Factors influencing breast cancer awareness: a cross-sectional study in China

Health-promoting lifestyle among Chinese patients with colorectal polyps: a cross-sectional study

This study aims to investigate the level of health-promoting lifestyles and its influencing factors in Chinese patients with colorectal polyps. A total of 169 colorectal polyps patients from three tertiary care hospitals in Nanchong and Deyang, China, were recruited. Data were collected using the Impact of Health-Promoting Lifestyle Profile-II (HPLP-IIR), Colorectal Cancer Knowledge Questionnaire, Colorectal Cancer Health Belief Scale, the Chinese version of the Health Information Literacy Self-Rating Scale, and a demographic questionnaire. Factors influencing health-promoting lifestyles in patients with colorectal polyps were analyzed using multiple linear regression analysis. The mean HPLP-IIR score was 96.02 ± 14.42, indicating a moderate level of health promotion. Multiple linear regression analysis revealed that the total score of health information literacy, colorectal cancer knowledge and health beliefs were significantly associated with the total score of health promotion lifestyle in Chinese patients with colorectal polyps (P < 0.001), explaining 36.1% of the total variance. The health-promoting lifestyle of colorectal polyp patients was at an intermediate level. Health information literacy, colorectal cancer health knowledge, and colorectal cancer health beliefs were identified as key factors influencing their health-promoting lifestyles. Efforts should focus on improving health information literacy, increasing colorectal cancer health knowledge, and promoting positive health beliefs to establish a better health-promoting lifestyle.

The Potential Metalloestrogenic Effect of Aluminum on Breast Cancer Risk for Antiperspirant Users

The etiopathogenesis of breast cancer depends on genetic conditions, but recently more attention has been paid to the dependence of BC on certain environmental factors, for example, metalloestrogens, which include aluminum (Al) contained in antiperspirants used daily. The use of Al derivatives in antiperspirants in concentrations specified by the FDA, as well as European regulations (SCCS, 2020), do not classify Al as a hazardous and carcinogenic substance for humans. However, Al used to treat excessive sweating raises concerns, as many in vitro studies indicate that it can cause gene instability, change gene expression or increase oxidative stress, and also affect the body's hormonal balance as a metalloestrogen. The environmental reality is that the breast is constantly exposed to many different chemicals, such as Al. This article reviews the literature to determine whether Al-based products can harm the body, as there are many facts and myths on the subject. The aim of the study is to present the current state of knowledge on the use of aluminum antiperspirants and the risk of breast cancer (BC). The article is based on data from the scientific literature, published in the PubMed and Google Scholar databases, as well as Science Direct, Scopus, Ovid MEDLINE, Ovid EMbase. It includes articles published in the years 2003-2023 mainly in English. Literature databases regarding human and animal studies were searched. To sum up, evaluating the effect of Al as a risk factor for breast cancer requires many studies using different research models focused on long-term exposure to Al-containing antiperspirants. Consumers are advised to limit their exposure to Al by making a conscious choice to minimize exposure to this compound.

Magnitude of non-communicable disease screening and factors associated with awareness among reproductive age women in Gofa and Basketo zones, Southern Ethiopia: a community-based cross-sectional study

Background

The burden of non-communicable diseases (NCDs) increasing at an alarming rate in Ethiopia. NCDs affect reproductive-age women and cause significant threats to future generations. Screening is an important aspect leading to early diagnosis, treatment and preventing the risk of complications and future mortality. However, less attention has been paid in the post-pandemic era of COVID-19. Therefore, this study aims to assess awareness of NCD screening and associated factors among reproductive-age women in the Gofa and Basketo zones.

Methods

A community-based cross-sectional study design was undertaken, employing a multistage cluster sampling method to select participants from the designated zones. Multivariate logistic regression was conducted using Statistical Package for the Social Sciences (SPSS) software. Associations were deemed statistically significant if the p-value was ≤0.05.

Results

The awareness level for screening NCDs among women was found to be 54.8%. Specifically, the percentages for awareness of hypertension (HTN), diabetes, cervical cancer, and breast cancer screenings were 52.7%, 42.4%, 38.1%, and 34.8% respectively. However, the study revealed that only 43.0%, 9.4%, 16.2%, and 20.7% of the participants had undergone screening for HTN, diabetes, breast cancer, and cervical cancer respectively. High awareness of NCD screening was significantly associated with urban residence (AOR: 1.68, 95% CI: 1.63, 1.73), Gofa zone residence (AOR: 2.04, 95% CI: 1.95, 2.13), being able to read and write (AOR: 1.06, 95% CI: 1.02, 1.11), having primary (AOR: 1.13, 95% CI: 1.09, 1.16) and secondary school education (AOR: 1.11, 95% CI: 1.00, 1.14), being in the age group of 25-34 (AOR: 1.45, 95% CI: 1.41, 1.49) and ≥35 years (AOR: 1.22, 95% CI: 1.18, 1.26), being married (AOR: 1.25, 95% CI: 1.16, 1.35) and single women (AOR: 1.31, 95% CI: 1.18, 1.43), government employees (AOR: 1.65, 95% CI: 1.54, 1.77), having larger family sizes (>4) (AOR: 1.11, 95% CI: 1.05, 1.12) and having a family member diagnosed with NCD (AOR: 1.16, 95% CI: 1.11, 1.22).

