Awareness and practices regarding breast and cervical cancer among Turkish women in Gazientep

Digital health interventions for cervical cancer care: A systematic review and future research opportunities

BACKGROUND

Cervical cancer is a malignancy among women worldwide, which is responsible for innumerable deaths every year. The primary objective of this review study is to offer a comprehensive and synthesized overview of the existing literature concerning digital interventions in cervical cancer care. As such, we aim to uncover prevalent research gaps and highlight prospective avenues for future investigations.

METHODS

This study adopted a Systematic Literature Review (SLR) methodology where a total of 26 articles were reviewed from an initial set of 1110 articles following an inclusion-exclusion criterion.

RESULTS

The review highlights a deficiency in existing studies that address awareness dissemination, screening facilitation, and treatment provision for cervical cancer. The review also reveals future research opportunities like explore innovative approaches using emerging technologies to enhance awareness campaigns and treatment accessibility, consider diverse study contexts, develop sophisticated machine learning models for screening, incorporate additional features in machine learning research, investigate the impact of treatments across different stages of cervical cancer, and create more user-friendly applications for cervical cancer care.

CONCLUSIONS

The findings of this study can contribute to mitigating the adverse effects of cervical cancer and improving patient outcomes. It also highlights the untapped potential of Artificial Intelligence and Machine Learning, which could significantly impact our society.

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.

Evaluation of knowledge, awareness and attitudes towards breast cancer risk factors and early detection among females in Bangladesh: A hospital based cross-sectional study

Background

Breast cancer (BCa) is a leading cause of mortality among women in Bangladesh. Many young women in Bangladesh have poor knowledge about breast cancer screening, including risk factors, warning signs/symptoms, diagnosis and early detection. We investigated awareness about breast cancer risk factors as a screening tool among women at the Sheikh Hasina Medical College (SHMC) of Tangail district in Bangladesh.

Methods

A cross sectional survey was conducted to collect data via a structured questionnaire from SHMC during the period of February to December 2019. A total of 1,007 participants (aged 33.47 (±12.37 years)) was considered for data analysis.

Results

Of the 1,007 women, about 50% were knowledgeable about the risk factors. Pain in the breast was identified as the most commonly warning sign/symptom of breast cancer. Only 32.2% of respondents knew at least one breast cancer screening method. The mean knowledge was scored 3.43 ± 2.25 out of a total possible score of 8. Awareness of BCa was associated with residence, family history of breast cancer, marital, literacy and socio-economic status (p <0.05). Only 14.7% of women who knew about BSE said they were conducting regular breast self-examination. Unmarried women (aOR: 2.971; 95% CI: 1.108–7.968) were more likely to have performed BSE compared to married women (p <0.05).

Conclusion

Although most participants were aware of breast cancer; knowledge about risk factors, warning signs/symptoms, early diagnosis and detection was relatively poor. Knowledge about performing BSE was particularly low. This highlights the importance of increasing awareness about breast cancer risk factors and early detection among young women in Bangladesh.

The Impact of Education on Knowledge Attitude and Practice of Breast Self-Examination Among Adolescents Girls at the Fiwasaye Girls Grammar School Akure, Nigeria

Breast cancer is the second most common cancer in women aged 15-45 after the non-melanoma of the skin. Lack of knowledge and practice of breast self-examination (BSE) have been blamed for the high morbidity and mortality associated with breast cancer among women and adolescents in particular. The study assessed the impact of education on knowledge, attitude and practice of breast self-examination among adolescent girls. A quasi-experimental study of only one group was conducted among school-going adolescents at Fiwasaye Girls Grammar School in Akure, Ondo State, Nigeria. Data were collected using a self-developed questionnaire adapted from previous studies. Statistical Package for the Social Science (SPSS) version 20 was used for data analysis, and data were presented using descriptive statistics. A total of 280 respondents took part in the study with the mean age of 13.21 ± 5.68. Over 60% knew about breast examination before education, and this percentage increased to 91.7% after training. The pre-assessment attitude towards and practice of breast self-examination were also poor but improved after training. There was a significant difference among the students pre- and post-knowledge at t (558) = 14.49, p = 0.01 and for pre- and post-practice of BSE at t (558) = 6.38, p = 0.01. The study affirms the importance of continuous education as an effective tool in increasing awareness, knowledge, attitude and practice of BSE.

Application of the Champion Health Belief Model to determine beliefs and behaviors of Turkish women academicians regarding breast cancer screening: A cross sectional descriptive study

BACKGROUND

Breast cancer is an important cancer type and the most common malignancy among women in both developed and developing countries and the second leading cause of cancer death in women worldwide. This study aimed to examine the projected risk of breast cancer in Turkish women academician, determine the levels of their breast cancer screening behaviors and uncover the relationship between their health beliefs and screening behaviors.

