Breast Cancer Screening Services Research Articles

Assessing patient eligibility at breast imaging for receipt of additional health screenings.

e23099 Background: Cancer screenings reduce morbidity and mortality. Breast cancer screenings are a well-known and utilized tool by many women. However, a suboptimal percentage of women are receiving additional eligible health screenings. A lack of health literacy and knowledge surrounding the importance of timely screenings contributes to low uptake. In this study, we aim to investigate the uptake of osteoporosis screening in women who presented for breast cancer screening. Methods: Data from all breast imaging patients of an urban, academic breast imaging center from January 2020-July 2023 was extracted from the EMR. Eligibility for osteoporosis screening was determined through clinical data query and the National Osteoporosis Foundation. Data variables such as race, primary language, and whether eligible patients underwent an osteoporosis screening were analyzed. A chi-square analysis was performed to determine the significance of these results. Results: A total of 56,945 patients presented to the breast imaging center between July 2020-July 2023. Of those patients, 22,443 (42.6%) were aged 65 and older indicating eligibility for a DEXA scan. 61% of these patients who were eligible for a DEXA scan received at least one scan, while 38.9% of them who met criteria did not receive a scan. Within racial groups, the Hispanic population had the highest uptake with 2318 (68.8%), followed by African American 5624 (62.5%), Asian 508 (60.3%), White 6151 (58%), and Other 322 (51.5%). Within the identified primary language, 187 (70.57%) of the Bilingual, 1101 (66.7%) Spanish, Other (66.03%), English (59.9%) received a DEXA scan. Statistically significant results (p < 0.0001) indicated that bilingual patients were more likely to have a DEXA scan than English as primary language patients. The differences between demographics and receiving a DEXA scan were statistically significant for all analyses (p < .0001). Conclusions: The main variables that influence the decision of breast imaging patients to complete a DEXA scan are a non-White race and non-English primary language, possibly due to the presence of adequate interpretation services, culturally competent care, and available education material. Nearly 40% of patients who presented for breast cancer screening were eligible for a DEXA scan but did not receive one. This suggests the need for interventions to increase uptake. Pairing breast cancer screening services with osteoporosis screening can provide a potential opportunity to capture missed patients. Additionally, further studies are needed to assess the differences in disparities.

Knowledge, attitude and practices around breast cancer and screening services among women of reproductive age in Turbo sub-county, Kenya

BackgroundOnly 12% of Kenyan women use breast cancer (BC) screening programs. Early detection is critical for reducing the condition's associated morbidity and mortality. Unfortunately, few studies have been conducted on the screening program's implementation and the causes for the low usage rates in Turbo Sub-County, Kenya. The purpose of this study was to learn about women of reproductive age's (WRA) practices, attitudes, and knowledge regarding BC screening programs, as well as to investigate the potential association between lifestyle factors and BC screening service utilization. MethodsMixed-method approaches were used in an analytical cross-sectional study design. The study included 317 participants selected randomly. An interviewer-administered questionnaire was used to collect quantitative data while focus group discussion (FGD) and key informant interview (KII) guides were used for collecting qualitative data. The Statistical Package for Social Sciences (SPSS) version 26 was used to manage quantitative data, whereas NVivo version 12 was used to analyze qualitative data. Chi-square, Fisher's exact test, and multiple logistic regression were used to assess the degree of relationship between BC screening service uptake and independent variables. The qualitative data was transcribed verbatim, and the transcripts were automatically coded to generate themes. ResultsThe participants' mean age was 30.14 (9.64). Breast cancer screening services were used by 10.21% of the population. Women who were aware of the signs and symptoms of BC were 71.5 times more likely to undergo screening than their counterparts. Similarly, those with positive attitudes toward BC and screening programs were 84 times more likely to get screened than those with negative attitudes. Breastfeeding increased the likelihood of BC screening by OR = 37 (95% CI: 0.00–0.32), physical activity by OR = 37 (95% CI: 0.00–0.25), and chronic illnesses by OR = 37 (95% CI: 0.00–0.17). ConclusionKnowledge of signs and symptoms of BC and a positive attitude towards perceived barriers enhanced the probabilities of BC screening. Being physically active, breastfeeding, and having a chronic disease all increased the odds of BC screening uptake. To improve screening rates, it is necessary to provide sufficient information to those who are least likely to be screened.

