Promoting Breast Cancer Awareness and Clinical Breast Examination in the LMIC: Experiences from Tajikistan, Pakistan and Kenya

2019 ◽  
Vol 11 (3) ◽  
pp. 152-157 ◽  
Author(s):  
Zohray Talib ◽  
Farin Amersi ◽  
Attiya Harit ◽  
Mansoor Saleh
2021 ◽  
Author(s):  
Joyce Ayugi ◽  
George Ndagijimana ◽  
Stanley Luyima ◽  
David Lagoro Kitara

Abstract Background: Breast cancer (BC) is one of the most common cancers that occur worldwide among women. There were more disability-adjusted life years (DALYs) lost to breast cancer among women worldwide than any other cancers, and DALYs occurred in women globally after puberty, with increasing rates later in life. Improvements in breast cancer survival began in the 1980s in countries where early detection programs combined with different modes of treatment to eradicate the invasive form of the disease were practiced. Recent data showed that there was a higher prevalence of breast cancer among women in Northern Uganda than among women in the rest of Uganda.The objective of this study was to determine factors associated with breast cancer awareness, breast self-examination (BSE), clinical breast examination (CBE), and other modalities for screening and early breast cancer detection among adult women in the Gulu main market.Methods: A cross-sectional study was conducted in the Gulu main market in 2020. A total of 98 adult women were recruited for the study by a random sampling method. The questionnaire had an internal validity of Cronbach’s α=0.72. The study was approved by a local IRB. SPSS version 26.0 was used for data analysis, and a p-value less than 0.05 was considered significant.Results: Most participants were 20-29 years 41(41.8%), married 44(44.9%), monthly incomes of >UGX1 million shillings 51(52.2%), Acholi 81(82.7%), Catholics 46(46.9%), vendors 75(76.5%), duration of work in the market (1-10 years) 64(65.4%), primary level of education 39(39.8%), and had 1-2 pregnancies 37(37.8%). The independent factors associated with breast cancer awareness, breast self-examination, and clinical breast examination were vendor (primary occupation) (β=-0.130, t=-2.979, p<0.004), duration of work in the market (1-10 years) (β=-0.186, t=-2.452, p<0.016), and higher level of education (β=-0.091, t=-2.506, p<0.014).Conclusions: Breast cancer awareness and downstaging practices in adult women in the Gulu main market were thought-provoking. Women with better socioeconomic status (higher education, moderate work duration in the market and primarily vendors) in the Gulu main market were more likely aware and practiced breast cancer downstaging activities. There is a need to strengthen publicity on breast cancer-related knowledge for lower-income occupational groups and those with lower education levels to better understand the importance of conducting BSE, CBE, and mammography for early breast cancer detection.


2019 ◽  
Author(s):  
Abdou Aissami ◽  
Guido Van Hal ◽  
Dille Issimouha

Abstract Background: In Niger, breast cancer is the first cancer related morbidity and mortality within the female population. While Breast cancer awareness can contribute to early diagnosis and disease mortality reduction, Niger women’s knowledge of breast cancer is not well documented. The objective of this study was to assess the knowledge, attitudes and practices of women related to breast cancer and have a look on the factors associated this knowledge. Methods: The study was conducted thought a cross sectional survey in women population in Zinder and Niamey regions. A random sampling was used to select women in households within health districts. We defined a breast cancer knowledge score and used a generalized linear model to assess factors associated with breast cancer knowledge. Results: A total of 675 women were included in the survey. Average age of women was 39.2 years (38.2-40.2) and 48.4% (44.7-52.2) of them were not educated. Overall women’s knowledge of breast cancer is relatively low, only 41.2% (37.5-45.0) were aware of breast cancer. An area where women demonstrated an awareness was breast cancer symptoms knowledge with 65.0% (61.3-68.7). Insufficient level of knowledge was observed on knowledge of risk and protection factors with only 27.4 % (24.0-31.0) level of awareness and breast cancer good practice with 16.9% (14.2-19.7). Younger age OR=0.98 (0.96-0.99) practicing clinical breast examination OR=2.25 (1.31–3.16), breastfeeding 3.34 (2.12-5.26), not having a history of participation to breast cancer 0.53 (0.34-0.82) and living in rural and peri-urban areas 0.34 (0.20–0.44) were factors related to awareness of breast cancer. Conclusion: Niger women had overall low level of breast cancer awareness. While they were not acquainted with breast self-examination and clinical breast examination, their knowledge of breast cancer symptoms was acceptable. Clinical breast examination, area of residence, age, breastfeeding and history of participation to breast cancer screening were found to be associated with breast cancer knowledge. Awareness programs can promote clinical breast examination as mammography is not common and target older women. Focus should be given to awareness of breast cancer risk factors and promoting early detection procedures.