METHODS

This cross-sectional descriptive study was conducted from March to July 2018 in the province of Aydın, Turkey with a total of 200 female academicians. The data were collected using questionnaires filled out by the participants and the Turkish version of the Champion Health Belief Model Scale. Data were analyzed using t test, ANOVA, Chi-square and logistic regression performed with Statistical Package for Social Sciences version 20.

RESULTS

The mean age of the female academics was 36.1 ± 0.53 years. The female performing breast self-examination had higher perceived sensitivity (OR = 2.88, 95% Cl 1.32, 2.66) benefits to breast self-examination (OR = 0.90, 95% Cl 0.82, 0.99), self-efficacy (OR = 0.87, 95% Cl 0.81, 0.93) health motivation (OR = 1.74, 95% Cl 0.50, 0.90), benefit to mammography (OR = 0.97, 95% Cl 0.88, 1.08), lower barrier to mammography (OR = 1.05, 95% Cl 1.0, 1.09) than women who did not. Female academics with clinical breast examination had higher self-efficacy (OR = 0.91, 95% Cl 0.86, 0.97) and lower barrier to mammography (OR = 1.06, 95% Cl 1.02, 1.10) than women who did not. The female with take mammography had higher sensitivity (OR = 0.84, 95% Cl 0.72, 0.98), lower barrier to breast self-examination (OR = 1.08, 95% Cl 1.02, 1.15) and lower barrier to mammography (OR = 1.09, 95% Cl 1.04, 1.14) than female who did not.

CONCLUSIONS

Female academicians in Turkey exhibit positive attitudes towards breast self-examination, clinical breast examination and mammography as they have higher perceived sensitivity against breast cancer, self-efficacy and fewer barriers. Long-term community-based programs should be extended to different groups of women from a variety of socio-demographic environments.

Correlates of cervical cancer screening uptake among female under graduate students of Aksum University, College of Health Sciences, Tigray, Ethiopia

OBJECTIVES

Cervical cancer is among the leading cancer related causes of morbidity and mortality of women in the world. Ethiopia is among the highest risk countries with age adjusted incidence of cervical cancer 35.9 per 100,000 women or 7619 new cases and 6081 deaths of cervical cancer each year. The aim of this study was to examine correlates of cervical cancer screening uptake among female under graduate students of Aksum University, College of Health Sciences. Data was collected using self-administered structured questionnaire. Variables that were statistically significantly associated with the outcome in bivariate analyses were considered in a logistic multivariate regression analysis.

RESULT

Only 17.2% of students were screened for cervical cancer in their lifetime. Both in bivariate and multivariate analysis, sexual experience (AOR = 38.85; 95% CI [8.907, 169.51]), marital status (AOR = 3.481; 95% CI [1.167, 10.380]), Ppace of birth (AOR = 3.359; 95% CI [1.559, 7.235]), and student's year of study (AOR = 0.005; 95% CI [0.001, 0.031]) were the only correlates of cervical cancer screening uptake among female students. Therefore, the overall cervical cancer screening uptake was low and further study should be done other correlates.

The effect of peer education on health beliefs about breast cancer screening

AIM

The aim of this study was to evaluate the effect of peer education about breast cancer screening on the health beliefs of female university students.

BACKGROUND

The breast self-examination method is an effective technique that is also simple and inexpensive.

INTRODUCTION

In recent years, besides the classic methods of providing education on breast self-examination, it has been observed that the use of the technique of peer education is increasing and more and more studies are being conducted on this method and its effectiveness.

METHODS

This study is of quasiexperimental design using a single group, pretest/post-test model. The study was conducted with 742 university first-year students. The data for the study were collected using a Sociodemographic Questionnaire, the Breast Cancer Knowledge Questionnaire, Peer Education Satisfaction Questionnaire and Champion's Health Belief Model Scale.

RESULTS

It was found that the students' perception of barriers to performing the breast self-examination had declined and their self-efficacy had increased, and that the level of perceived barriers to having a mammogram had decreased and 98% of the students were satisfied with the peer education.

CONCLUSION

It was seen in this study that the level of knowledge of the students about breast cancer, perceived severity, barriers, benefits and self-efficacy as well as the rate of performing BSE displayed a significant increase after the peer education programme.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

The method of peer education may be utilized in the effort to increase young women's awareness about breast cancer and ensure that they learn about breast self-examinations. The peer education model can be useful in providing breast self-examination education to young people in school. The results of the present study may be beneficial in developing policies on health education on university campuses.

