Health empowerment and health rights in Saudi Arabia.

[No Abstract Available].

Health rights knowledge among medical school students at King Abdulaziz University, Jeddah, Saudi Arabia.

BACKGROUND: Health care is a basic human right, and Saudi Arabia affirms these rights for all its citizens. OBJECTIVES: To assess the knowledge of medical students regarding health rights in Saudi Arabia. METHODS: This cross-sectional study was conducted at King Abdulaziz University (KAU) from September 2015 through November 2015. A questionnaire written in English collected demographic data and included questions about reproductive health care and health rights of women and patients with cancer, senility, or special needs. RESULTS: Of the 267 participants, 184 (68.9%) were female, and 252 (94.4%) were Saudi. Regarding consent, 87 (32.6%) and 113 (42.3%) participants believed a female patient required the consent of a male guardian to receive medical treatment or surgery, respectively, in Saudi Arabia, and only 106 (39.7%) knew that a female patient could provide consent for a caesarean section. Sixty-six (24.7%) believed that abortion is never allowed in Islam. Only 93 (34.8%) were aware that acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) patients had health rights, about half (144, 53.9%) knew that cancer patients have a right to full information, and most (181, 67.8%) believed that a patient had the right to withhold health information from his/her family. Approximately half were aware that cancer patients have the right to free medical treatment (138, 51.7%) or that health rights applied to special needs patients (137, 51.3%) and senile patients (122, 45.7%). CONCLUSIONS: The knowledge of KAU medical students regarding health rights of certain patient populations highlights the importance of health rights education in medical school.

Breast Cancer Knowledge Among Male High School Students in Saudi Arabia.

Breast cancer (BC) accounts for 24 % of all women cancer cases diagnosed in Saudi Arabia each year. Awareness is extremely important in combating this disease. This study was undertaken to assess male high school students' response to BC. This cross-sectional survey was performed on male high school students across schools in Jeddah. A questionnaire gathered data on respondent demographics, beliefs about BC, BC risk factors, early screening methods, and role of men in BC. Statistical analysis was done using SPSS 20. A total of 824 students participated, with an average age of 17.0 years. There was more than 50 % agreement that early detection of BC enhances the chances of recovery, that BC is treatable, and that clinical breast examination and breastfeeding provide protection from BC. Around half the survey population thought that BC was fatal and contagious. Fewer than 50 % thought that BC was inherited and related to smoking, consumption of contraceptive pills, repeated exposure to radiation, obesity, and wearing a bra and that breast tumors were all malignant and spread to different parts of the body. Others knew that mammograms should be performed periodically. A high percentage persuaded their relatives to have mammograms and provided them with psychological support. Knowledge of BC among male high school students in Saudi Arabia is still limited, and, therefore, programs and activities need to be established to increase awareness among high school students.

Breaking the silence: breast cancer knowledge and beliefs among Somali Muslim women in Seattle, Washington.

We elicited the perspectives of Somali women in Seattle, Washington, about breast cancer. We conducted a focus group of 14 Somali immigrant women at a community center in Seattle, Washington. Participants reported barriers to seeking cancer screening, including fear of pain, difficulty with transport, and lack of knowledge. Participants explained that Somali women tended not to discuss breast cancer or breast cancer screening, and said religion played a central role in their care and treatment decisions and coping mechanisms. If such barriers are addressed, fewer women may present with late-stage breast cancer, resulting in greater chances for long-term breast cancer survival.

Metaplastic carcinoma of the breast: an immunohistochemical study.

BACKGROUND: Metaplastic breast carcinoma is a rare entity of breast cancer expressing epithelial and/or mesenchymal tissue within the same tumor. The aim of this study is to evaluate the clinicopathological features of metaplastic breast carcinoma and to confirm the triple negative, basal-like and/or luminal phenotype of this type of tumor by using immunohistochemical staining. METHODS: Seven cases of MBC were evaluated for clinico-pathological features including follow up data. Cases were studied immunohistochemically by CK-Pan, Vimentin, ER, PR, HER2, basal markers (CK5/6, p63, EGFR, SMA and S-100), luminal cytokeratins (CK8, CK18 and CK19), markers for syncytial cells (ß-HCG and PLAP), as well as prognostic markers (p53, ki-67 and calretinin). RESULTS: The mean age of the patients was 36 years. Three cases showed choriocarcinomatous features. All of our cases were negative for ER, PR and HER2. Six out of the 7 cases showed basal-like differentiation by demonstrating positivity with at least one of the basal/myoepithelial markers. Also 6 out of the 7 cases expressed luminal type cytokeratins (CK8, CK18 and/or CK19). P53 was positive in 3 cases, ki-67 was strongly expressed in only one case, while calretinin was expressed in 6 cases. CONCLUSION: Metaplastic breast carcinoma presents in our population at a younger age group than other international studies. All cases are categorized immunohistochemically under the triple negative group of breast cancer and 86% of them exhibited basal-like and luminal phenotype. Majority of cases developed local recurrence and distant metastasis in a relatively short period of time. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1101289295115804.

