Breast Cancer Prevention: The Key Role of Population Screening, Breast Self-Examination (BSE) and Technological Tools. Survey of Italian Women.

Breast cancer is the most common tumor among women worldwide and still remains the leading cause of death in women in Italy. Although survival from this pathology has increased, this disease and its treatment can have lasting or delayed effects that can greatly affect a woman's quality of life. Primary and secondary prevention are currently the best strategies to combat this cancer: improved lifestyle, early adherence to screening, Breast Self-Examination (BSE), and even now the use of technology, have become among the most important tools to ensure increasingly early diagnosis of this disease, which is a major cause of suffering and premature mortality in women. Indeed, early diagnosis of the disease can lead to a good prognosis and a high survival rate. This study investigates the attitude of Italian women to perform clinical checkups aimed at cancer prevention, particularly adherence to free screening programs offered by the National Health Service (NHS) for women in the 50-69 age group. The knowledge, use and emotional approach toward BSE as a screening tool and the use of dedicated apps for this purpose are also investigated. Low adherence to screening programs, lack of BSE practice, and nonuse of dedicated apps are just some of the results observed in this study. Therefore, it becomes essential to spread the culture of prevention, cancer awareness and the importance of screening throughout life.

Breast self-examination as a route to early detection in a lower-middle-income country: assessing psychosocial determinants among women in Surabaya, Indonesia.

BACKGROUND: Breast cancer has become a public health concern in Indonesia. Regular breast self-examination (BSE) is considered an important first step for its early detection, especially in countries with limited healthcare access, as it is the case in Indonesia. This study aimed to confirm and assess the psychosocial determinants of intention to perform BSE and BSE performance. METHODS: The cross-sectional study was conducted on 204 women aged 18-65 years in Surabaya, Indonesia. A 64-item survey was conducted, included variables from the Reasoned Action Approach, and the Health Belief Model, presented questions about demographics, breast cancer knowledge, and behavior related to BSE. RESULTS: Most women (72.5%) expressed intention to perform BSE; however, only 7.8% and 2.9% performed BSE per week and per month, respectively, in the past year. Breast cancer knowledge and attitudes towards BSE were uniquely associated with BSE performance. Perceived behavioral control (PBC) and BSE attitudes were unique correlates of intention. Perceived benefits and barriers and subjective norms were significantly associated with intention and BSE behavior in bivariate analyses. CONCLUSIONS: Breast screening education should incorporate strategies for improving attitudes towards BSE, PBC, and breast cancer knowledge with perceived benefits and barriers and subjective norms as relevant targets.

Effectiveness of educational intervention on breast cancer knowledge and breast self-examination among female university students in Bangladesh: a pre-post quasi-experimental study.

BACKGROUND: Breast cancer is a global health issue and a leading cause of death among women. Early detection through increased awareness and knowledge on breast cancer and breast cancer screening is thus crucial. The aim of the present study was to assess the effect of an educational intervention program on breast cancer knowledge and the practice of breast self-examination among young female students of a university in Bangladesh. METHODS: A quasi-experimental (pre-post) study design was conducted at Jahangirnagar University in Bangladesh. Educational information on breast cancer and breast self-examination (BSE), demonstration of BSE procedure and leaflets were distributed among 400 female students after obtaining written informed consent. The stepwise procedures of BSE performance were demonstrated with images. Pre-intervention and 15 days post-intervention assessments were conducted to assess the changes in knowledge on breast cancer and practices of BSE. Mc-Nemar's tests and paired sampled t-tests were performed to investigate the differences between pre- and post-test stages. RESULTS: A total of 400 female university students aged 18-26 years were included in the sample. Significant changes were found in knowledge and awareness about breast cancer and BSE practices after the educational intervention. The significant differences were measured in the mean scores of pre-test vs. post-test: breast cancer symptoms (2.99 ± 1.05 vs. 6.35 ± 1.15; p < 0.001), risk factors (3.35 ± 1.19 vs. 7.56 ± 1.04; p < 0.001), treatment (1.79 ± 0.90 vs. 4.63 ± 0.84; p < 0.001), prevention (3.82 ± 1.32 vs. 7.14 ± 1.03; p < 0.001), screening of breast cancer (1.82 ± 0.55 vs. 3.98 ± 0.71; p < 0.001) and process of BSE (1.57 ± 1.86 vs. 3.94 ± 0.93; p < 0.001). Likewise, a significant percentage of change in BSE practices was obtained between pre-test and post-test (21.3% vs. 33.8%; p < 0.001). CONCLUSIONS: Study findings confirm that the study population had inadequate awareness and knowledge at baseline which was improved significantly after educational intervention. A nationwide roll-out with community-based interventions is recommended for the female population in both rural and urban areas.