Customer-Care Initiatives of Service Providers and the Uptake of Breast and Cervical Cancer Screening Services in Mutare, Zimbabwe

Social marketing globally promotes social mobilization to increase uptake of recommended health services. The Ministry of Health and Child Care in Zimbabwe markets breast and cervical cancer screening for reproductive-age women. Despite efforts, uptake remains low, particularly in Mutare district. To address this, an analytical cross-sectional study was conducted in Dangamvura suburb to explore the relationship between service providers' customer-care initiatives and screening uptake. Qualitative and quantitative data was collected via interviews with 96 women aged 18 to 49, randomly selected from Dangamvura Poly-Clinic departments. Of these women, 13.5% were screened for breast cancer, 30.3% for cervical cancer, and 78.8% expressed intent to screen. 90.3% had accurate knowledge of breast and cervical cancer, but only 30.3% could identify screening sites. Among those screened, 75.8% intended to retest. Primary motivations for screening included a desire for health status knowledge (39.2%) and reproductive system issues (32.1%). Main barriers for non-screened women were lack of motivation (56%) and fear of positive results (16.7%). Logistic regression indicated protective factors for screening uptake: history of reproductive issues (AOR: 9.0678, p: 0.0029), prior breast cancer screening (AOR: 21.4347, p: 0.0006), and age 31 to 49 (AOR: 0.1754, p: 0.0066). Overall, uptake was low, influenced by customer factors (age, reproductive issues, prior breast cancer screening) and cost factors (perceived wait times, screening duration, perceived costs). Future interventions aimed at improving uptake of screening services should be tailored to address fears, misconceptions, and lack of motivation to screen among women of reproductive age.

Factors affecting the participation and utilization of breast cancer screening services among health care workers Kolar: a qualitative study

Factors affecting the participation and utilization of breast cancer screening services among health care workers Kolar: a qualitative study

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.

What Breast Cancer Screening Program do Rural Women Prefer? A Discrete Choice Experiment in Jiangsu, China.

Chinese rural women aged 35-64 years are encouraged to complete breast cancer screening (BCS) free of charge. However, it is challenging to reach a satisfying BCS uptake rate. In this study, rural women's preferences and preferences heterogeneity were measured for the development of strategies to enhance participation in BCS. A cross-sectional survey with a discrete choice experiment (DCE) was conducted via convenience sampling via face-to-face interviews in Jiangsu, China. Six DCE attributes were identified through a systematic literature review; our previous study of Chinese rural women's BCS intentions; a qualitative work involving in-depth interviews with rural women (n = 13), medical staff (n = 4), and health care managers (n = 2); and knowledge of realistic and actionable policy. The D-efficient design was generated using Ngene 1.3.0. A mixed logit model (MXL) in Stata 18.0 was used to estimate the main effect of attribute levels on rural women's preferences. The relative importance and willingness to utilize BCS services (WTU) were also estimated. The heterogeneous preferences were analyzed by a latent class model (LCM). Sociodemographic status was used to predict the characteristics of class membership. The WTU for different classes was also calculated. A total of 451 rural women, aged 35-64 years, were recruited. The MXL results revealed that the screening interval (SI) was the most important attribute for rural women with regard to utilizing BCS services, followed by the level of screening, the attitude of medical staff, ways to get knowledge and information, people who recommend screening, and time spent on screening (TSS). Rural women preferred a BCS service with a shorter TSS; access to knowledge and information through multiple approaches; a shorter SI; a recommendation from medical staff or workers from the village or community, and others; the enthusiasm of medical staff; and medical staff with longer tenures in the field. Two classes named "process driven" and "efficiency driven" were identified by the preference heterogeneity analysis of the LCM. There is a higher uptake of breast cancer screening when servicesare tailored to women's preferences. The screening interval was the most important attribute for rural women in China with a preference for a yearly screening interval versus longer intervals.

Knowledge about Breast Cancer and Barriers to Screening among Saudi Women in Al-Baha Region.