BMJ ◽  
2021 ◽  
pp. n256
Author(s):  
Indraneel Mittra ◽  
Gauravi A Mishra ◽  
Rajesh P Dikshit ◽  
Subhadra Gupta ◽  
Vasundhara Y Kulkarni ◽  
...  

Abstract Objective To test the efficacy of screening by clinical breast examination in downstaging breast cancer at diagnosis and in reducing mortality from the disease, when compared with no screening. Design Prospective, cluster randomised controlled trial. Setting 20 geographically distinct clusters located in Mumbai, India, randomly allocated to 10 screening and 10 control clusters; total trial duration was 20 years (recruitment began in May 1998; database locked in March 2019 for analysis). Participants 151 538 women aged 35-64 with no history of breast cancer. Interventions Women in the screening arm (n=75 360) received four screening rounds of clinical breast examination (conducted by trained female primary health workers) and cancer awareness every two years, followed by five rounds of active surveillance every two years. Women in the control arm (n=76 178) received one round of cancer awareness followed by eight rounds of active surveillance every two years. Main outcome measures Downstaging of breast cancer at diagnosis and reduction in mortality from breast cancer. Results Breast cancer was detected at an earlier age in the screening group than in the control group (age 55.18 (standard deviation 9.10) v 56.50 (9.10); P=0.01), with a significant reduction in the proportion of women with stage III or IV disease (37% (n=220) v 47% (n=271), P=0.001). A non-significant 15% reduction in breast cancer mortality was observed in the screening arm versus control arm in the overall study population (age 35-64; 20.82 deaths per 100 000 person years (95% confidence interval 18.25 to 23.97) v 24.62 (21.71 to 28.04); rate ratio 0.85 (95% confidence interval 0.71 to 1.01); P=0.07). However, a post hoc subset analysis showed nearly 30% relative reduction in breast cancer mortality in women aged 50 and older (24.62 (20.62 to 29.76) v 34.68 (27.54 to 44.37); 0.71 (0.54 to 0.94); P=0.02), but no significant reduction in women younger than 50 (19.53 (17.24 to 22.29) v 21.03 (18.97 to 23.44); 0.93 (0.79 to 1.09); P=0.37). A 5% reduction in all cause mortality was seen in the screening arm versus the control arm, but it was not statistically significant (rate ratio 0.95 (95% confidence interval 0.81 to 1.10); P=0.49). Conclusions These results indicate that clinical breast examination conducted every two years by primary health workers significantly downstaged breast cancer at diagnosis and led to a non-significant 15% reduction in breast cancer mortality overall (but a significant reduction of nearly 30% in mortality in women aged ≥50). No significant reduction in mortality was seen in women younger than 50 years. Clinical breast examination should be considered for breast cancer screening in low and middle income countries. Trial registration Clinical Trials Registry of India CTRI/2010/091/001205; ClinicalTrials.gov NCT00632047 .


2016 ◽  
Vol 2 (3) ◽  
pp. 114-122 ◽  
Author(s):  
Naftali Wisindi Busakhala ◽  
Fredrick Asirwa Chite ◽  
Juddy Wachira ◽  
Violet Naanyu ◽  
Job Wapangana Kisuya ◽  
...  