Impact of maternal breast cancer on school-aged children in Saudi Arabia.

BACKGROUND: We examine whether mothers with breast cancer told their children about the diagnosis, explore mothers' perceptions of the impact of doing so on the mother-child relationship, and assess perceptions of how this affected the children. METHODS: A convenience sample of 28 women with breast cancer ages 35 to 60 was interviewed using a 39-item close-ended questionnaire at the Al-Amoudi Breast Cancer Center of Excellence, King Abdulaziz University, Jeddah, Saudi Arabia. Inclusion criteria were having a diagnosis of breast cancer and having school-aged children (ages 5 to 16 years). Questions were asked concerning each child (n = 99). RESULTS: The majority of women (75%) told their children about the diagnosis, and explained the treatment (61%). In most cases, telling the children had a positive effect on how the children treated their mothers (84%), on the maternal-child relationship (80%), and on the personality and behavior of the child (90%). The most common negative reaction by children was increased clinging behavior to the mother (15%). Despite the perceived positive impact on the mother-child relationship and on the child's overall behavior towards the mother, school performance suffered as a result (77%). CONCLUSIONS: These preliminary results suggest that when a mother with breast cancer tells a child about the diagnosis and discusses it with them, this often results in an improvement in the maternal-child relationship. However, the knowing the mother's diagnosis may adversely affect the child's school performance, which will need to be anticipated and addressed with formal counseling if it persists.

Potential breast cancer risk factors among Saudi women aged 19-50 years in Jeddah: a case-control study.

BACKGROUND AND OBJECTIVES: The Saudi cancer registry reported in 2009 that the frequency of breast cancer is the highest among all types of cancer among Saudi women aged 30-59 years. The Makkah region had the second highest frequency of reported breast cancer cases, with patients having a median age of 46 years. The objectives of this study were to explore the distribution of selected known and hypothetically claimed breast cancer risk factors among Saudi women aged 19-50 years and describe the association of breast cancer with selected risk factors. DESIGN AND SETTING: An unmatched case-control study was conducted on breast cancer cases at three different hospitals in Jeddah. PATIENTS AND METHODS: Online OpenEpi was used and the method of Kelsey and colleagues was selected from OpenEpi output; the calculated number of cases and controls was 134 each. Women aged 19-50 years were included and the analysis was conducted on 151 cases and 166 controls as they met the age inclusion criteria. RESULTS: The mean age of patients was 40 years. A subgroup analysis for age at menarche less than 12 years showed an odds ratio (OR) of 1.4 6 [95% confidence interval (CI) 0.88-2.44]. A high proportion of cases reported the use of exogenous estrogen and progesterone (OR=4.7, 95% CI 1.7-13.0), previous mammography screening (89% of cases vs. 11% of controls), and affected family members (4.6 vs. 1.8, OR=2.64 [95% CI 0.67-10.4]. The OR for exercise frequency in the study group was 1.45 (95% CI 0.90-2.35). The OR for breastfeeding among mothers who breast-fed for more than 12 months was 0.56 (95% CI 0.35-0.88). CONCLUSION AND RECOMMENDATIONS: This study provides information on associative factors such as early age at menarche (<12 years), monthly income of at least 20 000 SR (5333 USD), use of exogenous estrogen and progesterone, previous biopsies/surgeries, previous clinical breast examination and mammography screening, and affected family members. Protective factors among premenopausal women, such as breastfeeding and exercising, have been described. Conducting comprehensive sessions on breastfeeding and physical education targeting young generations is highly recommended in order to reduce the risk for breast cancer among Saudi women aged 19-50 years.

Do Saudi nurses in primary health care centres have breast cancer knowledge to promote breast cancer awareness?

