Breast Cancer Screening Awareness and Associated Factors Among Saudi Females: A Cross-Sectional Study in Jeddah, Saudi Arabia (2024).

BACKGROUND: Breast cancer (BC) represents a major health concern for women globally, including those in Saudi Arabia. Awareness and early detection through screening practices are vital measures in improving BC outcomes. OBJECTIVE: This study aims to assess the awareness and associated factors of BC screening among Saudi females in Jeddah, Saudi Arabia. METHODS: A cross-sectional study was conducted in 2024 among Saudi females aged 18 and above, residing in Jeddah. Data was collected using a structured questionnaire that included sections on demographic characteristics, Breast Cancer Awareness Measure (Breast CAM), knowledge, and factors influencing participation in screening programs. The collected data was analyzed using IBM SPSS Statistics. RESULTS: The study, consisting of 454 participants, found that half of them rarely or never checked their breasts and many were not confident about noticing any changes in their breasts. There was a strong awareness of the Ministry of Health's (MOH) BC screening program, but most were uncertain about the age at which screenings should start and end. Only a small percentage reported receiving an invitation for breast screening and an even smaller percentage have participated in the screening. Significant associations were found between higher awareness of BC signs, a monthly family income of over 20,000, and being medically free (p-value <0.05). CONCLUSION: The study found a significant gap in BC awareness and screening practices among females in Jeddah, Saudi Arabia. This underlines the importance of targeted health education and awareness programs, as well as accessible and affordable screening services, to improve early detection and outcomes for BC.

Factors Associated With the Uptake of Cervical Cancer Screening Among Family Medicine Physicians, Compared With Women of the Community in Riyadh, Saudi Arabia.

BACKGROUND: Cervical cancer is the ninth diagnosed cancer among Saudi women. The majority of cervical cancer cases occur in women who did not undergo screening. However, the screening rates in several countries, including Saudi Arabia, remain suboptimal. It is important to identify the factors associated with the uptake of screening and predictors of screening in order to increase the uptake rate. AIM: To determine the factors associated with the uptake of cervical cancer screening among family medicine physicians (FMPs), compared with women of the community. METHODS: This was a cross-sectional study conducted in the central region (Riyadh), Kingdom of Saudi Arabia from February 2021 for 12 months on female physicians and women of the community. An electronic questionnaire was used to investigate the demographics of women and variables related to the uptake of screening. RESULTS: A total of 126 FMP and 127 women from the community were included. The factors affecting screening among FMP included age (P=0.013), health insurance (P=0.002), availability of Pap smear (P˂0.001), and physician encouragement (P˂0.001). The factors affecting the screening of community women included the availability of Pap smears (P˂0.001) and physician encouragement (P˂0.001). Multivariate analysis revealed that physician encouragement of Pap smear was a significant predictor of screening among FMP (OR=8.26, P˂0.001) and community women (OR=6.67, P˂0.001). The perceived benefit was the only predictor for screening among FMP (OR=0.75, P=0.004). CONCLUSION: The uptake of cervical cancer screening was higher in the community women. The factors linked to the uptake differed among the two groups, but the support of doctors played a significant role in the likelihood of uptake, regardless of the group of women. It is recommended to enhance the guidance of medical personnel in recommending screening during clinic visits for the specific target group. Additionally, there should be increased education on the significance of screening and efforts to educate the community about cervical cancer and screening.

Prospective Functions of miRNA Variants May Predict Breast Cancer Among Saudi Females.