Examination of Knowledge and Fear Levels of Breast Cancer With the Spiritual Characteristics of Nurses

Introduction: Breast cancer is a common problem and it is important to understand the beliefs that increase awareness of breast cancer and guide early diagnosis behaviors. This research is planned to examine the knowledge and fear levels of breast cancer along with the spiritual characteristics of nurses. Methods: This is a descriptive type research. The domain of the research consists of women nurses working in Health Sciences University Samsun Education and Research Hospital. Sampling was not undertaken, rather 327 nurses who were on duty between January and May of 2016 and were willing to cooperate were incorporated into the study. Data was collected by use of the survey forms, "Breast Cancer Fear Scale" and "Comprehensive Breast Cancer Knowledge Test (GKMBT)." Data were analyzed with SPSS 21 Software. Results: Nurses who participated in the research had an average of age of 32.27 ± 1.04 years, 60.6% of whom were married, and had an average duration of nursing practice of 12.49 ± 9.92. The nurses' breast cancer fear level point average was 26.11 ± 6.58, the GMKBT scale general information sub-dimension point average was 7.20 ± 2.81, the treatability sub-dimension point average was 5.80 ± 1.68, and the total point average was found out to be 12.87 ± 2.81. It was determined that nurses' knowledge levels of breast cancer were not related to fear levels. Conclusion: It was concluded that the nurses' breast cancer fear level was high and their knowledge level was moderate. In line with the results obtained, it might be recommended that studies should be made to increase the nurses' knowledge and awareness on breast cancer.

Women's knowledge about risk factors of breast cancer in a Brazilian community

Knowledge about risk factors for breast cancer was identified as an important variable that affects women's avoidance behavior and their screening performance. The present study assessed women's knowledge about risk factors and associated socio-economic variables. Data from 417 women aged 20-86 years were obtained in Caicó, Rio Grande do Norte, Brazil. In agreement with the recognition of 26 potential risk factors and prevention behaviors, two groups with good (N = 203) and poor (N = 214) knowledge were formed, respectively. Having a close relative with cancer remained the unique significant variable in the adjusted model. Women without any close relative with cancer, were 1.54 (95% confidence interval [CI] 1.036-2.288) times as likely to have poor knowledge, compared to women who had a close relative with cancer (p = 0.033). Other socio-economic variables, including income, employment status and educational level had no significant association with knowledge (p = 0.450, p = 0.914, p = 0.639, respectively). Of 417 women, 302 (72.42%), 339 (81.29%), and 309 (74.10%), respectively, did not identify "physical inactivity," "overweight after menopause," and "no breastfeeding of children" as risk factors. Knowledge could help to avoid risk factors and motivate prevention behavior. Information about risk factors should be disseminated in health campaigns.

Peer Leaders and Phone Prompts: Implications in the Practice of Breast Care among College Students

Background:

Compliance with breast self-examination (BSE) guidelines helps detect breast cancer early while increasing physical activity decreases the risk of having breast cancer. Finding ways to early initiate and maintain such behavior among youth is therefore important. In this study we aimed to determine the effects of two health promotion education interventions on knowledge and attitude to breast care, as well as practice of BSE and physical activity by female college students.

Materials and Methods:

A total of 999 students from ten colleges underwent two kinds of health education strategies for three months, namely the traditional health education program (THEP) and tapping peer leaders using mobile phone prompts (PPHEP).

Results:

Improvement in knowledge and attitude was shown for both groups as compared to the control group. Both interventions equally increased the practice of BSE and maintenance of the recommended level of physical activity.

Conclusion:

There was an increase in the knowledge and positive attitude to breast care and practice of BSE with an improvement in the level of exercise when THEP and PPHEP interventions were used. Health education with peers using mobile phone prompts offers an alternative and effective way of promoting BSE and acceptable levels of exercise.

Knowledge About Cervical Cancer Risk Factors and Practices of Pap Testing Among Turkish Immigrant Women in the United States

The objective of this study was to examine knowledge about cervical cancer risk factors and practices of Pap testing among female Turkish immigrants in the state of Florida in the United States of America (USA). This descriptive study was conducted between April and September 2012. The study sampling was consist of 156 Turkish women living in the state of Florida. A questionnaire-based survey was conducted among the population of Turkish immigrant women. On the survey form comprised of a total of 37 questions and three sections there are questions pertaining to the socio-demographic characteristics of the individuals, their knowledge on the cervical cancer risk factors and their approach to getting Pap smear tests. Statistical Package for Social Sciences (version 16.0) was used to compute frequency and descriptive statistics related to demographic data. The average age of the women is 35.67 ± 10.0. More than half of women (66%) women reported cervical cancer screening at least one. Over two-thirds knew that having abnormal vaginal bleeding (85.8%) and vaginal infections (78.2%), having sexual activity with a man who has had multiple sexual partners (61.5%), and having multiple sexual partners (61.5%) increase the risk of cervical cancer. The result of the multivariate regression analysis have determined that the age of immigrant women (OR 11.3, 95 % CI 5.1-25.2, p:0.000) and the number of children ( OR 3.4, 95 % CI 1.7-6.9, p:0.000) are factors that impact pap smear testing behavior. Our study findings confirm low levels of Pap testing and show important knowledge deficits about cervical cancer risk factors and the importance of Pap testing among Turkish immigrant women. It is recommended that the immigrant women be educated about cervical cancer by means of organizing conferences in their own language and preparing informative materials.