Conclusions

Nearly half of the study population had no awareness of NCD screening and the vast majority had poor screening practice. Strengthening the provision of behavioral change communication strategies through trained health professionals based on the audience's segmentation by age, educational and economic status is needed.

Awareness about Breast Cancer and Breast Self-Examination among Undergraduate Female Students at the University of Agadir, Morocco: A Cross-Sectional Descriptive Study

Breast cancer is a pressing public health issue globally and in Morocco, with rising cases among women. This study aims to evaluate breast cancer awareness and self-examination practices among female university students, informing future educational interventions. A cross-sectional study surveyed 437 students at Ibn Zohr University, Agadir, using a questionnaire covering demographics, knowledge of breast cancer, risk factors, symptoms, and breast self-examination (BSE). Results showed high awareness of breast cancer (95.3%), with social networks and media being primary information sources. However, only 48.25% had intermediate knowledge levels, and BSE awareness was moderate (60.8%) with low practical skills (28.0%). Reasons for not performing BSE included lack of knowledge and discomfort. Significant associations were found between knowledge levels and age, year of study, study options, and information sources. Despite high awareness, there is a crucial need to enhance knowledge about breast cancer risk factors, symptoms, and BSE practices among young women in Morocco. Educational programs targeting university students are essential for promoting early detection and improving attitudes toward breast health.

Factors Influencing Breast Cancer Awareness in Rural Southwest China: A Cross-Sectional Study

Background

This study aimed to explore the current knowledge level of breast cancer among rural women in Southwest China and analyze the influencing factors of breast cancer cognition.

Methods

From May to November 2022, 1468 rural women were invited to participate in this study. Demographic information and the Chinese version of the Breast Cancer Awareness Measure (C-BCAM) were collected through one-on-one investigations. The data were analyzed using descriptive statistics, chi-square tests, and multiple regression analysis in SPSS 26.0.

Results

The study included a total of 1468 rural women with a median age of 54.0 (IQR, 47.0, 60.0).The average score of breast cancer in the study population was 73.0 (IQR, 66.0, 82.0). Among women in Southwest China, the awareness rates of knowledge on breast cancer symptoms, barriers to seeking medical help, and risk factors were 68.8%, 98.4%, and 62.1%, respectively. The awareness rate was found to increase with higher education levels (P<0.001) and decrease with increasing age (P<0.001). Multivariate logistic regression analysis identified three variables that might influence breast cancer awareness: education level, contraceptive measures, and history of breast disease (all P<0.05). Specifically, history of breast disease (Odds ratio (OR) = 1.907, 95% CI = 1.128 ~ 3.223), middle school education (OR = 2.155, 95% CI = 1.585 ~ 2.928), and junior college education and above (OR = 5.536, 95% CI = 1.898 ~ 16.148) were positive factors for women's breast cancer awareness. Conversely, the use of intrauterine devices (OR = 0.523, 95% CI = 0.384 ~ 0.712) was found to be a negative factor for women's breast cancer awareness.

Conclusion

This study highlights the insufficient awareness of breast cancer among women in rural area of Southwest China. It emphasizes the necessity of health education to improve female breast cancer awareness.

Psychometric evaluation of the Chinese version of the breast cancer perception scale for community women: a translation and validation study

BACKGROUND

Breast cancer perception is closely associated with the incidence of breast cancer among community-dwelling women. Consequently, it is crucial to enhance their breast cancer survival rate by assessing their cognitive status and implementing targeted interventions. This study aimed to translate the breast cancer perception scale into Chinese and validate its psychometric properties among community women.

DESIGN

A cross-sectional study method was introduced in this study.

METHODS

After obtaining the original author's authorization, the breast cancer perception scale was translated into Chinese using the Brislin back-translation method. Item analysis was employed to examine the discriminative power of the items, and the Delphi method was utilized to assess content validity. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to evaluate the scale's construct validity. Internal consistency and test-retest reliability were calculated to analyze reliability.