Background Growing knowledge supports the importance of microRNAs (miRNAs) in modulating the initiation and development of breast cancer (BC) and underlying mechanisms. BC is a significant public health in females worldwide, where it remains the leading cause of death among Saudi females. Here, we evaluate the susceptibility of the miRNA genetic variants to the risk of BC in Saudi females. Methods One hundred fifty-four females, including 76 females diagnosed with BC and 78 healthy controls, were analyzed using TaqMan™ (Thermo Fischer Scientific, Waltham, MA) genotyping assays for the miR-196a2 rs11614913 C>T, miR-146a rs2910164 C>G, and miR-499 rs3746444 A>G. We utilized the SNPStats software (https://www.snpstats.net) (Institut Català d'Oncologia, Barcelona, Spain) to choose the best interactive inheritance model for the examined miRNAs. Results The examined miRNA single-nucleotide polymorphisms (SNPs) showed no clear association with the risk of BC (P > 0.05). As for genotypic distributions, significant associations were found for the rs2910164 SNP in most interactive models of inheritance: 2.50 (95% confidence interval {CI}, 1.2-5.17; P = 0.0135) in the codominant model, 2.34 (95% CI, 1.11-4.8; P = 0.0197) in the dominant model, and 2.40 (95% CI, 1.22-4.73; P = 0.0113) in overdominant model. The rs2910164 C/G heterozygosity showed overexpression in cases compared to controls (73.7% versus 53.9%; chi-squared (χ2) = 6.5; P = 0.0109), but the homozygous rs2910164 G/G showed a significant protective effect (21.1% versus 38.5%; χ2 = 17.4; P = 0.019). The heterozygosity did not affect the risk to the BC in the two miRNAs (rs11614913 C>T and rs3746444 A>G). Conclusion Despite lacking associations with the examined miRNAs, the heterozygous genotype rs2910164 C/G can identify at-risk females. More studies should be replicated using a panel of miRNA genes to discover significant associations with the risk of BC.

Association Between Vitamin D Level and Z-Score Changes of Bone Density in College-Age Saudi Girls: A Cross-Sectional Study.

Objective: Vitamin D (VD) deficiency is a worldwide health problem. VD plays a crucial role in calcium homeostasis, phosphorus metabolism and bone health. Still much remain to understand the effect of VD deficiency on bone mass. This study aimed to evaluate the relationship between VD levels and bone mass density (BMD) among college-age Saudi females. Methods: In a cross-sectional study, 460 females with a median age of 21 years, were enrolled, completed a comprehensive, structured questionnaire which was validated by experienced endocrinologist, a dietician, and a statistician. Body mass indexes (BMI) were calculated, and BMD was estimated through quantitative ultrasound to ankle. Serum VD, calcium, phosphate, parathyroid hormone, and alkaline phosphatase were measured using chemiluminescent immunoassay technique. Results: VD deficiency reached up to 83.3% (66.9% insufficiency and 16.4% deficiency). Lower than normal BMD was detected in 18.3% of subjects, with only 1.1% having a non-age-matched high risk for osteoporosis. The significant independent predictors of Z-score were age of menarche, menstrual irregularities, dairy products consumption, physical activity, BMI, alkaline phosphatase, and history of previous VD supplementation. Conclusion: VD deficiency and low BMD are highly prevalent among college-age Saudi females. Low BMD is not linked to serum level of VD but to its previous use as a supplementation. Early lifestyle changes, attention to gynecological problems, and prevention of VD deficiency are all needed to support BMD among these girls.

Exome-wide analysis identify multiple variations in olfactory receptor genes (OR12D2 and OR5V1) associated with autism spectrum disorder in Saudi females.

Background: Autism Spectrum Disorder (ASD) is a multifactorial, neurodevelopmental disorder, characterized by deficits in communication, restricted and repetitive behaviors. ASD is highly heritable in Saudi Arabia; indecencies of affected individuals are increasing. Objectives: To identify the most significant genes and SNPs associated with the increased risk of ASD in Saudi females to give an insight for early diagnosis. Methods: Pilot case-control study mostly emphasized on the significant SNPs and haplotypes contributing to Saudi females with ASD patients (n = 22) compared to controls (n = 51) without ASD. With the use of allelic association analysis tools, 243,345 SNPs were studied systematically and classified according to their significant association. The significant SNPs and their genes were selected for further investigation for mapping of ASD candidate causal variants and functional impact. Results: In females, five risk SNPs at p ≤ 2.32 × 10-05 was identified in association with autism. The most significant exonic variants at chromosome 6p22.1 with olfactory receptor genes (OR12D2 and OR5V1) clustered with high linkage disequilibrium through haplotyping analysis. Comparison between highly associated genes (56 genes) of male and female autistic patients with female autistic samples revealed that 39 genes are unique biomarkers for Saudi females with ASD. Conclusion: Multiple variations in olfactory receptor genes (OR5V1 and OR12D2) and single variations on SPHK1, PLCL2, AKAP9 and LOC107984893 genes are contributing to ASD in females of Arab origin. Accumulation of these multiple predisposed coding SNPs can increase the possibility of developing ASD in Saudi females.