Awareness of Breast Cancer among Female Care Givers in Tertiary Cancer Hospital, China

Objective:

Breast cancer is a worldwide public health issue and most common cancer diagnosed among women including China, where advanced stages at diagnosis appears to be increasing and an ever-rising incidence twice as fast as global rates. The study was conducted to describe the awareness of breast cancer and associated factors among care giver women in tertiary Cancer Hospital, China.

Methods:

Institutional based cross-sectional study was conducted among 261 women selected by systematic random sampling. Information provided by the participants was converted into awareness scores for analysis using SPSS version 23. Awareness scores were dichotomized in to ‘good awareness and ‘poor awareness’ taking median score=11 as the cut-off point. Data analysis was performed using the binary logistic regression. A p-value of <0.05 was considered statistically significant.

Result:

The study showed that 46.7% of the respondents had good awareness. Breast lump was the most commonly known symptom of cancer by 61.7% of the respondents. Slightly more than half of the study participants acknowledged having a past history of breast cancer, drinking alcohol and having close relative with breast cancer as potential risk factors for breast cancer (63.6%, 58.6%, and 55.6% respectively). Nevertheless, a vast majority of the study participants were unable to appreciate modifiable risk factors of the disease. More than half of the participants had never/rarely checked their breasts and all of the participants wrongly answered breast cancer knowledge age related risk. Awareness level was significantly associated with entertainment preference (OR=3.57; 95%CI=1.71, 7.44) and residence setting areas (OR=2.4; 95%CI=1.04, 5.69).

Conclusion:

The study indicated suboptimal awareness while entertainment preference and residence setting were significantly associated with awareness level. Public awareness campaigns should be made by dissemination of information about breast cancer through health education and printed Medias with great emphases on women living in rural areas.

Interventions Promoting Breast Cancer Screening Among Turkish Women With Global Implications: A Systematic Review

BACKGROUND

Breast cancer is a major health concern and remains the most common malignancy in women worldwide and in Turkey. Mammography, clinical breast examination (CBE), and breast self-examination (BSE) are recommended methods to detect early breast cancer in women. Many strategies have been developed to increase the rates of mammography, CBE, and BSE among Turkish women. Despite the benefits of breast cancer screening, these modalities are still underutilized by the majority of Turkish women.

AIM

To systematically review the scientific evidence on the effectiveness of various strategies aimed at improving screening behaviors for breast cancer in Turkish women.

METHODS

A systematic review of the literature published between 2000 and 2015 was conducted, searching 10 databases of Ovid MEDLINE, PubMed, Cochrane CENTRAL Register of Controlled Trials, CINAHL, PsycINFO, Web of Knowledge, Scopus, Google Scholar, ULAKBIM Turkish Medical Database, and Council of Higher Education Thesis Center.

RESULTS

Twenty-three studies were included in the final review. The majority of the studies investigated the effects of multiple strategies to improve BSE. Group education comprised educational sessions, printed and audiovisual materials, which significantly improved BSE, CBE, and mammography screening rates at 3 months, 6 months, and 12 months after the intervention. One-to-one education demonstrated no significant difference in BSE rates at 6-month and 12-month follow-up. However, one-to-one education demonstrated significant differences in CBE and mammography rates at the 3-month follow-up.

LINKING EVIDENCE TO ACTION

The use of group education comprising a multicomponent intervention demonstrated an increase in breast-screening behaviors among Turkish women. Further research investigating the duration of educational interventions is needed in order to suggest a "dose response."

Knowledge about Risk Factors for Breast Cancer and Having a Close Relative with Cancer Affect the Frequency of Breast Self-Examination Performance

BACKGROUND

Breast cancer incidence and mortality rates are increasing in North-Eastern Brazil and the patients with the disease often presented at advanced stages. The present study was focused on identifying variables that affect women's frequency of breast self- examination (BSE) performance.

MATERIALS AND METHODS

Data on BSE, socio-economic parameters and risk factors for breast cancer were obtained from 417 women from a community in North-Eastern Brazil by a self-informant method. To identify independent variables that affect frequency of BSE, nominal logistic regression analysis was performed.