The role of psychosocial variables in breast self-examination practice: Results from focus group discussions in Surabaya, Indonesia.

INTRODUCTION: Breast cancer is a global life-threatening disease. Breast self-examination (BSE) followed by timely diagnosis and treatment is a viable screening method for populations with limited health care access such as Indonesia. Knowledge of the beliefs underlying BSE could benefit the development of future health education efforts to promote BSE and breast cancer awareness among Indonesian women, with the ultimate aim to achieve early detection and promote long-term survivals. The purpose of this study was to explore the underlying beliefs of BSE among women in Surabaya, Indonesia in accordance with the reasoned action approach (RAA) framework. Moreover, we investigated what these women considered an effective approach to improve breast awareness and promote BSE in their social networks. METHOD: The participants included 62 women aged 18-55 (M = 32,9) in Surabaya, Indonesia who were divided into nine focus groups. Directed content analysis was employed to analyze the data. RESULTS: Six psychosocial determinants of performing BSE emerged from the analysis: knowledge, attitude and beliefs, risk perception, norms, perceived behavior control, and intention. Furthermore, the participants identified face-to-face meetings with visual media and healthcare professionals as effective channels to enhance breast awareness. CONCLUSION: This study sheds light on the application of the RAA for BSE, and reveals the importance of face-to-face meetings involving healthcare professionals and women's social networks for breast education.

Women's health behaviour change after receiving breast cancer risk estimates with tailored screening and prevention recommendations.

BACKGROUND: The Predicting Risk of Cancer at Screening (PROCAS) study provided women who were eligible for breast cancer screening in Greater Manchester (United Kingdom) with their 10-year risk of breast cancer, i.e., low (≤1.5%), average (1.5-4.99%), moderate (5.-7.99%) or high (≥8%). The aim of this study is to explore which factors were associated with women's uptake of screening and prevention recommendations. Additionally, we evaluated women's organisational preferences regarding tailored screening. METHODS: A total of 325 women with a self-reported low (n = 60), average (n = 125), moderate (n = 80), or high (n = 60) risk completed a two-part web-based survey. The first part contained questions about personal characteristics. For the second part women were asked about uptake of early detection and preventive behaviours after breast cancer risk communication. Additional questions were posed to explore preferences regarding the organisation of risk-stratified screening and prevention. We performed exploratory univariable and multivariable regression analyses to assess which factors were associated with uptake of primary and secondary breast cancer preventive behaviours, stratified by breast cancer risk. Organisational preferences are presented using descriptive statistics. RESULTS: Self-reported breast cancer risk predicted uptake of (a) supplemental screening and breast self-examination, (b) risk-reducing medication and (c) preventive lifestyle behaviours. Further predictors were (a) having a first degree relative with breast cancer, (b) higher age, and (c) higher body mass index (BMI). Women's organisational preferences for tailored screening emphasised a desire for more intensive screening for women at increased risk by further shortening the screening interval and moving the starting age forward. CONCLUSIONS: Breast cancer risk communication predicts the uptake of key tailored primary and secondary preventive behaviours. Effective communication of breast cancer risk information is essential to optimise the population-wide impact of tailored screening.

Knowledge and Practices of Female Nurses at Primary Health Care Clinics in Gaza Strip-Palestine Regarding Early Detection of Breast Cancer.

