Facilitating Factors for the Early Detection of Breast Cancer among a Sample of Women Attending Primary Health Care Centers
Abstract
Background: Breast cancer is the most common cancer and the leading cause of death among Iraqi women. It has a significant impact on the patient's social life, family life, and employment situation. Factors facilitating early detection of breast cancer include knowledge of disease, access to information sources, physician recommendation, and social networks.
Objectives: To identify factors facilitating early detection of breast cancer, and barriers that prevent women from attending a consultation for early detection of breast cancer.
Subjects and methods: A cross sectional study was carried out at Primary Health Care Centers at Al-Karkh health directorate in Baghdad from 1st of February 2023 till end of November 2023. Data of 400 woman aged 20 and older, who had never been diagnosed with breast cancer before were obtained by direct interview. Chi2 test (or fisher’s exact test) was used. P value of less than 0.05 was considered statistically significant.
Results: Most common age group was 30-39 years 130 (32.5%). Concerning knowledge about risk factors of breast cancer among participants family history of breast cancer represent 352 (88.0%), exposure to radiation 295 (73.8%), smoking 230 (57.6%), and use of hormonal replacement therapy 193 (48.3%). Poor knowledge was associated significantly with housewife, negative family history of breast cancer, and those who didn’t have breast cancer check-up before; (P=0.001, P=0.022, and P=0.002) respectively. Most common barriers that prevent women from attending a consultation for early detection of breast cancer were feeling afraid of getting tested 123 (30.8%), feeling ashamed of getting tested 114 (28.5%), and fear of checkup because of result 111 (27.8%).
Conclusions: The level of knowledge about risk factors of breast cancer and family history of the disease were significantly associated with seeking regular checkups, suggesting that these risk factors and the family history of the disease play a pivotal role in facilitating early detection of breast cancer.
Housewife, negative family history of breast cancer, and those who didn’t have breast cancer check-up before were risk factors for Poor knowledge. Most common barriers that prevent women from attending a consultation for early detection of breast cancer were feeling afraid of getting tested 30.8%, feeling ashamed of getting tested 28.5%, and fear of checkup because of result 27.8%
Full text article
References
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249.
Abdalzahra RN, Ali RM. Burdens of breast cancer upon women’s psychological health at Oncology Hospitals in Baghdad City. Iraqi J Public Health. 2017; 1:15–9.
Zuhair A, Khudyair R, Abdulsamad R. Analyze predisposing risk factor of breast cancer (BC) among Iraqi women in Baghdad teaching hospital and oncology unit center in Baghdad. Baghdad Med J Stud. 2020;1(1):9–12.
Annual Report Iraqi Cancer Registry 2021. Ministry of Health. Accessed on 6 February 2024. Available at https://moh.gov.iq/upload/1691449545.pdf.
Kvillemo PK, Chen L, Bottai M, Frumento P, Almondo G, Mittendorfer-Rutz E, et al. Sickness absence and disability pension among women with breast cancer: a population-based cohort study from Sweden. BMC Public Health. 2021 Apr 9;21(1):697.
Endogenous Hormones and Breast Cancer Collaborative Group; Key TJ, Appleby PN, Reeves GK, Travis RC, Alberg AJ, Barricarte A et al. Sex hormones and risk of breast cancer in premenopausal women: a collaborative reanalysis of individual participant data from seven prospective studies. Lancet Oncol. 2013 Sep;14(10):1009-19.
Giordano SH. Breast Cancer in Men. N Engl J Med. 2018 Jun 14;378(24):2311-2320.
McGuire A, Brown JA, Malone C, McLaughlin R, Kerin MJ. Effects of age on the detection and management of breast cancer. Cancers (Basel). 2015 May 22; 7(2):908-29.
Baglia ML, Tang MC, Malone KE, Porter P, Li CI. Family History and Risk of Second Primary Breast Cancer after In Situ Breast Carcinoma. Cancer Epidemiol Biomarkers Prev. 2018 Mar; 27(3):315-320.
Wu HC, Do C, Andrulis IL, John EM, Daly MB, Buys SS et al. Breast cancer family history and allele-specific DNA methylation in the legacy girls study. Epigenetics. 2018; 13(3):240-250.
Shiovitz S, Korde LA. Genetics of breast cancer: a topic in evolution. Ann Oncol. 2015 Jul; 26(7):1291-9.
Hill DA, Prossnitz ER, Royce M, Nibbe A. Temporal trends in breast cancer survival by race and ethnicity: A population-based cohort study. PLoS One. 2019 Oct 24; 14(10).
Husby A, Wohlfahrt J, Øyen N, Melbye M. Pregnancy duration and breast cancer risk. Nat Commun. 2018 Oct 23;9(1):4255.
Kim EY, Chang Y, Ahn J, Yun JS, Park YL, Park CH et al. Mammographic breast density, its changes, and breast cancer risk in premenopausal and postmenopausal women. Cancer. 2020 Nov 1; 126(21):4687-4696.
