cancer increased until 2010, followed by a stabilisation. Several factors influencing pMBC incidence and survival, including screening prevalence, staging methods, and classification standards, remain pivotal but inadequately documented. This retrospective observational study involving pMBC patients diagnosed between 2000 and 2020 encompassed all Danish oncology departments. Data from the Danish Breast Cancer Group database and the National Patient Register included diagnosis specifics, demographics, treatment, and follow-up. Between 2000 and 2020, 3,272 patients were diagnosed with pMBC, a rise from 355 patients in 2000-2004 to 1,323 patients in 2015-2020. The increase was particularly observed in patients aged 70 years or older. Changes in tumour subtypes were observed, notably with a rise in human epidermal growth factor receptor 2 (HER2)-positive cases but a steady distribution of estrogen receptor (ER) status. Diagnostic practices changed over the two decades, with 6% evaluated with PET/CT (positron emission tomography-computed tomography) or CT (computed tomography) with a bone evaluation in 2000-2004 and 65% in 2015-2020. Overall survival (OS) improved from 23 months in 2000-2004 to 33 months in 2015-2020. In patients with ER-positive and HER2-positive disease, the multivariable model showed improved survival by year of diagnosis, and further, patients with ER-negative/HER2-negative disease fared worse the first 2 years after diagnosis. Our study delineates changes in the treatment and survival of pMBC over two decades. Stage migration, screening introduction, and changes in registration practice, however, prevent a valid assessment of a possible causal relationship.

Abstract PO2-28-09: Long-term Breast Cancer Risk Prediction in Black Women: External Validation of a Mammography-driven AI Model

Abstract Despite the demonstrated potential of artificial intelligence (AI) in breast cancer risk assessment for personalizing screening recommendations, further validation is required regarding AI model bias and generalizability. We performed external validation in Black women of a mammography-driven AI breast cancer risk model (Mirai) originally developed on screening cohorts primarily consisting of White women. In this institutional review board-approved, Health Insurance Portability and Protection Act (HIPAA)-compliant study under a waiver of consent, we retrospectively analyzed a case–cohort sample nested within the core academic breast cancer screening practice of BJC Healthcare, the hospital partner of Washington University in St. Louis. For the purposes of this validation study, relying on 2D digital mammography (DM) images, we focused on Black women presenting for annual DM screening (Selenia or Selenia Dimensions; Hologic) between 2008 and 2018. Eligible breast cancer cases were derived from all women with a breast cancer diagnosis (with associated biopsy-confirmed tumor pathology via institutional cancer registry) after negative (BI-RADS 1 or 2) DM screening 1 to 5 years prior to cancer diagnosis. We also identified a random sample of controls, defined as women who had negative (BI-RADS 1 or 2) DM screening, with 1 to 5 years of screening follow-up without a cancer diagnosis. Risk scores for all DM exams were calculated via the Mirai model. Performance was evaluated using concordance-index (C) analyses and associated 95% confidence intervals (CIs) for the entire cohort, as well as for study subgroups of invasive versus in-situ cancer and cancer molecular subtypes. We analyzed 1368 DM screening exams, including 672 DM exams from 391 women diagnosed with breast cancer (mean age, 58 years; standard deviation, 10 years) and 696 DM exams from 406 controls (mean age, 55 years; standard deviation, 10 years). The overall C-index was 0.62 [95% CIs 0.60–0.64] for all Black women, which was lower compared to previously reported validation results for Mirai in studies of similar design on predominantly White and racially diverse screening cohorts (C-index = 0.67-0.78). There was no evidence of a significant difference between invasive and in-situ cancer (C-index = 0.64 [95% CIs 0.61–0.66] vs. 0.64 [95% CIs 0.61–0.67]). Compared to other cancer molecular subtypes, performance was significantly higher among triple-negative (C-index = 0.67 [95% CIs 0.62–0.71]) and estrogen receptor (ER) negative cancer (C-index = 0.66 [95% CIs 0.61–0.70]). A previously developed mammography-driven AI model showed overall good performance in long-term breast cancer risk assessment in a dataset of Black women only, particularly for triple-negative and ER- cancer types. However, performance was lower compared to previously reported validation results from similar studies on predominantly White and racially diverse screening cohorts. Our results suggest that further refinements are needed towards more accurate breast cancer risk assessment in Black women. Long-term breast cancer risk prediction performance (C-indices) of Mirai in the full cohort of Black women and in study subgroups. Citation Format: Juanita Hernandez Lopez, Zhixin Sun, Shirin Shoushtari, Ulugbek Kamilov, Debbie Bennett, Aimilia Gastounioti. Long-term Breast Cancer Risk Prediction in Black Women: External Validation of a Mammography-driven AI Model [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-28-09.

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.