The aim of this study was to measure the knowledge about breast cancer and to identify the barriers in screening among Saudi women in the Al-Baha region. To achieve this, a cross-sectional study was conducted, involving 468 women, to assess their understanding of breast cancer and to explore the obstacles they face in accessing breast cancer screening services. The cross-sectional study included 468 women from Al Baha, Saudi Arabia, starting from May 17, 2022, to May 17, 2023. Participants were interviewed by well-trained team members of the research, and their responses were subsequently entered into a Google Form. This process aimed to evaluate their awareness, knowledge, and barriers to breast cancer screening. The majority of participants (48.9%) were in the 18-28 age group. The findings reveal a high level of awareness (96.4%) among participants regarding the significance of early breast cancer detection. For the effectiveness of breast cancer treatment, 59% believed there is an effective treatment, while 32.9% were uncertain or did not know. Knowledge about various risk factors for breast cancer varied. Smoking (73.5%), genetic factors (65.6%), and a family history of breast cancer (70.7%) were well-recognized as risk factors. Education and occupation significantly influenced knowledge about breast cancer (p-value of 0.000, and 0.035 respectively). this research highlights strong awareness of breast cancer's importance but gaps in knowledge regarding lesser-known factors. Education is crucial, requiring tailored campaigns and healthcare professional engagement.

Factors influencing the utilization of breast cancer screening services in Korean women using Andersen’s behavioral model

Background: Breast cancer is a major health concern worldwide, and timely screening plays an important role in early detection and improved treatment outcomes. In this study, factors influencing the utilization of breast cancer screening services were examined using Andersen’s behavioral model, which is widely known as a framework for research on health services utilization. Methods: In this cross-sectional study, data from 2,602 women aged 35 and older were analysed. Results: The results of this study shown that the utilization of breast cancer screening was significantly related to predisposing factors, including age and marital status. Moreover, enabling factors, such as income, were also found to be related to screening utilization. However, need factors, such as perceived health status and limitation of activity, did not show a significant association with the utilization of breast cancer screening services. Conclusions: This study identified factors significantly associated with the utilization of breast cancer screening among Korean women. The findings of this study will contribute to better understand the factors influencing the utilization of breast cancer screening and the development of policies for breast cancer prevention.

Abstract C134: Efficacy of mobile mammography and state-funded cancer services in reducing disparities in follow-up adherence: A retrospective analysis

Abstract Objective: Mobile mammography programs, such as the one at Stony Brook Cancer Center (SBCC), play an important role in providing breast cancer screening services to underserved communities. Follow-up to abnormal mammogram screenings is critical for early cancer detection, but patients often encounter barriers that prevent timely diagnostic procedures. We aim to evaluate the role of New York State’s Cancer Services Program (CSP) in facilitating follow-up care among underserved patients who participated in SBCC’s mobile mammography initiative. Methods: We conducted a retrospective analysis of 817 mobile mammography patients who required additional testing following an abnormal mammogram over a five-year period. Of these, 68% were beneficiaries of the CSP, while 32% were insured. Results: Our findings revealed that among CSP beneficiaries, only 3.5% were lost to follow-up, compared to a significant 16.5% of insured patients who did not adhere to recommended follow-up care. This suggests that the CSP’s supportive role is critical in ensuring follow-up care among underserved communities. Conclusions: The CSP’s substantial impact on follow-up care adherence highlights the program's effectiveness in reducing healthcare disparities. However, more work is needed to enhance follow-up care adherence among insured patients. Solutions may include identifying and addressing barriers to care and implementing targeted interventions to improve patient outcomes. Implications for Policy or Practice: Mobile mammography programs, such as SBCC’s initiative, demonstrate a potential strategy for reducing health disparities in breast cancer screening and detection. Securing access to follow-up care is crucial for improving patient outcomes. Addressing barriers to care, strengthening patient education, and enhancing outreach efforts can increase participation in screening initiatives, thus advancing health equity and reducing disparities in breast cancer outcomes. Citation Format: Patrick J. Dineen, Mollie M. Williams. Efficacy of mobile mammography and state-funded cancer services in reducing disparities in follow-up adherence: A retrospective analysis [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C134.