BACKGROUND: Breast cancer is one of the leading causes of death among cancer patients in Saudi Arabia. It is known that nurses play a key role in promoting breast cancer awareness among women in any society. Nurses in primary health care centres (PHCC) have more direct contact with general population. This study aimed to investigate nurse knowledge of breast cancer and practice of early screening in PHCC in Jeddah city. METHODS: A cross-sectional study was conducted using a self-administered questionnaire to assess the general knowledge of breast cancer, risk factors, and practice of 210 PHCC nurses. Data were analysed using SPSS v.16. RESULTS: The mean age of the PHCC Nurses was 36.9 (SD ±8.6). Only 11% percent scored <50% of the total score for general epidemiological knowledge on breast cancer, about 35% scored <50% of the total score for breast cancer risk factors. Sixty seven percent scored >75% of the total score on breast cancer signs. Majority of nurses 62.8% practiced BSE, but only 4% practiced regularly every month. Some 28% practiced once per year. About 81% of the nurses had not had a clinical breast examination and only 14% had had a mammography. The results of the study failed to show any correlation between the knowledge scores with age, education, year of experience, family history of BC and marital status of the nurses. CONCLUSION: The results from the study reflect that there is a need to provide continuing nursing education programmes for PHCC nurses to improve their breast cancer knowledge and practice.

Men's knowledge and attitude towards breast cancer in Saudi Arabia. A cross-sectional study.

OBJECTIVE: To identify men's knowledge and attitude towards early detection of breast cancer. METHODS: This cross-sectional study was conducted at the outpatient clinics of King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. Five hundred and fifty participants were selected by systemic randomization. The distributed questionnaire included: demographics, knowledge and its source on breast cancer, beliefs and practice regarding breast self-examination (BSE), mammography, and difficulties that may prevent women from seeking medical help. The questionnaire was filled anonymously and in private. RESULTS: The response rate was 90.9%, and most were employees (63.2%). Physicians represented 43.4% of the source of knowledge, followed by the internet (40.4%), and last, the media (30.4%). Breast mass was the most common symptom (36.6%), followed by change of breast size (26%) and pain (20.2%), while 24% did not know the symptoms of breast cancer. Approximately 13% believed that all cases of breast cancer ended with mastectomy. Only 57.6% were aware of the importance of BSE in early detection of breast cancer, and approximately 90% did not know the importance of mammography. CONCLUSION: Awareness campaigns aimed at husbands and men in general are to be strongly considered. They should encourage their wives and families to enroll in awareness and screening campaigns.

Health care provider's role in facing the future burden of breast cancer in Saudi.

OBJECTIVE: To investigate the knowledge, attitude, and practice of health care professionals on the early detection of breast cancer. METHODS: A cross-sectional study was conducted in Jeddah and Abha regions of Saudi Arabia from May to November 2009. A detailed questionnaire was distributed to 500 doctors from different hospitals. The questionnaire contained items on the practice of clinical breast examination and mammogram examination, and the doctor's perception of their roles in education. RESULTS: The results of 337 questionnaires analyzed indicated that most health care professionals do not practice clinical breast examination and mammography, and the perception of their roles in education is not as expected. CONCLUSION: Health care providers are one of the main barriers in improving early detection of breast cancer in Saudi Arabia. There is a need to increase awareness among health care providers of their role in the fight against breast cancer through focused education and training programs.

The knowledge of breast cancer among young Saudi females.

OBJECTIVE: To assess the breast cancer knowledge level of Saudi female school students. METHODS: A detailed questionnaire on cancer breast was designed with all the needed information. Using a map of the Jeddah area of Saudi Arabia, schools were identified in each area and permission was sought from the Ministry of Education to distribute the questionnaire to the students. A team of volunteers was instructed on how to distribute and collect the questionnaires. The collected questionnaires were then statistically analyzed. This Pilot study of 500 students was performed in King Abdul-Aziz University Hospital using high schools from the city of Jeddah between April and June 2009. The results were used to build up a base for designing a community educational program. RESULTS: Analysis of the data from 337 questionnaires from high school and college students showed that the level of knowledge of young females on breast cancer is limited. However, it also indicated that the students are very enthusiastic to learn about cancer breast, and its prevention. CONCLUSION: The limited knowledge level of breast cancer in the younger generation might be an obstacle to screening programs and early diagnosis. Awareness programs should be developed including lectures, seminars workshops, and on hands training.