Abstract CT272: A cluster randomized trial to evaluate a church-based navigation model to increase breast cancer screening in Korean women (Faith In Action!): Trial in progress

Abstract Background: Breast cancer is the most commonly diagnosed cancer among Korean American women and incidence in this group is rising. Advanced-stage disease is more frequent among Korean women diagnosed with breast cancer than in other ethnicities due to low adherence to screening. Lower socioeconomic status, cultural barriers, perceived norm, distrust of healthcare system, and lack of awareness and culturally tailored communication on benefits of screening contribute to low screening utilization. Church settings offer important platforms for education as a majority of Korean American women >50 years regularly attend church services. Thus, the objective of this trial was to evaluate the efficacy of a culturally tailored intervention “Faith in Action!” on breast cancer screening adherence rates among Korean American women. Methods: A parallel cluster randomized trial with staggered roll-out will be conducted to evaluate the efficacy of the “Faith in Action!” intervention, a church-based small group education and lay health navigator program, delivered by trained church members, on breast cancer screening among Korean American women (NCT05298605). This study was designed and conducted in partnership with a Community Advisory Board. Trial enrollment began in July 2022 and is ongoing. Twenty-four total Korean churches in Los Angeles were randomized within blocks of 8 churches to either intervention or waitlist control conditions in a 1:1 ratio. Using a train-the-trainer approach, lay navigators from the Korean Church community nominated by church leadership are trained and certified to deliver the Faith in Action! intervention to study participants over a 6-month program period. Participants at churches randomized to the waitlist control group receive an educational presentation on physical activity and nutrition and, after 6-month follow-up, are invited to receive the Faith in Action! intervention. Eligible participants include women of Korean descent, ages 45-75 years, who: attend a participating church, do not have a breast cancer diagnosis, and did not receive mammogram in the last 2 years. The primary outcome is adherence to breast cancer screening guidelines within 6 months from end of program. Secondary outcomes include adherence to breast cancer screening within 1 year and participant knowledge about breast cancer screening practices. Qualitative interviews will be conducted to assess participants’ knowledge and barriers surrounding cancer screening decisions and program acceptability. To date, 16 churches (149 total participants) have been enrolled in the study and are being followed. It is expected that findings from this research will inform community-based efforts to increase breast cancer screening adherence among Korean American women and improve understanding of screening barriers in this group that is disproportionately impacted by breast cancer, while building capacity and opportunities for sustainability in the Korean faith community. Citation Format: Gillian Gresham, Christie Y. Jeon, Dong Hee Kim, Min Jung Sung, Laurel J. Finster, Marcio A. Diniz, Michael Fine, Zul Surani, Alison K. Herrmann, Jeong Yup Lee, Robert W. Haile. A cluster randomized trial to evaluate a church-based navigation model to increase breast cancer screening in Korean women (Faith In Action!): Trial in progress [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr CT272.

Lacked of Breast Cancer Awareness of Indonesian Rural Women: A Descriptive Study to Adult Women in District Pangandaran, Indonesia

Breast cancer remains a significant global health challenge, particularly in low and middle-income countries like Indonesia. Patients with advanced metastatic breast cancer have a dismal prognosis. A cancer promotion program’s failure can be attributed to low awareness of breast cancer. This descriptive study aimed to evaluate breast cancer awareness among adult women in District Pangandaran, Indonesia. Data was gathered in July 2018 from 189 individuals using a verified Breast Cancer Awareness Measure instrument developed by Cancer Research UK. Results revealed a concerning lack of awareness among participants regarding various breast cancer risk factors, symptoms, and screening practices. Additionally, reluctance to seek medical help due to fear of diagnosis was observed, particularly among housewives without health insurance. These findings highlight the urgent need for comprehensive health programs to enhance breast cancer awareness and promote early detection strategies tailored to the Indonesian population, especially in rural areas. Healthcare providers and public health workers play a vital role in this effort, along with implementing innovative health promotion policies by the government to improve cancer prevention programs.

229 (PB-136) Poster - Breast cancer knowledge and screening practices among women in Uruguay

229 (PB-136) Poster - Breast cancer knowledge and screening practices among women in Uruguay

Perceptions of breast cancer screening programs and breast health among immigrant women: Qualitative study in Alberta.

To examine how women who have emigrated from the Middle East and North Africa (MENA) region perceive breast cancer risk and screening in Canada and how they approach breast health, and to explore barriers to breast cancer screening in this population. Focused ethnography. Edmonton, Alta. Women who were born in MENA countries (eg, Egypt, Iraq, Lebanon, Libya, Saudi Arabia, Somalia, Sudan, and Syria) and had immigrated to Canada less than 5 years prior to study recruitment and lived in Edmonton, Alta. Six focus groups were conducted over a 6-week period in July and August 2018 with 6 participants in each group (N=36); results were analyzed thematically. Three broad themes were identified: knowledge about breast health, cancer risk, and screening services; barriers to maintaining breast health and to screening; and potential solutions for overcoming these barriers. Findings indicated participants have limited knowledge about breast cancer screening practices in Alberta and that multiple barriers to screening remain. This study can help inform the development of culturally appropriate interventions to overcome barriers and to motivate women from MENA countries to use breast cancer screening.