Breast Cancer Screening: Knowledge, Attitudes, and Practices among Female University Students in The Gambia

Background. Breast cancer is the second most prevalent form of cancer in The Gambia, with an incidence rate of approximately 15% and a mortality rate exceeding 50% in 2020. The all-age prevalence stands at 11.25 per 100,000 population. In light of this, we conducted a study to assess the knowledge, attitude, and practice of breast cancer screening among female university students. Method. We conducted an institutional cross-sectional study involving 361 randomly sampled female university students. Data collection was done using a pretested, self-administered questionnaire. We utilized descriptive statistics to describe the prevalence and burden of breast cancer screening among the participants. Results. Our study revealed good knowledge regarding breast cancer screening among female university students, yet 82.8% had a negative attitude about the disease. More than three-quarters (76.6%) of the respondents had never practiced any form of breast cancer screening. Notably, there was a significant association between knowledge of breast cancer screening and attitude ( p = 0.027 ), and factors such as level of study ( p = 0.041 ), ethnicity ( p = 0.026 ), parity ( p = 0.018 ), and faculty of study ( p = < 0.001 ) influenced the participants’ knowledge. Conclusion. It is crucial to implement comprehensive awareness campaigns to address the negative attitude and poor screening practices among female university students regarding breast cancer. Additionally, providing free and widespread breast cancer screening services to students should be considered as a means to combat this disease.

Cost-effectiveness requirements for implementing artificial intelligence technology in the Women’s UK Breast Cancer Screening service

The UK NHS Women’s National Breast Screening programme aims to detect breast cancer early. The reference standard approach requires mammograms to be independently double-read by qualified radiology staff. If two readers disagree, arbitration by an independent reader is undertaken. Whilst this process maximises accuracy and minimises recall rates, the procedure is labour-intensive, adding pressure to a system currently facing a workforce crisis. Artificial intelligence technology offers an alternative to human readers. While artificial intelligence has been shown to be non-inferior versus human second readers, the minimum requirements needed (effectiveness, set-up costs, maintenance, etc) for such technology to be cost-effective in the NHS have not been evaluated. We developed a simulation model replicating NHS screening services to evaluate the potential value of the technology. Our results indicate that if non-inferiority is maintained, the use of artificial intelligence technology as a second reader is a viable and potentially cost-effective use of NHS resources.

Assessment of organization of cervical and breast cancer screening programmes in the Latin American and the Caribbean states: The CanScreen5 framework.

In the Community of Latin American and Caribbean States (CELAC), breast cancer and cervical cancer are the first and third causes of cancer death among females. The objectives are to assess the characteristics of the cervical and breast cancer screening programmes in CELAC, their level of organization, and the association of screening organization and coverage of essential health services. Representatives of the Ministries of Health of 33 countries were invited to the CanScreen5 project. Twenty-seven countries participated in a "Train The Trainers" programme on cancer screening, and 26 submitted data using standardized questionnaires. Data were discussed and validated. The level of organization of the screening programmes was examined adapting the list of essential elements of organized screening programmes identified in a recently published IARC study. Twenty-one countries reported a screening programme for cervical cancer and 15 for breast cancer. For cervical cancer, 14 countries dedicated budget for screening (66.7%), and women had to pay in 3 countries for screening (14.3%), 9 for diagnosis (42.9%) and 8 for treatment (38.1%). Only 4 countries had a system to invite women individually (19.0%). For breast cancer, 8 countries dedicated budget for screening (53.3%), and women had to pay for screening in 3 countries (20.0%), diagnosis in 7 (46.7%) and treatment in 6 (40.0%). One country (6.7%) invited women individually. There was variability in the level of organization of both cancer screening programmes. The level of organization of cervical cancer screening and coverage of essential health services were correlated. Large gaps were identified in the organization of cervical and breast cancer screening services. CELAC governments need pragmatic public health policies and strengthened health systems. They should guarantee sustainable funding, and universal access to cancer diagnosis and treatment. Moreover, countries should enhance their health information system and ensure adequate monitoring and evaluation.