RESULTS

Of 417 women, 330 (79.3%) reported performing BSE. Compared to high-income women, BSE performance by low-income women every month was 7.69 (OD=0.130; CI 95%: 0.044- 0.0386; p=0.000) times lower. Women who did not live in a stable union performed BSE each month 2.73 (OD=0.366; CI 95%: 0.171-0.782; p=0.010) less often than those living in a stable union. BSE performance every month and every six months or every year by women with poor knowledge about risk factors for breast cancer was 3.195 (OD=0.313; CI 95%: 0.141- 0.695; p=0.004) times and 2.028 (OD=0.493; CI 95%: 0.248- 0.979; p=0.043) times lower, compared to women with good knowledge. Participants who had a close relative with cancer performed BSE every month and every six months or every year 2.132 (OD=0.469; CI 95%: 0.220-0.997; p=0.049) times and 2.337 (OD=0.428; CI 95%: 0.219-0.836; p=0.013) times less often, compared to those women without close relatives with cancer.

CONCLUSIONS

The results of this study indicated that income, marital status, knowledge about risk factors and having a close relative with breast cancer, affect the frequency of BSE performance. Information about risk factors in public health campaigns could additionally strengthen avoidance behaviour and also motivate BSE performance.

Breast Cancer Awareness at the Community Level among Women in Delhi, India

BACKGROUND

To assess women's awareness from diverse sections of society in Delhi regarding various aspects of breast cancer (BC)--perceptions, signs and symptoms, risk factors, prevention, screening and treatment.

MATERIALS AND METHODS

Community-level survey was undertaken in association with the Indian Cancer Society (ICS), Delhi during May 2013-March 2014. Women attending BC awareness workshops by ICS were given self-administered questionnaires before the workshop in the local language to assess BC literacy. Information provided by 2017 women was converted into awareness scores (aware=1) for analysis using SPSS. Awareness scores were dichotomized with median score=19 as cut off, create more aware and less aware categories. Bivariate and multivariate analysis provided P-values, odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

Broadly, 53.4% women were aware about various aspects of BC. Notably, 49.1% women believed that BC was incurable and 73.9% women believed pain to be an initial BC symptom. Only 34.9% women performed breast self-examination (BSE) and 6.9% women had undergone clinical breast-examination/mammography. 40.5% women had higher awareness (awareness score>median score of 19), which was associated with education [graduates (OR=2.31; 95%CI=1.78, 3.16), post-graduates (OR=7.06; 95%CI=4.14, 12.05) compared to ≤high school] and socio-economic status (SES) [low-middle (OR=4.20; 95%CI=2.72, 6.49), middle (OR=6.00; 95%CI=3.82, 9.42) and upper (OR=6.97; 95%CI=4.10, 11.84) compared to low SES].

CONCLUSIONS

BC awareness of women in Delhi was suboptimal and was associated with low SES and education. Awareness must be drastically increased via community outreach and use of media as a first step in the fight against BC.

Update knowledge on cervical cancer incidence and prevalence in Asia

Cervical cancer is the second most common cause of cancer-related death among women worldwide, with over 500,000 new cases diagnosed annually and 50% mortality rate in Asia. In the United States, approximately 10,370 new cases of cervical cancer are diagnosed annually, and estimated 3,710 deaths occur from the disease, making it the sixth most common cause of malignancy among American women. This study aims to provide awareness about cervical cancer as well as an updated knowledge about the prevalence and incidence of cervical cancer in Asia.

Breast and cervical cancer knowledge and awareness among university students

BACKGROUND

Breast and cervical cancers are the most common types of cancer in women worldwide. Previous studies in Asia have shown that related knowledge and awareness is low among female university students. The goal of this study was to assess breast and cervical cancer knowledge, practices, and awareness among female university students in Samsun,Turkey.

MATERIALS AND METHODS

This research was a cross-sectional survey of female university students using a self-administered. questionnaire to investigate participant awareness and knowledge of breast and cervical cancer. A total of 301 female university students participated. Descriptive statistics and chi square tests were used for data analysis.

RESULTS

The mean age of the participants in this study was 22.0 ± 5.91 years. Regarding family history, 89.7 % of the students had no known familial history of breast cancer. Students (65.4%) had knowledge about breast self examination and 52.2 % of them had performed breast self examinationm while 55.1% of them had knowledge about prevention of cervical cancer.

CONCLUSIONS

Although the results are preliminary, the study points to an insufficient knowledge of university students in Samsun about breast and cervical cancer.

Public awareness of warning signs and symptoms of cancer in oman: a community-based survey of adults

BACKGROUND

The majority of deaths from cancer occur in low and middle income countries, partly due to poor public awareness of the signs and symptoms of cancer.

MATERIALS AND METHODS

A community based survey using the Cancer Awareness Measure (CAM) questionnaire was conducted in three different communities in Oman. Omani adults aged 18 years and above were invited to participate in the study.

RESULTS

A total of 345 responded from 450 invited participants (response rate=76.7%). The majority of respondents were unable to identify the common signs and symptoms of cancer identified in the CAM (average awareness was 40.6%). The most emotional barrier to seeking help was worry about what the doctor might find (223, 64.6%); a practical barrier was too busy to make an appointment (259, 75.1%) and a service barrier was difficulty talking to the doctor (159, 46.1%). The majority of respondents (more than 60% for seven out of ten symptoms) would seek medical help in two weeks for most signs or symptoms of cancer. Females were significantly more likely than males to be embarrassed (p<0.001), scared (p=0.001), and lack confidence talking about their symptoms (p=0.022).