Assessing Awareness, Attitude, and Practices of Breast Cancer Screening and Prevention Among General Public and Physicians in Pakistan: A Nation With the Highest Breast Cancer Incidence in Asia

Introduction: Breast cancer is a global health challenge with significant mortality, affecting millions worldwide. The current study is aimed at evaluating awareness and practices related to breast cancer screening, prevention, and treatment among the general public and physicians in Lahore, Pakistan, which has a significant incidence of breast cancer.Methodology: The current study adopted a cross‐sectional study design conducted in Lahore, Pakistan, between March and August 2023, among 404 participants from the general public and 240 physicians. Data collection and evaluation involved the use of validated questionnaires, and both descriptive and inferential statistics were performed using SPSS Version 25.Result: In Lahore, Pakistan, breast cancer awareness among the public was low, with 80.2% unaware of its global prevalence, 65.3% believing not everyone is at risk, and only 42.1% recognizing symptoms. Females showed greater awareness (OR: 1.020, CI: 0.617–1.686, p = 0.002) and positive attitudes (OR: 2.711, CI: 1.478–6.478, p = 0.045), while the 18–29 age group had higher odds of positive practices (OR: 4.317, CI: 2.678–5.956, p = 0.004). Educational attainment significantly influences knowledge and attitudes. Only 13.9% practiced self‐examination. Among physicians, 88.8% were confident in screenings, but patient fear (42.9%) and financial barriers (79.2%) hindered action. Physicians with FCPS qualifications had higher odds of awareness (OR: 1.550, CI: 1.130–2.117, p = 0.007), attitudes (OR: 1.500, CI: 1.050–2.150, p = 0.025), and practices (OR: 1.470, CI: 1.070–2.017, p = 0.020). Those with 11–20 years of experience also showed better awareness (OR: 1.400, CI: 1.050–1.868, p = 0.022) and attitudes (OR: 1.450, CI: 1.045–2.018, p = 0.029).Conclusion: In conclusion, breast cancer awareness among the general public is limited, highlighting the need for tailored education programs. Although most physicians show high awareness, challenges in patient communication and barriers, such as fear and financial constraints, must be addressed to improve screening uptake. These findings emphasize the importance of targeted interventions to enhance public awareness, screening practices, and physician‐patient communication.

Knowledge and practice of breast cancer screening among PHC centre doctors in Al-Karkh, Baghdad

Knowledge and practice of breast cancer screening among PHC centre doctors in Al-Karkh, Baghdad

Study of North Jordanian women's knowledge of breast cancer causes and medical imaging screening advantages

Backgroundamong both industrialized and developing nations, breast cancer is the most prevalent type of cancer among women. The purpose of this research project is to evaluate adult females in northern Jordan's level of awareness regarding breast cancer risk factors and potential causes. A link between certain variables and their comprehension of breast cancer risk factors was established, enabling us to take appropriate measures to increase women's awareness. MethodsWe conducted a cross-sectional study using a self-administered questionnaire to assess the awareness of breast cancer risk factors, treatment beliefs, and screening practices among adult females in north Jordan. There was a scoring system used. IBM SPSS Statistics (Version 20.0) was used to conduct all statistical analyses. ResultsOnly 18.11% of participants (n = 201) reported having little understanding of breast cancer risk factors; 36.31% of participants (n = 403) reported having fair knowledge; and 45.58% of participants (n = 506) reported having a good grasp of breast cancer risk factors. ConclusionThe study's findings show that North Jordanian women are well informed about breast cancer and its potential causes. To improve females' knowledge of breast cancer, however, we advocate for the need for ongoing medical education programs.

The Impact of Artificial Intelligence on the Uptake of Mammography Screenings in Women

This comprehensive review examines the role of artificial intelligence (AI) in influencing the uptake of mammography screenings in women. The review includes an analysis of peer-reviewed articles exploring the various aspects of AI's impact on breast cancer screening rates, accuracy, efficiency, patient experiences, and cost-effectiveness. Through this analysis, the review aims to shed light on the potential of AI to enhance breast cancer screening practices and outcomes.