BACKGROUND: Breast cancer (BC) is the leading cause of cancer deaths among females in Palestine. Female nurses play a vital role in increasing women's awareness of BC early detection. OBJECTIVE: This study aimed to assess the knowledge and practices of female nurses at Primary Health Care Clinics (PHCCs) in the Gaza Strip regarding early detection of BC. MATERIALS AND METHODS: This is an analytical, cross-sectional study with a census sample that includes all target female nurses (152) currently working at PHCCs. The study was conducted during the period February 2019 - March 2020.  A structured self-administered questionnaire was used to collect data among female nurses. Descriptive and inferential analyses were used to examine the relationship between the variables. Ethical approval was obtained from a Helsinki Committee Gaza Strip-Palestine. RESULTS: The nurses demonstrated a good knowledge of signs and risk factors of BC,  with scores of 85.3% and 77.9%, respectively. The majority of the participants correctly defined breast self-examination (BSE) and claimed that clinical breast examination (CBE) is a useful tool to detect BC (94.1% and 97.4%, respectively). Nurses who had previous training in CBE had better knowledge than those who had not (t = 3.5; P-value <0.001). Nurses who previously performed mammography had a knowledge score (mean ± SD = 78.1±12.8) higher than those who did not (mean ± SD = 72.5±14). Nurses having previous training had a knowledge score of 8.9 times higher than those without relevant training (t = 4.2, P-value < 0.001). Nurses' knowledge of BC risk factors  increased the practicing score by a factor of 0.22 (t = 3.0, P-value = 0.003). CONCLUSION: Nurses demonstrate good knowledge and practices of early BC detection. Previous education sessions affect the knowledge of early detection methods positively.

Determinants of Breast Cancer Screening Practice among Women in Indonesia: A Nationwide Study.

BACKGROUND: Breast cancer remains the leading cause of death for women globally, including in Indonesia. Breast cancer screening plays a vital role in reducing deaths caused by breast cancer. However, breast cancer screening rate is still low and studies on determinants for breast cancer screening is limited in Indonesia. This study aimed to identify the determinants of breast cancer screening among women in Indonesia. METHODS: This population-based study was conducted among 827 women who lived in either rural and urban areas, using a stratified sampling design where were based on province and locality combinations. Data were analysed using a binary logistic regression model to assess the associations between independent and dependent variables. RESULTS: As many as 827 women with an average age of 29.91 (± 11.14) years old participated in this study. The overall breast cancer screening among women was 18.74%. Knowledge of breast cancer risk factors, signs, and symptoms (adj.OR = 1.75, 95%CI: 1.20 - 2.56), age of 35 to 39 years old (adj.OR. = 1.52, 95% CI: 1.02 - 2.26), and household income of ≥6,000,000 IDR (≥457 USD) (adj.OR. = 5.19, 95%CI: 1.43-18.84) were associated with breast cancer screening attendance. In contrast, Christian women had a significantly lower breast cancer screening rate that women from other religions (adj. OR. = 0.45, 95%CI: 0.24 - 0.85). CONCLUSION: The overall breast cancer screening attendance was poor among Indonesian women population. Age, household income, religion, and knowledge of breast cancer risk factors were identified as the determinant factors for breast cancer screening.

Breast Cancer Knowledge and Practice of Breast Self-Examination among Female University Students, Gaza.

Breast cancer is the highest public detected cancer among female population in the majority of countries worldwide. Breast self-examination (BSE) is a useful screening tool to empower women and raise awareness about their breast tissues and help detect any breast abnormalities when they occur. This study aimed to assess the level of female university students' knowledge and practice of BSE. A self-administered questionnaire was used to assess the knowledge about breast cancer and related items, and an observation checklist was used to test practicing BSE using a breast simulator. Eighty-six students participated in the study, 58.1% studying nursing and 41.9% studying clinical nutrition in the third (40.7%) or the fourth level (59.3%). Of them, 24.4% had previous family history of breast cancer. The majority of the students (80.2%) had previous information about breast cancer acquired from different sources, university studies (57%), the Internet (45%), and social media (41%). Findings showed good scores (≥70%) regarding signs and symptoms and risk factors of breast cancer; however, low knowledge scores (<70%) were detected regarding general knowledge about breast cancer disease, methods of early detection and management, and applying steps of practicing BSE. Roughly all the students (96.5%) have heard about BSE, and 69.8% knew the time to do BSE; however, only 31.4% practice it regularly. Three barriers to practice were dominant among students who do not have a breast problem (39.7%), do not know how to do it (37.9%), and being busy 31%. On the other hand, breast cancer early detection purpose and the presence of family history of breast cancer were considered facilitators to regular practice BSE. A statistically significant relationship existed between knowledge about the steps of applying the BSE and regular practicing. A training program should be implemented to increase the level of awareness about BC and practicing BSE.

Knowledge, awareness, and practice of breast self-examination among females in Mosul city, Iraq.