Eating Concerns Associated with Nutritional Information Obtained from Social Media among Saudi Young Females: A Cross-Sectional Study.

Eating disorders have been highly prevalent in young females for decades for many reasons. Social media platforms have an enormous impact on users, especially young adults, who use them every day. In Saudi Arabia, social media is popular, with an estimated 72% of users being active in 2020. Therefore, the primary aim of this study was to assess the relationship between using social media to search for nutritional information and eating concerns. A nationwide study was conducted on 1092 young Saudi females aged 18-30 years from five administrative regions in the Kingdom of Saudi Arabia. Data were collected using an online validated questionnaire, and symptoms of eating concerns were assessed using two brief instruments: SCOFF [Sick, Control, One Stone, Fat, Food] and Eating disorders Screen for Primary care [ESP]. The prevalence of eating concerns was 49.6% among Saudi females. Moderate eating concerns were more prevalent in the central region 24.8%, whereas high eating concerns were more prevalent in the southern region 27.6%. Personal accounts of dietitian/nutritionists (OR = 1.170; 95% CI 1.071-1.277; p ≤ 0.001), interaction with offered experiments about new meals/restaurants, and diets on social media that were mostly promoted by celebrities/influencers (OR = 1.554; 95% CI 1.402-1.723; p ≤ 0.000) were the most prominent risk factors associated with being more likely to suffer from eating concerns. The present study recommends opening clinics specializing in nutrition on social media platforms that target young females to provide nutritional counselling and encourage a healthy lifestyle. In addition, it is important to plan awareness campaigns intended to educate young females on how to deal with messages that circulate on social media without any evidence regarding their truthfulness.

Sexual Harassment and Mental Health of Female Healthcare Workers in a Tertiary Care Hospital in Riyadh, Saudi Arabia.

Background In this study, we aimed to estimate the prevalence and identify the correlates of sexual harassment among female healthcare workers in a tertiary care hospital in Riyadh, Saudi Arabia. Methodology A cross-sectional study was conducted among 432 female healthcare workers in both Arabic and English languages. The questionnaire consisted of five sections which included the sociodemographic characteristics, a sexual harassment survey, the Kessler distress scale, social support, and the Rosenberg self-esteem scale. Unadjusted odds ratios with 95% confidence intervals were calculated to identify the significant factors associated with harassment. Results Sexual harassment was reported by 15.5% of the participants, with verbal harassment being the most commonly reported (66%), followed by physical harassment (34%). Around three-fourths of harassment acts took place during the daytime, and 18% of the participants preferred to keep quiet about it. Moderate distress [2.38 (1.17, 4.84)] and severe distress [2.31 (1.09, 4.90)], feeling hopeless [2.86 (1.47, 5.57)] and feeling depressed [3.70 (1.62, 8.48)] were significantly associated with sexual harassment. Low self-esteem items, such as "I don't have good qualities" [4.78 (2.0, 11.43)], "don't have much to be proud of" [2.10 (1.22, 3.63)], "wish that I have more respect for myself" [2.30 (1.36, 3.90)], and "inclined to feel that I am a failure" [2.27 (1.24, 4.16)] were significantly associated with sexual harassment. Conclusions It is important for all employees to know about their rights and report all types of harassment acts. Counseling sexually harassed victims should focus on improving the self-esteem and mental distress of these women. Prevention of harassment against female healthcare workers can improve their mental health as well as their quality of work.

Quality of life assessment of breast cancer patients in Saudi Arabia.