Breast Cancer Awareness Among Pregnant Women at Hoima Regional Referral Hospital, Western Uganda

Breast cancer is a significant public health challenge, especially in less developed regions like sub-Saharan Africa. This study assessed the awareness of breast cancer among pregnant women attending antenatal care services at Hoima Regional Referral Hospital in Western Uganda. A total of 200 participants were involved in this cross-sectional study. The results showed that 86% of the participants had heard about breast cancer, while 14% had never heard of it. Factors like age, level of education, religion, and occupation were found to influence awareness levels. However, most women had insufficient knowledge about breast cancer risk factors. This study highlights the need for intensified health education programs and the decentralization of breast cancer screening services to improve awareness and early detection. Keywords: Breast cancer, cancer mortality, Antenatal care services, Women, Mammography.

Provision of screening services for cervical and breast cancer – A scientific study commissioned by the European Board & College of Obstetrics and Gynaecology (EBCOG)

ObjectiveCancer screening can play an important role in early detection, improving treatment outcomes and reducing morbidity and mortality. Breast and cervical cancers belong to the most common gynaecological cancers group. Countries provide different screening programmes on its eligible population basis centred on different health care policies. This scientific study aims to assess and understand the health inequalities in the member countries of the European Board & College of Obstetrics and Gynaecology (EBCOG) as regards screening programmes of gynaecological cancer, with a special focus on breast and cervical cancers’ screening strategies. Study designA descriptive questionnaire-based study was conducted, addressed to EBCOG member countries. ResultsNinety-one percent of the countries have an organized national or regional screening programme for cervical cancer. Of these, 45% of countries use both cytology and testing for Human Papilloma Virus (HPV) as screening test, 31% use cytology exclusively and 17% only perform HPV testing. Considerable differences were found regarding the interval of screening test: there are countries performing HPV detection triennially, while others perform only conventional cytology every 5 years. Sixty-nine percent of countries included in this study begin screening for cervical cancer in women aged 25 to 29 years, four of them using HPV detection as the screening test. Six countries begin cervical cancer screening before the age of 25. As regards vaccination against HPV, almost all countries have implemented national HPV vaccination programme, except in Poland and Turkey. The 9-valent HPV vaccine is the most frequently offered (77% of countries) and the majority vaccination programmes include both girls and boys. As regards breast cancer screening, all thirty-two countries have an implemented screening programme. All countries perform mammography as the screening test, 62.5% of them begin in women aged 50 to 54, with a 2-yearly interval in the majority. In five countries, screening programmes are performed biennially, starting between 45 and 49 years old. Seven countries start in women aged 41 to 44. ConclusionsThere are discrepancies around gynaecological cancer screenings provision among EBCOG member countries. It is important to establish European recommendations about screening for gynaecological cancers, in order to standardize the access to equitable better health care in gynaecological cancers within Europe.

Access to breast cancer screening among females in China: a focus report on screening rate and composition

Objective: To systematically integrate and analyze the breast cancer screening rates among females in China and to estimate the composition of different screening service types. Methods: Based on core literature, relevant official websites, projects/survey reports, and information on breast cancer screening rates of Chinese females were extracted and analyzed, and the screening rates for 40-69 years old and 35-64 years old were standardized and compared using 2010 China's population structure. The literature review method was used to retrieve the journal literature related to the composition of breast cancer screening services types (organized screening, physical examination and opportunistic screening). The number of detected literature and the median sample size of individual screening people of the three screening service types were analyzed, and used them as weights to estimate the composition of screening service types. Results: A total of 6 related national surveys on breast cancer screening rate were identified, including 2 from the National Health Service Surveys (broader definition of "breast screening" in 2013, 2018) and 4 from the chronic disease monitoring system of China CDC (the exact definition of "breast cancer screening" in 2010, 2013 and twice in 2015). The age-standardized analysis indicated that 1-year, 2-year and 3-year breast cancer screening rates in 2015 among females in China aged 40-69 years old were 16.9%, 20.2% and 21.4%, respectively. The ever-breast cancer-screened rates were 21.1% in 2013 and 23.5% in 2015 among females aged 40-69, and the corresponding rates were 23.3% and 25.7%, respectively, among females aged 35-64. When taking the literature published in 2015 for further literature review, 130 articles were included, in which the proportions of numbers of reports on organized screening, physical examination, and opportunistic screening were 71.0%, 23.7%, and 5.3%, respectively. Along with the extracted data on median sample sizes (shown in the main text) by breast cancer screening types, it was estimated that the individual service volume of corresponding screening types accounted for 88.0%, 11.2% and 0.8% among all the screened females in China in 2015. Conclusions: The breast cancer screening rates among females of appropriate age in China in 2015 are higher than those in 2013. The literature review analysis preliminarily suggested that the current breast cancer screening service type in China is mainly organized screening service.