AIMS: This study is carried out to report on the knowledge and practice regarding breast self-examination (BSE) among women from the city of Mosul in Iraq and to evaluate the prevalence of performing clinical breast examination (CBE) and mammography among them. SETTINGS AND DESIGN: A descriptive, cross-sectional survey carried out among females working in the University of Mosul, as a sample of the female population of Mosul city. SUBJECTS AND METHODS: The sample was collected conveniently, and the data were collected from July to November 2018. Data were collected by interviews with 405 participants. Knowledge answers were scored and categorized into two groups: good and poor level of knowledge. RESULTS: A final sample of 384 participants were included in the analysis, with a mean age of 42.58 ± 8.9. Only 39 (10.1%) and 37 (9.6%) participants performed mammographic examination and CBE of their breasts, respectively. Just 100 (30.3%) of the 330 females who knew BSE performed BSE routinely or intermittently. The mean knowledge score was 4.22 ± 1.66, and only 141 females (42.7%) were found to have a good level of knowledge. A statistically significant association of knowledge level with marital status (P = 0.015), perceived benefit of BSE (P = 0.001), previous gain of instructions of BSE (P < 0.05), and the provider (P < 0.05) was found. CONCLUSIONS: The performance results of BSE were poor as well as for CBE and mammography among the study participants. There is a need for educational programs to create awareness and improve knowledge about routine breast cancer screening behavior.

Impact of Educational Level and Family income on Breast Cancer Awareness among College-Going Girls in Shillong (Meghalaya), India.

BACKGROUND: Breast cancer (BC) is the most common cancer among women in India and shows an increasing trend. The mammography screening seems unfeasible as a public health service in India. Thus, breast self-examination (BSE), followed by clinical breast examination (CBE), is the affordable method to downstage BC. A cross-sectional study was conducted with senior school and college-going girls in Shillong (Meghalaya) to study the impact of girls' academic level and family income on breast cancer knowledge and the prevalence of BC's known risk factors in girls.  Methods: A self-administered questionnaire was employed to collect relevant information. The data were analysed using statistical software SPSS version 22. The categorical data presented as frequency (%) and the comparison made using Chi-square or Fisher exact test. RESULTS: (i) 78.2% girls knew about breast cancer, 19.2% of these were aware of BSE, and 22.9% of BSE knowing ever performed it (ii) Awareness of breast cancer and BSE, and its practice is significantly associated with their academic level and family income (iii) The consumption of alcohol beverages and physical activity of girls was positively associated with educational level and family income (iv) Body mass index (BMI) was weakly associated with family income with an insignificant relationship with academic level (v) oily food consumption related inversely with the level of education irrespective of family income (vi) there was a positive correlation between parents education and family income. CONCLUSIONS: The results show a severe lack of breast cancer knowledge in senior school and college-going girls under the survey. To spread community awareness, we suggest a public health policy-driven educational intervention through culturally relevant mass/social media on the risk factors of breast cancer and practice of BSE. It is also recommended that dedicated facilities be created for breast cancer early diagnosis in the public health system.

Factors associated with breast cancer awareness and breast self-examination in Fiji and Kashmir India - a cross-sectional study.

BACKGROUND: In low-income countries breast cancer awareness (BCA) is essential to reduce the proportion of advanced stage presentations of breast cancer. There is a lack of studies using multivariable techniques to explore factors related to BCA in low-income countries. The objective of this study was to identify to what extent women in Fiji and Kashmir, India have BCA and practice breast self-examination (BSE) as well as factors associated with BCA and BSE. METHODS: A survey of women aged ≥18 years was conducted in Fiji and Kashmir, India to assess BCA and rates of BSE. Comparison between Fiji and Kashmir was done using student's t-test for continuous data and chi-square for binary data. Factors associated with BCA and BSE were analysed using a multivariable logistic regression for Fiji and Kashmir separately. RESULTS: Data were collected from 399 and 1982 women in Kashmir and Fiji, respectively. Of 1968 women in Fiji 57% were deemed to have an acceptable BCA compared to only 7.3% of 395 women in Kashmir. Having some education was associated with having BCA with an odds ratio of 4.7 (1.7-13) in Fiji and 10 (1.7-59) in Kashmir. Of 1976 women in Fiji 40% had tertiary education while 40% of 392 women in Kashmir had no education at all. The marital status was similar in both samples (n = 1973 and 395) with 68-69% being married and 21-26% being single. The lack of female doctors or nurses with whom to discuss issues, was perceived as a problem in both countries. CONCLUSIONS: The key finding is an association between having any level of education and BCA. This correlation was much stronger than for a family history of breast cancer and BCA. Hence, general education to illiterate women may reduce the proportion of women in low-income countries presenting with advanced-stage breast cancer.