RESULTS

A total of 24 items were retained in the item analysis, and the content validity index of the translated scale was 0.964. In the EFA, six common factors were extracted, namely perceived knowledge, perceived treatment belief, perceived need for health checks, perceived stigma, perceived fear, and perceived risk, accounting for 74.911% of the cumulative variance. The CFA results were as follows: χ2/df = 1.301, GFI = 0.903, NFI = 0.913, TLI = 0.975, CFI = 0.978, IFI = 0.979, RMSEA = 0.037. The Cronbach's α coefficients, split-half reliability, and test-retest reliability of the translated scale were 0.895, 0.661, and 0.865, respectively.

CONCLUSIONS

The Chinese version of the breast cancer perception scale demonstrated suitable psychometric properties among community women. By evaluating results according to the scale, medical staff can enhance breast cancer prevention awareness and care for community-dwelling women and subsequently implement corresponding modifications.

Relationship between health information literacy and health promoting lifestyle among first-degree relatives of patients with colorectal cancer in China: the mediating effect of health belief

Background

History of first-degree relatives with colorectal cancer is one of the most important and common risk factors for colorectal cancer in China. Most chronic diseases, such as malignancies, are preventable by adopting health-promoting behaviors and other approaches. However, the relationships among factors affecting the health-promoting lifestyles of first-degree relatives with colorectal cancer have not been sufficiently studied. This study aimed to test the mediation effects of Health belief in the relationship between health-promoting lifestyle and health information literacy among first-degree relatives with colorectal cancer.

Methods

A cross-sectional descriptive design was conducted using convenience sampling of 856 first-degree relatives of CRC patients attending three tertiary care hospitals in Nanchong and Deyang of China from December 2020 to December 2022. Questionnaires were used to collect data on the participants' demographic information, the colorectal cancer health beliefs, the health promotion lifestyle, and the health information literacy. Data were analyzed with descriptive statistics, one-way ANOVA, Pearson's correlation coefficients, and mediation analysis using SPSS 25.0 program and its macro-program PROCESS.

Results

The findings indicated health information literacy was less, health belief was at the medium level, and performance of health promotion behavior was average for first-degree relatives of colorectal cancer. Whereas first-degree relatives of colorectal cancer health-promotion lifestyle had a positive correlation with health beliefs (r = 0.376, p < 0.01) and health information literacy (r = 0.533, p < 0.01), health beliefs had a positive correlation with health information literacy (r = 0.337, p < 0.01). Health beliefs mediated the positive effect of health information literacy on health-promoting lifestyles (β =0.420, 95% CI, 0.288-0.581), and indirect effects accounted for 14.0% of the total effect.

Conclusion

Health information literacy and health beliefs are key factors associated with a health-promoting lifestyle among first-degree relatives with colorectal cancer. These factors have direct and indirect effects on each other and on health-promoting lifestyles. To enhance health-promoting lifestyles among first-degree relatives with colorectal cancer, interventions that strengthen health beliefs and provide health information literacy should be developed.

Breast cancer awareness among women in the Syrian Coast: a cross-sectional study

Breast cancer is the most common malignancy in women and represents a leading cause of cancer-related mortalities. Females' awareness toward breast cancer is essential for the early diagnosis and detection especially in low and middle-income countries. This study aims to assess the awareness of breast cancer risk factors among females in the Syrian Coast.

METHODOLOGY

An online cross-sectional survey was conducted among Syrian females during the COVID-19 pandemic. The questionnaire used in the study was derived from the Cancer Research UK questionnaire and modified to fit the perspective of the study. Statistical Package for Social Sciences (SPSS) was used for data analysis. The independent samples t-test and the one-way analysis of variance (ANOVA) were applied to determine whether there is statistical evidence or any statistically significant differences between the variables.

RESULTS

A total of 1305 females participated in the study. The majority aged between 18 and 25, (28.8%) of the participants obtained their information related to breast cancer from internet, (36.7%) of were smokers and (82.8%) had a family member with breast cancer. These results suggested a significant correlation between smoking, family history of cancer, marital status, and breast cancer awareness.

CONCLUSION

This study showed which factors are significantly related to women's awareness of breast cancer risk factors. These results can contribute in the implementation of awareness programs and campaigns, thus raising the level of awareness among women.

Factors associated with awareness of breast cancer among women of reproductive age in Lesotho: a national population-based cross-sectional survey

BACKGROUND

Breast cancer is a leading cause of cancer mortality and a major public health problem. The growing number of breast cancer-related deaths has been largely attributed to a lack of awareness of the disease among women. Whilst there have been frequent campaigns promoting breast cancer awareness, evidence suggests that women still lack awareness. Therefore, this study assessed the prevalence and factors associated with the awareness of breast cancer among women of reproductive age in Lesotho.

METHODS

We used population-based cross-sectional data from the 2014 Lesotho Demographic and Health survey. A total of 6,620 women of reproductive age were included in the analysis. The outcome variable was awareness of breast cancer. Women who heard about breast cancer were considered to be aware of the disease. Multilevel binary logistic regression models were fitted to determine the factors associated with breast cancer awareness among women.