The review of genetic screening services and common BRCA1/2 variants among South African breast cancer patients.

The South African genetic screening services for breast cancer comprise targeted and comprehensive tests that screen for the presence of genetic alterations. Clinically, these variants determine the risk of disease development as well as treatment approaches best suited for carriers. The current targeted tests screen for seven pathogenic sequence variants, which are mainly common among Whites, a population that constitutes 9.1% of South Africa. However, these tests are offered to all patients despite consistent negative results observed among Blacks, Indians, and Mixed ancestry (known as Coloreds in South Africa). Consequently, Blacks, White, and Colored patients who potentially carry other variants receive unbefitting treatment, resulting in poor clinical response, recurrence, and high mortality. This review aimed to identify the presence and incidence of pathogenic variants in BRCA1/2 previously reported in all South African populations. We selected literature using a scoping review approach, from which we included eight articles and two reports. Overall, we identified 59 BRCA1 and 60 BRCA2 pathogenic sequence variants from a cohort of 5709 patients and unknown patients from 90 families. The most reported variant was BRCA2 c.7943delG, which was common in White and Colored patients. None of the seven common variants was reported in either Blacks or Indians, which demonstrates the urgency to tailor genetic tests which are optimal for all South African patients and present a range of variants which could serve as diagnostic targets for Black, Indian, and Colored patients.

“Everyone needs a Deb”: what Australian indigenous women say about breast cancer screening and treatment services

BackgroundBreast cancer continues to be the second most diagnosed cancer overall and the most diagnosed cancer for women in Australia. While mortality rates overall have declined in recent years, Indigenous women continue to be diagnosed at more marginal rates (0.9 times) and are more likely to die (1.2 times). The literature provides a myriad of reasons for this; however, the voices of Indigenous women are largely absent. This study sets out to understand what is happening from the perspectives of Australian Indigenous women with a view to charting culturally safer pathways that improve participation in screening and treatment by Indigenous women.MethodsThis co-design study was conducted using semi-structured, in-depth interviews and focus group discussions. Recruitment of study participants was via snowball sampling. Participants were subsequently consented into the study through the Aboriginal Health Service and the research team. Interviews were audio recorded and transcribed verbatim, and data coded in NVivo12 using inductive thematic analysis.ResultsA total of 21 Indigenous women and 14 health service providers were interviewed predominantly from the same regional/rural area in NSW, with a small proportion from other states in Australia. Six major themes were identified: Access, Awareness, Community and Family, Lack of control, Negative feelings and associations and Role of services.ConclusionTo improve access and participation of Indigenous women and ultimately improve mortality rates, breast cancer services must explicitly address cultural and community needs.

Knowledge, attitude, and practice towards breast cancer and breast cancer screening among women in Homa Bay County, Kenya