CONCLUSIONS

Urgent strategies are needed to improve public awareness of the signs and symptoms of cancer in Oman. This might leads to earlier diagnosis, improved prognosis and reduced mortality from cancer.

The spectrum of genetic mutations in breast cancer

Breast cancer is the most common malignancy in women around the world. About one in 12 women in the West develop breast cancer at some point in life. It is estimated that 5%-10% of all breast cancer cases in women are linked to hereditary susceptibility due to mutations in autosomal dominant genes. The two key players associated with high breast cancer risk are mutations in BRCA 1 and BRCA 2. Another highly important mutation can occur in TP53 resulting in a triple negative breast cancer. However, the great majority of breast cancer cases are not related to a mutated gene of high penetrance, but to genes of low penetrance such as CHEK2, CDH1, NBS1, RAD50, BRIP1 and PALB2, which are frequently mutated in the general population. In this review, we discuss the entire spectrum of mutations which are associated with breast cancer.

Determinants of Cervical Cancer Screening Uptake among Women in Ilorin, North Central Nigeria: A Community-Based Study

Introduction. Cancer of the cervix is the leading cause of cancer deaths among women in developing countries. Screening is one of the most cost effective control strategies for the disease. This study assessed the determinants of cervical cancer screening uptake among Nigerian women. Methodology. This cross-sectional study was conducted using multistage sampling technique among 338 participants in Ilorin, North Central Nigeria. A pretested questionnaire was used for data collection and data analysis was done using SPSS version 21. Chi-square test was used for bivariate analysis while binary logistic regression was used for multivariate analysis. Statistical significance was set at p < 0.05. Results. Only 8.0% of the respondents had ever been screened for cancer of the cervix. The proportion of women who had ever been screened was significantly higher among those who demonstrated positive attitude to screening (81.5%, p = 0.001), respondents who were aware of the disease (100.0%, p = 0.001), and those who were aware of cervical cancer screening (88.9%, p = 0.001). Respondents who had negative attitude had 63% lesser odds of being screened compared to those who had positive attitudes towards screening (AOR; 0.37, 95% CI; 0.01–0.28). Conclusion. There is urgent need to improve the knowledge base and attitude of Nigerian women to enhance cervical cancer screening uptake among them.

Knowledge of Female Undergraduate Students on Breast Cancer and Breast Self-examination in Klang Valley, Malaysia

BACKGROUND

In Malaysia, breast cancer is the first cancer among females regardness of race.

AIM

The purpose of this study was to identify the knowledge and BSE practice among undergraduate female students at four public universities in Klang Valley, Malaysia.

MATERIALS AND METHODS

This cross-sectional study was conducted among 820 undergraduate female students using a self-administered questionnaire covering socio-demographic data, knowledge of breast cancer and BSE practice.

RESULTS

The mean age of the respondents was 21.7±1.2 years. The majority of them were single (96.8%), Malay (91.9%) and 16.5% of respondents had a family history of breast cancer. This study showed low level of knowledge on breast cancer and breast self-examination among participants. Only 19.6% participants were performing BSE regularly. Knowledge of breast self-examination was significantly associated with BSE practice (p=0.00). Also, there were significant associations between performing BSE with age, marital status and being trained by a doctor for doing BSE (p<0.05).

CONCLUSIONS

Our findings showed that the rate of BSE practice and knowledge of breast cancer is inadequate among young Malaysian females. A public health education program is essential to improve breast cancer prevention among this group.

Knowledge, attitudes and behaviors of women over 20 years old on cervix cancer in Istanbul, Turkey

PURPOSE

The aim of the study was to evaluate knowledge, attitudes and behaviors of Turkish women over 20 years old on cervix cancer.

MATERIALS AND METHODS

This descriptive study was performed at a primary care center covering 246 women using a questionnaire composed of 3 sections and 38 questions. The data were analyzed using descriptive statistics, chi-square test in univariate analysis and multivariate hierarchical logistic regression analysis.

RESULTS

Of the 93.7% women who knew about cervical cancer, 68.0% of them had heard pap smear test and 46.1% had actually undergone a Pap smear once or more throughout their lives. According to the results of the hierarchical logistic regression analysis about factors affecting the Pap smear test; in Model 1, increase in age and education levels, in Model 2 and Model 3 increase in age and cervical cancer information points were determined. The most important information source for cervical cancer was TV-radio/media (59.9%) and health care workers (62.8%) for pap smear test.