Breast self-examination and associated factors among women in Wolaita Sodo, Ethiopia: a community-based cross-sectional study.

BACKGROUND: The early detection of breast cancer plays an important role in decreasing morbidity and mortality of breast cancer. Breast self-examination (BSE) is one screening method used for the early detection of breast cancer. BSE involves the woman looking at and feeling each breast for possible lumps, distortions, or swellings. BSE is a simple exercise that can potentially save women's lives, but BSE receives relatively little attention and no study has yet addressed BSE at the community level. Here we assessed BSE and associated factors among women aged 20-65 years in Wolaita Sodo city, Ethiopia. METHODS: This was a community-based, cross-sectional study. Systematic random sampling was used to select 626 women aged 20-65 years old. Data were collected using a pre-tested and structured questionnaire. Data were recorded using EpiData version 3.5.1 and exported to SPSS version 21 for cleaning and statistical analysis. Bivariable analysis was performed, and variables with a p-value < 0.25 were used in multiple logistic regression analysis. Multiple logistic regression was employed, and variables with p-values < 0.05 were considered statically significant. RESULTS: A total of 629 women aged between 20 and 65 years were included in the study. Over half (60.9%) of participants were aged between 20 and 29 years, and 8.2% were < 50 years old. Women who mentioned BSE as a method for the early detection of breast problems were 6.36-times (95% CI: 3.72, 10.71) more likely to perform BSE than those who reported that they did not know of any method. Those who had breast fed for 13-24 months were 2.43 times (95% CI: 1.28, 4.59) more likely to examine their breasts than those who breast fed for different durations or used other methods. Employed study participants were 3.13-times (95% CI: 1.14, 8.58) more likely to practice BSE than those who were not employed. Likewise, students were 3.73-times (95% CI: 1.19, 11.73) more likely to perform BSE. CONCLUSIONS: In our sample, women's practice of BSE was relatively low. Knowledge of BSE, breastfeeding up to 24 months, being employed, and being a student were factors affecting performing BSE. Educating girls and increasing awareness, including through electronic media, are important to encourage BSE and improve breast cancer outcomes.

Awareness of Breast Cancer Risk Factors, Symptoms and Breast Self-Examination Among Omani Female Teachers: A cross-sectional study.

OBJECTIVES: This study aimed to assess knowledge of breast cancer (BC) risk factors, warning signs and symptoms and breast self-examination (BSE) practice among Omani female teachers in Al-Dhahira Governorate. METHODS: A cross-sectional sample of female teachers aged 20-50 years was collected from January to December 2018 from three wilayats (provinces) in Al-Dhahira-Ibri, Dhank and Yunqal. A questionnaire that included the Breast Cancer Awareness Scale and demographic characteristics was administered. Data were analysed using descriptive statistics, regression analysis and Pearson's Chi-square test. RESULTS: A total of 478 female teachers were included in the study (response rate: 72.4%). The majority of participants (60.5%) had good overall knowledge about BC while 19.9% of participants had excellent overall knowledge. Only 9% of participants demonstrating excellent knowledge of BC risk factors. More than half of the participants (56.1%) reported excellent knowledge in screening methods. Unfortunately, only 57% of the female teachers indicated practising BSE. Knowledge of BC symptoms was closely divided between excellent and good levels (45.8 and 42.5%, respectively). BSE practice was significantly (P <0.05) correlated with overall knowledge of BC and its symptoms and screening methods, but not with knowledge of BC risk factors. CONCLUSION: This study revealed unsatisfactory overall knowledge of BC risk factors, symptoms, screening methods and BSE practice among female Omani teachers in Al-Dhahira Governorate. These findings constitute a challenge to healthcare providers to continue developing awareness of BC and providing health information to the public.

Understanding women's perspectives on breast cancer is essential for cancer control: knowledge, risk awareness, and care-seeking in Mwanza, Tanzania.