Background: Late diagnosis of breast cancer lowers survival rates in resource-poor nations like Kenya. Due to a lack of screening programs, breast cancer awareness, and modern cancer treatment treatments. Rural areas, where most poor people live, are worse. The study examined breast cancer knowledge, attitude, and practice among Homa Bay County women. Methods: A cross-sectional study included 340 samples from two sub counties chosen for their rural nature. 170 women were randomly selected from from each sub county. Questionnaires collected data. Four significant informants were interviewed. Only descriptive statistics were used in data analysis. Results: The results showed lower level of breast cancer screening of 9.7%. Average knowledge was 44.39%. The average score in attitude was 1.7 showing a positive attitude towards breast cancer. The mean age of the participants was 44.30±14.32 in Ndhiwa and 45.16±14.35 in Kasipul. The general knowledge for breast cancer screening was considerably poor. Majority scored below 60% was considered low. In in terms of attitude, women had a positive attitude towards breast cancer screening and thought these was contradicted by key informant who said most had negative attitude. In terms of practice toward breast cancer screening services, only a paltry 9.7 % had gone for screening. Conclusions: Clinical breast examination was preferred over mammography. This study will educate Kenyan public health implementers on ways to improve screening for rural women. Education on early screening towards breast cancer can help in improving breast cancer screening uptake. Breast cancer awareness was considerably lower. Health policymakers can use this findings to improve on cancer management.

Factors associated with breast cancer screening services use among women in the United States: An application of the Andersen's Behavioral Model of Health Services Use

This study applied Andersen's Behavioral Model of Health Services Use to examine predisposing, enabling, and need factors associated with adherence to the United States Preventive Services Task Force (USPSTF) guidelines for breast cancer screening (BCS). Multivariable logistic regression was used to determine factors of BCS services utilization among 5484 women aged 50–74 from the 2019 National Health Interview Survey. Predisposing factors significantly associated with use of BCS services were: being a Black (odds-ratios [OR]:1.49; 95% confidence interval [CI]:1.14–1.95) or a Hispanic woman (OR:2.25; CI:1.62–3.12); being married/partnered (OR:1.32, CI:1.12–1.55); having more than a bachelor's degree (OR: 1.62; CI:1.14–2.30); and living in rural areas (OR:0.72; CI:0.59–0.92). Enabling factors were: poverty level [≤138% federal poverty level (FPL) (OR:0.74; CI:0.56–0.97), >138–250% FPL (OR:0.77; CI:0.61–0.97), and > 250–400% FPL (OR:0.77; CI:0.63–0.94)]; being uninsured (OR:0.29; CI:0.21–0.40); having a usual source of care at a physician office (OR:7.27; CI:4.99–10.57) or other healthcare facilities (OR:4.12; CI:2.68–6.33); and previous breast examination by a healthcare professional (OR:2.10; CI:1.68–2.64). Need factors were: having fair/poor health (OR:0.76; CI:0.59–0.97) and being underweight (OR:0.46; CI:0.30–0.71). Disparities in BCS services utilization by Black and Hispanic women have been reduced. Disparities still exist for uninsured and financially restrained women living in rural areas. Addressing disparities in BCS uptake and improving adherence to USPSTF guidelines may require revamping policies that address disparities in enabling resources, such as health insurance, income, and health care access.

Understanding Barriers and Facilitators of Breast and Cervical Cancer Screening among Singapore Women: A Qualitative Approach.

The uptake of breast and cervical cancer screening services among women in Singapore remains inadequate. Little is known about how gender norms influence women's decision to undergo these screening services in a multi-ethnic Asian context. This research aimed to explore how gender-based qualitative factors influence women's decision to screen. Qualitative data were collected using semi-structured interviews from 40 racially diverse women aged 25 and above who had visited polyclinics for their chronic disease management. Women were recruited using a purposive maximum variation sampling strategy to ensure representation of their views from the three major ethnic groups and based on inclusion criteria. Interviews were conducted either face-to-face or via telephone call. Interviews were audiotaped and lasted 30 minutes on average. Interviews were conducted until data saturation was reached. The data was transcribed and analysed thematically. Gender norms and gender non-concordance with the healthcare professionals did not inhibit women from undergoing breast and cervical cancer screening services to a large extent. Women were empowered and had a central role in decision-making for screening services. Healthcare initiatives such as subsidies and mobile health applications facilitated the uptake of breast and cervical cancer screening services but can be improved further. Some of the barriers reported by Malay Muslims were not dissimilar to previous qualitative studies with women in this ethnic and religious group. Gender socialisation, empowerment, and healthcare initiatives did not inhibit our study participants' decision to undergo breast and cervical cancer screening services. However, new initiatives and strengthening of the existing healthcare initiatives are needed to overcome any remnants of gender-related nuances and convert non-doers into doers.