CONCLUSIONS

Although most women have heard of cervical cancer, knowledge about cervical cancer and also Pap smear screening rate are significantly lower. Having Pap smear test for women was affected by age and knowledge level about cervical cancer. Informing women about cervical cancer would be an important intervention.

Risk of cancer with combined oral contraceptive use among Iranian women

Oral contraceptive use is the most common type of contraception. More than 300 million women worldwide take oral contraceptives every day. However, there is a concern about the relationship with the incidence of cancer. This analytical retrospective study aimed to investigate the relationship between the incidence of cervical and breast cancers and oral contraceptive use in 128 Iranian patients with cervical cancer, 235 with breast cancer and equal numbers of controls. Data were collected through interviews with an organized set of questions. Details were also extracted from patient files. Data were analyzed using Student's t-test, chi-square and Fisher's exact tests, and Pearson's correlation analysis. The result revealed correlations between both cervical and breast cancers and history of contraceptive pills use. While cervical cancer significantly correlated with duration of use of pills, breast cancer had significant correlations with the type of oral contraceptive and age at first use. No significant relationships were found between the two types of cancer and age at discontinuation of oral contraceptives, patterns of use, and intervals from the last use. The use of oral contraceptives may triple the incidence of cervical cancer and doubles the incidence of breast cancer. Therefore, performing Pap smears every six months and breast cancer screening are warranted for long-term oral contraceptive users.

Cost-effectiveness analysis of HPV vaccination: comparing the general population with socially vulnerable individuals

BACKGROUND

After the WHO recommended HPV vaccination of the general population in 2009, government support of HPV vaccination programs was increased in many countries. However, this policy was not implemented in Korea due to perceived low cost-effectiveness. Thus, the aim of this study was to analyze the cost-utility of HPV vaccination programs targeted to high risk populations as compared to vaccination programs for the general population.

MATERIALS AND METHODS

Each study population was set to 100,000 people in a simulation study to determine the incremental cost-utility ratio (ICUR), then standard prevalence rates, cost, vaccination rates, vaccine efficacy, and the Quality-Adjusted Life-Years (QALYs) were applied to the analysis. In addition, sensitivity analysis was performed by assuming discounted vaccination cost.

RESULTS

In the socially vulnerable population, QALYs gained through HPV vaccination were higher than that of the general population (General population: 1,019, Socially vulnerable population: 5,582). The results of ICUR showed that the cost of HPV vaccination was higher for the general population than the socially vulnerable population. (General population: 52,279,255 KRW, Socially vulnerable population: 9,547,347 KRW). Compared with 24 million KRW/QALYs as the social threshold, vaccination of the general population was not cost-effective. In contrast, vaccination of the socially vulnerable population was strongly cost-effective.

CONCLUSIONS

The results suggest the importance and necessity of government support of HPV vaccination programs targeted to socially vulnerable populations because a targeted approach is much more cost-effective. The implementation of government support for such vaccination programs is a critical strategy for decreasing the burden of HPV infection in Korea.

Are primary health care workers aware of cervical cancer risk?

BACKGROUND

We here examined the awareness of female health employees (doctors, nurses, midwives) working in primary health care service about cervical cancer and its risk factors. Additionally attitude and behavior for gynecologic examination and pap smear screening were researched.

MATERIALS AND METHODS

This cross-sectional, descriptive study concerned female health employees working at primary health care services in two southern cities of Turkey, over a four month period in 2013. Participants were recently or previously sexually active research was explained and verbal informed consent was obtained face to face. The questionnaire consisted of two parts; socio-demographic characteristics and level of knowledge about cervical cancer and its risk factors.

RESULTS

The average age of the participants (midwives 43.7%, n=143; nurses 40.4%, n=132; doctors 6.4%, n=21; emergency medical technicians and others, 9.5%, n=31; total, n=327) was 30.9±6.41 years. 64.2% (n=210) were working in Diyarbakir and 35.8% (n=117) in Batman. A large proportion reported low knowledge and inadequate screening practice Conclusions: Health employees should be better informed about the importance of screening for cancers, given their preventive roles for the general population.

Knowledge of breast cancer and breast self-examination practice among Iranian women in Hamedan, Iran

BACKGROUND

In Iran, breast cancer is the most prevalent cancer in women and a major public health problem.

METHODS

A cross sectional study was carried out to determine knowledge on breast cancer and breast self- examination (BSE) practices of 384 females living in the city of Hamadan, Iran. A purposive sampling method was adopted and data were collected via face-to-face interviews based on a validated questionnaire developed for this study.

RESULTS

Among respondents 268 (69.8%) were married and 144 (37.5%) of the respondents reported having a family history of breast cancer. One hundred respondents (26.0%) claimed they practiced BSE. Level of breast cancer knowledge was significantly associated with BSE practice (p=0.000). There was no association with demographic details (p<0.05).

CONCLUSION

The findings showed that Iranian women's knowledge regarding breast cancer and the practice of BSE is inadequate. Targeted education should be implemented to improve early detection of breast cancer.