RESULTS

The level of awareness of breast cancer was 86.8% (95% CI: 85.5, 87.9). Women aged 45-49 years [adjusted odds ratio (AOR) = 2.87, 95% confidence interval (CI): 1.83, 4.48], married women [AOR = 1.51 (95% CI: 1.19, 1.93)], and women with higher educational level [AOR = 12.56, (95% CI: 4.35, 36.28)] were more likely to be aware of breast cancer. Additionally, women who listened to the radio at least once a week [AOR = 1.96, (95% CI: 1.63, 2.37)], those who read newspapers or magazines [AOR = 1.91 (95% CI: 1.48, 2.46)] and women in the wealthiest group [AOR = 2.55, (95% CI: 1.67, 3.89)] had higher odds of breast cancer awareness. However, women who were in rural areas were less likely [AOR = 0.63, (95% CI: 0.47, 0.84)] to be aware of breast cancer than those in urban areas.

CONCLUSION

The level of awareness of breast cancer among women of reproductive age in Lesotho was extremely low. We recommend that policymakers, clinicians, and public health practitioners should consider the factors identified in this study when designing and developing intervention programs to improve the awareness of breast cancer among women in Lesotho.

Women's awareness of breast cancer symptoms: a national cross-sectional study from Palestine

Background

Early diagnosis is crucial to reduce the morbidity and mortality associated with breast cancer (BC). Awareness of BC symptoms plays a key role in this. This study aimed to evaluate the Palestinian women’s awareness of BC symptoms and determine factors associated with good awareness.

Methods

This was a national cross-sectional study conducted from July 2019 to March 2020 in Palestine. Convenience sampling was used to recruit adult women from hospitals, primary healthcare centers, and public spaces located in 11 governorates. A translated-into-Arabic version of the validated BC awareness measure was utilized for data collection. The awareness level was categorized based on the number of symptoms recognized into: poor (0 to 4), fair (5 to 9), and good (10 to 13).

Results

Of 6269 approached, 5434 participants completed the questionnaire (response rate = 86.7%). A total of 5257 questionnaires were included in the analysis: 2551 from the Gaza Strip and 2706 from the West Bank and Jerusalem (WBJ). Participants living in the WBJ were more likely to be older, have higher monthly income, and suffer from more chronic diseases than participants living in the Gaza Strip.

The most frequently identified BC symptom was ‘lump or thickening in the breast’ (n = 4887, 92.9%) followed by ‘lump or thickening under the armpit’ (n = 4394, 83.6%). The least frequently identified symptoms were ‘pulling in of the nipple’ (n = 2665, 50.7%) and ‘change in the position of the nipple’ (n = 2710, 51.6%).

A total of 2191 participants (41.7%) demonstrated good awareness of BC symptoms. Participants from the Gaza Strip were more likely than participants from the WBJ to have good awareness (47.0.0% vs. 36.7%). On the multivariable analysis, being ≥ 40 years, completing a post-secondary education, knowing someone with cancer, and visiting hospitals and primary healthcare centers were all associated with an increase in the likelihood of having good awareness. However, living in the WBJ was associated with a decrease in the likelihood of having good awareness.

Conclusion

Less than half of women included in this study showed good awareness of BC symptoms. More targeted educational interventions are needed to promote Palestinian women’s awareness of BC symptoms to facilitate early diagnosis.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13224-7.

A national survey to assess breast cancer awareness among the female university students of Pakistan

The incidence of breast cancer is increasing in Pakistan as well as globally. Awareness of women about breast cancer plays a cornerstone role in its early detection, better management, and prevention. Keeping this in mind, a cross-sectional study was carried out to assess the awareness of female university students about breast cancer’s risk factors, signs and symptoms, and breast cancer examination. The data was collected from female university students studying in Pakistan. A total of 774 participants completed the survey and recorded their responses on an online pre-tested self-administered questionnaire. Only 29.8% of the participants have identified breast cancer history in their first-degree relatives as a risk factor. Moreover, 14.1% of the participant considered that the use of oral contraceptives for more than 5 years can increase the risk of developing breast cancer. In addition, inward pulled nipple, wounds around the nipple, and abrupt changes in the breast size were considered as the sign and symptoms of breast cancer by 25.2%, 25.7%, and 31.7% of the participants, respectively. Moreover, only 20.9% of the participants identified the correct year for starting breast cancer examination and 44.4% of the respondents marked that mammography should be initiated after 40 years. Overall, the university female students of Pakistan were poorly aware of breast cancer’s risk factors, signs and symptoms, and breast examination. This study has highlighted the need for initiation of aggressive strategies regarding breast cancer awareness in both the literate and illiterate female population of Pakistan.