BACKGROUND: To assess the quality of life (QOL) of females with breast cancer in Saudi Arabia and its association with patients' demographic, social, and clinical data. MATERIALS AND METHODS: This analytical cross-sectional study was conducted among breast cancer patients attending King Abdullah Medical City, Makkah. Participants were asked to complete a self-administered structured questionnaire. We utilized the validated Arabic version of the European Organization for Research and Treatment of Cancer QOL-C30 (EORTC-QOL-C30) and breast cancer module QLQ-BR23 (EORTC-QOL-BR-23). Data were analysed using SPSS; mean and standard deviation computed for continuous variables, and percentages for categorical variables. Student's t-test performed to compare mean scores for various groups. RESULTS: Eighty-eight women participated in the study. The participants had a mean global health score of 64.0, standard deviation (SD) = 27.7. Of the functional scales, role functioning scored the highest (mean 71.2, SD = 31), while social and emotional functioning scored the lowest, (mean 57 SD = 35.8) and (mean 59.5 SD = 32), respectively. On the symptom scales, the most troubling symptoms were fatigue and insomnia, (mean 48.86 SD = 29.4) and (mean = 48, SD = 35), respectively. On the disease-specific tool (QLQ-BR23), body image and future perspective scored the lowest with a mean of 60.2 SD = 35 and 42.0 SD = 39.6, respectively. The most distressing symptom was hair loss (mean 61.56 SD = 41). CONCLUSIONS: Our population showed an acceptable overall global health score. However, they scored low on the important functional and symptoms domains. This study implies that patient age, social, and physical factors were possible determinants of global health and QOL scores. The healthcare system of Saudi Arabia should, therefore, address all these different aspects of QOL of breast cancer survivors.

Lifestyle Habits in Relation to Overweight and Obesity among Saudi Women Attending Health Science Colleges.

The study examined the associations between lifestyle habits and overweight/obesity among Saudi females attending health science colleges. A total of 454 female students were randomly recruited from five health science colleges at King Saud University, using a multistage stratified cluster sampling technique. Body weight and height were measured, and body mass index was calculated. All participants answered a validated questionnaire to assess physical activity (PA), sedentary behaviors (SB), sleep duration, and dietary habits. Results showed that the prevalence of overweight (21.4%) plus obesity (8.1%) among female participants was 29.5%. There was no significant difference between overweight/obese and nonoverweight/nonobese females in PA, screen time, sleep duration, or dietary habits. Overall, 50.4% of the participants were physically inactive (activity energy expenditure was <600 metabolic equivalent minutes per week). Active females showed significantly (p < 0.01) higher intakes of vegetables and fruits, lower chocolate/candy consumption (p = 0.05), and higher proportion of sufficient sleeping duration (>8 hours per night) (p < 0.001). It was concluded that half of the Saudi females in this study were physically inactive. Although PA positively impacted some of the lifestyle habits of college females, overweight/obesity was not associated with PA, SB, sleeping time, or dietary habits among the participants. Future research should attempt to elucidate the key factors involved in such relationship.

Typology of end-of-life priorities in Saudi females: averaging analysis and Q-methodology.

BACKGROUND: Understanding culture-and sex-related end-of-life preferences is essential to provide quality end-of-life care. We have previously explored end-of-life choices in Saudi males and found important culture-related differences and that Q-methodology is useful in identifying intraculture, opinion-based groups. Here, we explore Saudi females' end-of-life choices. METHODS: A volunteer sample of 68 females rank-ordered 47 opinion statements on end-of-life issues into a nine-category symmetrical distribution. The ranking scores of the statements were analyzed by averaging analysis and Q-methodology. RESULTS: The mean age of the females in the sample was 30.3 years (range, 19-55 years). Among them, 51% reported average religiosity, 78% reported very good health, 79% reported very good life quality, and 100% reported high-school education or more. The extreme five overall priorities were to be able to say the statement of faith, be at peace with God, die without having the body exposed, maintain dignity, and resolve all conflicts. The extreme five overall dis-priorities were to die in the hospital, die well dressed, be informed about impending death by family/friends rather than doctor, die at peak of life, and not know if one has a fatal illness. Q-methodology identified five opinion-based groups with qualitatively different characteristics: "physical and emotional privacy concerned, family caring" (younger, lower religiosity), "whole person" (higher religiosity), "pain and informational privacy concerned" (lower life quality), "decisional privacy concerned" (older, higher life quality), and "life quantity concerned, family dependent" (high life quality, low life satisfaction). Out of the extreme 14 priorities/dis-priorities for each group, 21%-50% were not represented among the extreme 20 priorities/dis-priorities for the entire sample. CONCLUSION: Consistent with the previously reported findings in Saudi males, transcendence and dying in the hospital were the extreme end-of-life priority and dis-priority, respectively, in Saudi females. Body modesty was a major overall concern; however, concerns about pain, various types of privacy, and life quantity were variably emphasized by the five opinion-based groups but masked by averaging analysis.