BACKGROUND: Breast Cancer is the most common cancer in women worldwide. Since 2008, Mwanza, Tanzania, has worked to provide comprehensive cancer services through its Zonal consultant hospital. New national guidelines focused on clinical breast exam requires that women be aware of and seek care for breast concerns. Therefore, this study aims to understand breast cancer awareness in Mwanza and describe women-level barriers, care-seeking behavior, and perspectives on breast cancer. METHODS: A community-based survey was administered to conveniently sampled women aged 30 and older to assess women's perspectives on breast cancer and care-seeking behavior. RESULTS: Among 1129 women with a median age of 37 (IQR: 31-44) years, 73% have heard of cancer and 10% have received breast health education. Women self-evaluated their knowledge of breast cancer (from 1-none to 10-extremely knowledgeable) with a median response of 3 (IQR: 1-4). Only 14% felt they knew any signs or symptoms of breast cancer. Encouragingly, 56% of women were fairly-to-very confident they would notice changes in their breasts, with 24% of women practicing self-breast examination and 21% reporting they had received a past breast exam. Overall, 74% said they would be somewhat-to-very likely to seek care if they noticed breast changes, with 96% noting severity of symptoms as a motivator. However, fear of losing a breast (40%) and fear of a poor diagnosis (38%) were most frequent barriers to care seeking. In assessing knowledge of risk factors, about 50% of women did not know any risk factors for breast cancer whereas 42% of women believed long term contraceptive use a risk factor. However, 37% and 35% of women did not think that family history or being older were risk factors, respectively. CONCLUSIONS: The success of efforts to improve early diagnosis in a setting without population-based screening depends on women being aware of breast cancer signs and symptoms, risks, and ultimately seeking care for breast concerns. Fortunately, most women said they would seek care if they noticed a change in their breasts, but the low levels of cancer knowledge, symptoms, and common risk factors highlight the need for targeted community education and awareness campaigns.

Effectiveness of self-instructional module on awareness on screening regarding breast cancer with Intelligent Breast Examination among primary schoolteachers in Karad.

AIM: As Breast cancer is most common in developed and developing world. Despite of seriousness & importance of breast cancer the awareness is low. This Study highlights the primary screening of breast cancer with the device Intelligent Breast Examination. OBJECTIVES: The objectives of this study are to assess the knowledge regarding awareness on screening of breast cancer with Intelligent Breast Examination (IBE), to develop a self-instructional module (SIM) on awareness on screening regarding breast cancer with IBE, and to assess its effectiveness on awareness about screening breast cancer with IBE. MATERIALS AND METHODS: Evaluative research approach was used. The study used preexperimental research design. The samples (60 primary schoolteachers) were selected by the use of two sampling techniques, i.e., random sampling (for schools) and purposive sampling (study participants). Data were collected in two phases (pre and post) using structured questionnaire followed by the administration of SIM. RESULTS: The results revealed a significant increase in mean knowledge scores (mean pre 11.16 standard deviation [SD] = 2.631 to mean post 21.2 SD = 1.842) regarding awareness on screening of breast cancer with IBE. The calculated paired t value (23.902) is greater than the table value ( t = 1.67) at 0.05 level of significance. CONCLUSION: The study concluded that the SIM prepared proved to be effective in increasing the awareness regarding screening with IBE in breast cancer.

Self-Efficacy and Perceived Barriers as Determinants of Breast Self-Examination Among Female Nonmedical Students of the University of Ghana.

Breast cancer mortality in sub-Saharan Africa is comparatively high largely because of low levels of knowledge and late presentation at hospitals. Breast self-examination (BSE) provides an important way of early detection of breast cancer, particularly for resource constrained countries. This study therefore examined the factors which influence the performance of BSE among female undergraduate nonmedical students of the University of Ghana. A cross-sectional survey was conducted between April and May 2018. It involved 308 students drawn from the University of Ghana. The instrument was based on the Health Belief Model and the Breast Cancer Knowledge questionnaires. The results suggest that about a quarter (23.4%) of the participants performed BSE at least once every month, despite 75.3% believing that checking the breast every month helps in early detection of breast cancer. As expected, those who had ever performed BSE had higher knowledge of breast cancer (M = 6.722, standard deviation [SD] = 2.090) compared with those who had never performed BSE (M = 4.850, SD = 1.982), p = . 000. Similarly, they perceived barriers to performing BSE to be lower (M = 17.900, SD = 5.733) compared with nonperformers (M = 19.850, SD = 6.976), p < .05. Results of logistic regression analysis indicated that knowledge level, self-efficacy, and level at the university were statistically significant predictors of BSE. Educational and training programs that focus on equipping women with the skill to perform BSE are therefore recommended.

Assessment of knowledge and practice of breast self-examination among reproductive age women in Akatsi South district of Volta region of Ghana.