EXPLORING BREAST CANCER SCREENING BEHAVIORS AMONG UNDERGRADUATE FEMALE STUDENTS IN PESHAWAR, PAKISTAN: A COMPARATIVE ANALYSIS OF MEDICAL AND NON-MEDICAL DISCIPLINES

BACKGROUND: Breast cancer is a growing global health concern, impacting even developing nations like Pakistan. Timely detection is pivotal, relying heavily on awareness campaigns and screening practices. OBJECTIVES: This study delves into knowledge regarding breast cancer screening techniques and screening practices among undergraduate female students in Peshawar, Pakistan, encompassing both medical and non-medical disciplines. METHODOLOGY: A comprehensive comparative observational study was conducted between April and July 2023. The research involved 600 students (301 medical, and 299 non-medical) who were surveyed through a self-constructed questionnaire. The data analysis encompassed demographics, breast cancer awareness, screening behaviors, and future intentions, providing a holistic perspective. RESULTS: Among participants, a noteworthy 96.7% (580) were already acquainted with breast cancer, but only 43.1% (250) had awareness of breast self-examination. Importantly, 46.4% (163) of the 580 participants who had never undergone screening cited a perceived low risk as the primary reason. Encouragingly, 70.7% (410) expressed their intent to commence screening in the future, with 34.3% (206) indicating an initiation age between 16 and 20 years. Information sources primarily included social media, teachers, and maternal guidance. CONCLUSION: The study accentuates the dire need for improved breast cancer education among female students, emphasizing the paramount importance of early detection. Key recommendations encompass educational initiatives within schools, hands-on self- examination workshops, and promoting consultations with healthcare professionals. KEYWORDS: Breast Cancer, Screening Practices, Early Detection of Cancer

Breast cancer quality of care in Syria: screening, diagnosis, and staging

BackgroundThe Syrian decade-long war has severely affected the healthcare system, including almost vanishing cancer screening practices, war-destroyed medical facilities, and lack of continuous medical education. This study aims to present data on the affected breast cancer screening practices, methods of diagnosis, and stages distribution in Syria.MethodsMedical charts of breast cancer patients treated at Albairouni University Hospital between January 2019 and May 2022 were retrospectively reviewed. Eligible patients were women diagnosed with primary breast cancer. Exclusion criteria included females receiving neoadjuvant chemotherapy and incomplete charts. Data regarding the patient’s age, city of residence, marital status, number of children, smoking habits, method of diagnosis, tumor size (T), lymph nodes (N), and distal metastasis (M) were collected. We used Microsoft Excel and Statistical Package for the Social Sciences (SPSS) to analyze data. Descriptive methodology (frequency [n], percentage) was used.ResultsThe number of charts reviewed was 4,500. The number of remaining charts after applying the exclusion criteria was 2,367. The mean age was 51.8 (SD = 11.3). More than half of the patients (58.3%) came from outside Damascus -where the hospital is located- and its suburbs. Less than 5% of the population detected cancer by screening mammography. Only 32.4% of patients were diagnosed by a biopsy, while surgical procedures (lumpectomy and mastectomy) were used to diagnose 64.8% of the population. At the time of diagnosis, only 8% of patients presented with local-stage disease (stages 0 & I), 73% had a regional disease (stages II & III), and 19% had metastatic breast cancer (stage IV).ConclusionOur retrospective chart review analysis is the first comprehensive review in Syria for female breast cancer patients. We found a significant low percentage of patients diagnosed based on a screening mammogram, much higher surgical biopsies rather than a simple imaging-guided biopsy, and much lower than the national average of early-stage disease. Our alarming findings can serve as the base for future strategies to raise the population’s health awareness, create more serious national screening campaigns, and adopt a multidisciplinary approach to the disease in Syria.

The Sociocultural Influences on Breast Cancer Screening among Rural African Women in South Africa.

The incidence of breast cancer in South Africa is increasing, with rural South African women presenting with advanced stages of the disease. A woman's breasts are a symbol of her womanhood; they also constitute a social definition of her femininity. Women with breast cancer in rural South Africa are heavily stigmatized and suffer from various sociocultural interpretations of the disease. Breast cancer is frequently interpreted in rural South Africa as a symbol of witchcraft, sin, and punishment, and traditionally, it is treated by offering animal sacrifices, consumption of herbs, and prayer to ancestors. Using care-seeking behaviour theory as the theoretical framework, we intend to explore the sociocultural factors influencing breast cancer screening practices among rural South African women. A qualitative exploratory study was conducted using semi-structured interviews with 22 rural South African women selected by purposive sampling. Thematic analysis was used to analyse the data. The study identified four sociocultural factors influencing women's practices of breast cancer screening in rural South Africa, including psychological factors, habits, beliefs, and perceptions of healthcare. Women in rural South African communities have deep-rooted traditional beliefs and practices regarding breast cancer. Consequently, this influences women's preventative health behaviours regarding breast cancer screening. The development of culturally appropriate health education programs involving traditional healers and influential community leaders is essential to increasing the number of women being screened for breast cancer in rural South Africa.