Bone mineral density in university aged Saudi females.

OBJECTIVE: The aim of the study was to investigate bone mineral density (BMD) in young Saudi females (20-25 years) using Dual-energy x-ray absorptiometry (DXA), as it is a widely utilized modality for the measurement of BMD, used for the diagnosis of osteoporosis and osteopenia. METHODS: BMD measurements were performed in the spine and the neck of the femur in 101 young females. RESULTS: 37% and 34% patients had osteopenia in the spine and the neck of the femur respectively, BMD values = 0.98 and 0.81 gm/cm(2) respectively). Whereas 5% had osteoporosis in the spine area, BMD values = 0.82 gm/cm(2)). Of the 101 subjects, 53 (52.5%) young females did not suffer from osteopenia in either both site, whereas 23 (22.7%) females had osteopenia in both sites, the remaining 25 subjects (25% of the subject included) had either osteopenia or osteoporosis in one of the sites. A strong association between BMD values with weight was found. CONCLUSIONS: We found that one third of the young Saudi females sampled suffer from osteopenia. Additionally, body weight has a positive relationship with bone mineral density.

Impact of obesity on fetomaternal outcome in pregnant saudi females.

BACKGROUND: Obesity is rapidly increasing in most populations of the world including Saudi community. Maternal obesity adversely impacts pregnancy outcome through increased rates of hypertensive disease, diabetes, cesarean section and infections. OBJECTIVES: The aim of this study is to determine frequency of obesity and its adverse effects on reproductive outcome in pregnant Saudi females. METHODS: Prospective Cohort study. Eight months (Nov 2008 to June 2009), Maternity and Children Hospital (MCH) Buraida, Saudi Arabia Sample included a group of 1000 randomly recruited pregnant Saudi females. Patients were admitted through Outpatient and Emergency Departments. Height was recorded once and weight twice; at the beginning (prepregnancy weight) and end of pregnancy. The difference between the two weights was taken as net weight gain in pregnancy. Prepregnancy weight was used to calculate Body mass index (BMI) using formula; Weight in Kg/Height in (m). 2 The sample was divided into 5 groups depending upon their BMI ;< 18.5, 18.5-24.9, 25-29.9, 30-39.9 &>40, classified as underweight, normal weight, overweight, obese & morbidly obese respectively. The normal weight group was used as control group. Data were collected regarding complications of obesity in pregnancy and labor and recorded on a Performa. Results were calculated by using computer programme SPSS Version 13 for windows. A p-value of< 0.05 is used to calculate statistical significance. RESULTS: The frequency of weight distribution in pregnant Saudi female calculated to be 2% (lean), 31% (normal weight), 33%(overweight), 30%(obese) and 4%(morbidly obese). Compared with normal weight women, both overweight and obese women had a significantly increased risk (p-value-<0.05) for gestational diabetes, preeclampsia, cesarean delivery, and delivery of a macrocosmic infant. CONCLUSION: Overweight & obesity is a growing problem in pregnant Saudi females associated with increased risks of fetomaternal complications like preeclampsia, gestational diabetes, cesarean delivery, and delivery of a macrocosmic infant.