Cytotoxicity of Trichoderma spp. cultural filtrate against human cervical and breast cancer cell lines

Trichoderma spp. are known as a rich source of secondary metabolites with biological activity belonging to a variety of classes of chemical compounds. These fungi also are well known for their ability to produce a wide range of antibiotic substances and to parasitize other fungi. In search for new substances, which might act as anticancer agents, the overall objective of this study was to investigate the cytotoxic effects of Trichoderma harzianum and Trichoderma asperellum cultural filtrates against human cervical and breast cancer cell lines (HeLa and MCF-7 cells respectively). To achieve this objective, cells were exposed to 20, 40, 60, 80 and 100 mg/ ml of both T. harzianum cultural filtrate (ThCF) and T. asperellum cultural filtrate (TaCF) for 24h, then the cell viability and the cytotoxic responses were assessed by using trypan blue and 3-(4,5-dimethylthiazol-2yl)- 2,5-biphenyl tetrazolium bromide (MTT) assays. Morphological changes in cells were investigated by phase contrast inverted microscopy. The results showed that ThCF and TaCF significantly reduce the cell viability, have cytotoxic effects and alter the cellular morphology of HeLa and MCF-7 cells in a concentration dependent manner. A concentration of 80 and 100mg/ml of ThCF resulted in a sharp decline in the cell viability percent of HeLa and MCF-7 respectively (25.2%, 26.5%) which was recorded by trypan blue assay. The half-maximal inhibitory concentrations (IC50) of ThCF and TaCF in HeLa and MCF-7 were recorded as 16.6, 12.0, 19.6 and 0.70 mg/ml respectively by MTT assay. These results revealed that ThCF and TaCF have a substantial ability to reduce the viability and proliferation of human cervical and breast cancer cells.

Awareness of breast cancer warning signs and screening methods among female residents of Pokhara valley, Nepal

BACKGROUND

Breast cancer is the second most common cancer in the world and by far the most frequent cancer among women.

OBJECTIVE

The present study was undertaken to assess the awareness of breast cancer warning signs and screening methods among the women of Pokhara valley, Nepal.

MATERIALS AND METHODS

A cross-sectional questionnaire survey was carried out in a community setting with the female population. The questionnaire was administered in face-to-face interviews by trained research assistants.

RESULTS

Nepalese women demonstrated poor awareness of warning signs like a breast lump, lump under the armpit, bleeding or discharge from the nipple, pulling of the nipple, changes in the position of the nipple, nipple rash, redness of the breast skin, changes in the size of the breast or nipple, changes in the shape of the breast or nipple, pain in the breast or armpit, and dimpling of the breast skin. While 100% of nurses were aware about breast self- examination (BSE), mammography and warning signs of breast cancer. Levels of knowledge were significantly poorer in women with other occupations. Graduates were more aware about BSE, mammogram and warning signs of breast cancer compared to those with other educational levels.

CONCLUSIONS

The findings indicated that the level of awareness of breast cancer, including knowledge of warning signs and BSE, is sub-optimal among Nepalese women.

Effectiveness of online education in teaching breast self- examination

BACKGROUND

This research evaluated the effectiveness of an online education model in teaching breast self- examination to university staff and students.

MATERIALS AND METHODS

1,679 women participated in a breast self-examination online training program. Breast self-examination knowledge evaluation forms developed by Maurer (1997) were used in the research and were evaluated on a 100 point scale. Paired t-test and McNemar's Test statistics were employed.

RESULTS

The participants scored an average of 46.5 (14.0%) on knowledge on breast self-examination before training, but 77.4 (11.0%) one month after education and 76.7 (9.52%) after six months. There was a clear significant difference between these knowledge levels (p<0.05). Similarly, while the rate for systematic practice of breast self-examination among women was 30.8% before training it increased to 47.8% afterwards. Again the difference was significant (p<0.05).

CONCLUSIONS

Online education is an effective method for teaching breast self-examination to women.

Breast cancer awareness among Turkish nursing students

BACKGROUND

This study conducted to determine breast cancer awareness and influencing factors among nursing students in the West Black Sea Region in Turkey.

MATERIALS AND METHODS

This cross-sectional descriptive study was conducted between April-May, 2014. The sample was 270 female nursing students. Data were collected by Personal Information Form and Champion's Health Belief Model Scale (CHBMS).

RESULTS

The students' mean age was 21.6±2.09 and 81.1% had knowledge about breast cancer from their academic education. It is found that 63.7% of the students performed Breast Self-Examination (BSE) and 11.1% had a family member diagnosed with breast cancer. The CHBMS mean score of the students was 117.7±14.5.

CONCLUSIONS

Breast cancer awareness of nursing students is on a good level and was affected by family history of breast cancer and health beliefs.