BACKGROUND: Breast cancer is the primary cause of cancer death among women globally, responsible for about 425,000 deaths in 2010. This study assessed the awareness, knowledge and practices of breast self-examination as a method of prevention and early diagnosis of breast cancer among reproductive aged women in Akatsi South district in Volta region of Ghana. METHODS: This study was a cross-sectional study involving 385 women between the ages of 15-49 years. Data were collected with a structured questionnaire and variables included socio-demographic characteristics, breast cancer knowledge, breast self-examination knowledge and practice. Descriptive statistics were used to analyze and present the data and chi square test of significance was used to determine association between socio-demographic variable and practice of breast self-examination. RESULTS: The mean age of the women was 24.54±7.19. Only 3.1% of women had no formal education and 58.9% were single. Although 88.3% of the respondents were aware of breast cancer, 64.9% of the respondents had good or sufficient knowledge of breast cancer and only 94(37.6%) practice BSE. Over 50% of the respondents did not know how to perform BSE. There was a significant association between knowledge on breast cancer and practice of BSE (χ2 = 36.218 p = 0.000). The higher the age of a participant, the lower practice of breast self-examination and this was significant (χ2 = 11.324, p = 0.003). CONCLUSION: Breast self-examination is a key strategy to early detection of breast cancer and subsequently critical for effective treatment and cure of the disease. The findings in this study have shown significant low levels of awareness and practice of breast self-examination among women in Akatsi South district of the Volta region. This pattern may be similar to other rural communities across the region. The need to create awareness and to educate women, especially rural women, on importance of breast self-examination as preventive measure for breast cancer is paramount.

Determinants of breast self-examination practice among women in Surabaya, Indonesia: an application of the health belief model.

BACKGROUND: Breast cancer has become one of the most common causes of mortality among Indonesian women. Many women in Indonesia present with late-stage breast cancer, negatively affecting prognosis and treatment outcomes. Better prognosis of breast cancer will be achieved if it is diagnosed in an earlier stage, thus efforts to detect breast cancer earlier are important. Breast Self-Examination (BSE) is considered as an important first step to encourage women to actively be responsible for their own health, especially for women in low-and middle-income countries with limited resources and access to other forms of preventive healthcare (e.g., screening programs). The present study aimed to predict BSE practice among women in Surabaya, Indonesia using the Health Belief Model (HBM). METHODS: This investigation was a cross-sectional survey which was distributed among 1967 women aged 20-60 years. The Indonesian version of Champion's Health Belief Model Scale (I-CHBMS) was used to explain self-reported BSE practice. Logistic regression analysis was used to examine the association of HBM variables with BSE practice. RESULTS: 44.4% of the respondents indicated they had performed BSE. Further, the results indicated that the HBM variables were significantly associated with BSE practice. Specifically, higher perceived benefits and self-efficacy, lower perceived barriers and less cues to action were unique correlates of BSE practice. The result also showed that perceived severity and susceptibility were not associated with BSE practice. CONCLUSION: This study indicated that several HBM constructs significantly associated with BSE practice among Indonesian women, suggesting that BSE health education programs should emphasize the perceived benefits of BSE, focus on increasing women's self-efficacy to address and overcome perceived barriers in performing BSE, and help them in identifying personally relevant cues to action.

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 Aydin, 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.

Breast self-examination practice and associated factors among female healthcare workers in West Shoa Zone, Western Ethiopia 2019: a cross-sectional study.

OBJECTIVE: Breast cancer is the leading cause of death among reproductive-age women worldwide and the second leading cause of death among women in Ethiopia. Regular breast self-examination is the most cost-effective methods for early detection of breast cancer. Despite this fact, breast self-examination was low among women in the general population and it was not well documented among health care workers. Therefore, this study intended to assess the magnitude of breast self-examination practice and associated factors among female healthcare workers in public health facility in West Shoa Zone, Ethiopia. Institutional based cross-sectional study was conducted among 379 female healthcare workers. The study participants were recruited by lottery method. Data were collected from March to April 2019. Data were entered into Epi data version 4.5 and analyzed using SPSS version 25. Bivariate and multiple logistic regressions analysis were done. With 95% CI, the level of significance was decided at P-value ≤ 0.05. RESULTS: The magnitude of regular breast self-examination practice was 32.6%. Educational levels, breast cancer awareness, knowledge towards breast self-examination were predictors of breast self-examination. Regular awareness creation forum on breast self-examination technique, risk factors, and related matters should be facilitated so that all female health care workers will be reminded.