Purpose More than 80% of women with breast cancer in Kenya present to medical care with established late-stage disease. We sought to understand why women might not participate in breast cancer screening when it is offered by comparing the views of a cohort of those who attended a screening special event with those of community controls who did not attend. Methods All residents living close to three health centers in western Kenya were invited to participate in screening. Participants (attendees) underwent clinical breast examination by trained physician oncologists. In addition, women who consented were interviewed by using a modified Breast Cancer Awareness Module questionnaire. Nonattendees were interviewed in their homes the following day. Results A total of 1,511 attendees (1,238 women and 273 men) and 467 nonattendee women participated in the study. Compared with nonattendees, the women attendees were older, more often employed, knew that breast cancer presented as a lump, and were more likely to have previously felt a lump in a breast. In addition, they were more likely to report previously participating in screening activities, were more likely to have performed breast self-examination, and were less concerned about wasting a doctor’s time. Almost all those surveyed (attendees and nonattendees) expressed interest in future breast cancer screening opportunities. Conclusion The women who volunteer for breast cancer screening in western Kenya are more aware of breast cancer than those who do not volunteer. Screening recruitment should seek to close these knowledge gaps to increase participation.


Author(s):  
Salene M W Jones ◽  
Tammy A Schuler ◽  
Tasleem J Padamsee ◽  
M Robyn Andersen

Abstract Background Previous studies have examined the impact of material financial hardship on cancer screening but without focusing on the psychological aspects of financial hardship. Purpose This study examined the effects of different types of financial anxiety on adherence to breast cancer screening in women at high risk of breast cancer. Adherence to cervical cancer screening was also examined to determine whether associations between financial anxiety and screening adherence were unique to breast cancer screening or more general. Methods Women (n = 324) aged 30–50 and at high risk for inherited breast cancer completed a survey on general financial anxiety, worry about affording healthcare, financial stigma due to cancer risk, and adherence to cancer screening. Multivariate analyses controlled for poverty, age, and race. Results More financial anxiety was associated with lower odds of mammogram adherence (odds ratio [OR] = 0.97, confidence interval [CI] = 0.94, 0.99), Pap smear adherence (OR = 0.98, CI = 0.96, 0.996), and clinical breast examination adherence (OR = 0.98, CI = 0.96, 0.995). More worry about affording healthcare was associated with lower odds of clinical breast examination adherence (OR = 0.95, CI = 0.91, 0.9992) but not mammogram or Pap smear adherence (p &gt; .05). Financial stigma due to cancer risk was associated with lower odds of Pap smear adherence (OR = 0.87, CI = 0.77, 0.97) but no other cancer screenings (p &gt; .07). Conclusions Financial anxiety may impede cancer screening, even for high-risk women aware of their risk status. Clinical interventions focused on social determinants of health may also need to address financial anxiety for women at high risk of breast cancer.


2017 ◽  
Vol 2 (2) ◽  
pp. 20-28
Author(s):  
Bekhal Abdalwahid Amin ◽  
Muhammed Babakir-Mina ◽  
Fadhil Ahmed Mohialdeen ◽  
Mohammed I. M. Gubari

Breast cancer is a devastating affliction, the frequency of which is gradually increasing all over the world. Cancer may be cured if properly intervened at the right time. The correct treatment, aided by professionals and the right technology can provide critical life support to breast cancer patients. This study was conducted to assessment knowledge, attitude and practice of breast cancer among Kurdish females visited Maternity Teaching Hospital in Sulaimani. A face-to-face interview through a question¬naire to assessment of knowledge and practices toward breast cancer of 500 non-breast cancer women visited Maternity Teaching Hospital was done. Data were computerized and analyzed using Statistical Package for the Social Science (SPSS, version 22). P-value of < 0.05 was considered as statistically significant. Out of 500 participants in the current study on knowledge and practices toward breast cancer among non-breast cancer women, consequently were 227 (45.4%) and 201 (40.2%) practiced breast self-examination(BSE) and clinical breast examination respectively. In this study the participants having no symptoms and lack of knowledge about how to do BSE where regarded as the barriers of not practicing BSE (44.7%, 55.3%) respectively. The most common reason for not doing clinical breast examination (CBE) is fear of the outcome and no sign & symptom of breast cancer (28.8%, 61.9%) respectively. The high education level showed significantly more knowledge of breast self-examination and mammography than Illiterate women P≤ 0.001 and P≤ 0.03 respectively. On the other hand, the high education level women showed significantly more practice of breast self-examination P≤ 0.001. In conclusion, the present study found the facts to the inadequate knowledge of female about breast cancer and recognized the negative influence of low knowledge on the practice of BSE, CBE and mammography and the breast cancer incidence. Therefore, more determinations are needed to develop a positive attitude toward BSE, CBE and mammography screening and practice in Sulaimani.


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