Schacht DV, Yamaguchi K, Lai J, Kulkarni K, Sennett CA, Abe H. Importance of a personal history of breast cancer as a risk factor for the development of subsequent breast cancer: results from screening breast MRI. AJR Am J Roentgenol. 2014 Feb; 202(2):289-92.
Brunicardi F, Andersen D, Billiar T, Dunn D, Hunter J, Matthews J et al. Schwartz’s Principles of Surgery, 10th edition. McGraw-Hill Education / Medical.2014
Kolb R, Zhang W. Obesity and Breast Cancer: A Case of Inflamed Adipose Tissue. Cancers (Basel). 2020 Jun 25; 12(6):1686.
Wang X, Hui TL, Wang MQ, Liu H, Li RY, Song ZC. Body Mass Index at Diagnosis as a Prognostic Factor for Early-Stage Invasive Breast Cancer after Surgical Resection. Oncol Res Treat. 2019; 42(4):195-201.
James FR, Wootton S, Jackson A, Wiseman M, Copson ER, Cutress RI. Obesity in breast cancer--what is the risk factor? Eur J Cancer. 2015 Apr; 51(6):705-20.
Rachdaoui N, Sarkar DK. Effects of alcohol on the endocrine system. Endocrinol Metab Clin North Am. 2013 Sep; 42(3):593-615.
Misotti AM, Gnagnarella P. Vitamin supplement consumption and breast cancer risk: a review. Ecancermedicalscience. 2013 Oct 23; 7:365.
Dandamudi A, Tommie J, Nommsen-Rivers L, and Couch S. Dietary Patterns and Breast Cancer Risk: A Systematic Review. Anticancer Res. 2018 Jun; 38(6):3209-3222.
Casey SC, Vaccari M, Al-Mulla F, Al-Temaimi R, Amedei A, Barcellos-Hoff MH et al. The effect of environmental chemicals on the tumor microenvironment. Carcinogenesis. 2015 Jun; 36.
Videnros C, Selander J, Wiebert P, Albin M, Plato N, Borgquist S et al. Investigating the risk of breast cancer among women exposed to chemicals: a nested case-control study using improved exposure estimates. Int Arch Occup Environ Health. 2020 Feb; 93(2):261-269.
Hassan LM, Mahmoud N, Miller AB, Iraj H, Mohsen M, Majid J, Reza SM, Mojgan M. Evaluation of effect of self-examination and physical examination on breast cancer. Breast. 2015 Aug;24(4):487-90.
Sultania M, Kataria K, Srivastava A, Misra MC, Parshad R, Dhar A, Hari S, Thulkar S. Validation of Different Techniques in Physical Examination of Breast. Indian J Surg. 2017 Jun;79(3):219-225.
Schwab FD, Huang DJ, Schmid SM, Schötzau A, Güth U. Self-detection and clinical breast examination: comparison of the two "classical" physical examination methods for the diagnosis of breast cancer. Breast. 2015 Feb;24(1):90-2.
Welch HG, Prorok PC, O'Malley AJ, Kramer BS. Breast-Cancer Tumor Size, Overdiagnosis, and Mammography Screening Effectiveness. N Engl J Med. 2016 Oct 13;375(15):1438-1447.
Løberg M, Lousdal ML, Bretthauer M, Kalager M. Benefits and harms of mammography screening. Breast Cancer Res. 2015 May 1;17(1):63.
Drukteinis JS, Mooney BP, Flowers CI, Gatenby RA. Beyond mammography: new frontiers in breast cancer screening. Am J Med. 2013 Jun;126(6):472-9.
Mann RM, Balleyguier C, Baltzer PA, Bick U, Colin C, Cornford E et al. European Society of Breast Imaging (EUSOBI), with language review by Europa Donna–The European Breast Cancer Coalition. Breast MRI: EUSOBI recommendations for women's information. Eur Radiol. 2015 Dec;25(12):3669-78.
Kuhl CK. Abbreviated Magnetic Resonance Imaging (MRI) for Breast Cancer Screening: Rationale, Concept, and Transfer to Clinical Practice. Annu Rev Med. 2019 Jan 27; 70:501-519.
Breast Cancer. Centers for Disease Control and Prevention. 2022. Accessed at 23 July 2023. Available at https://www.cdc.gov/cancer/breast/index.htm.
Familial breast cancer: classification, care and managing breast cancer and related risks in people with a family history of breast cancer. National Institute for Health and Care Excellence (NICE). 20 November 2019. Accessed at 23 July 2023. Available at https://www.nice.org.uk/guidance/cg164.
Guidelines for Early Detection and Periodic Screening of Breast and Cervical Cancers in Primary Health Care Settings in Iraq early detection of breast cancer. United States Agency for International Development Government agency.2013. Accessed at 6 February 2024. Available at https://pdf.usaid.gov/pdf_docs/PA00K4N5.pdf.
Hossaini F, Akbari ME, Soori H, Ramezankhani A. Perceived Barriers to Early Detection of Breast Cancer in Iranian Women: A Qualitative Content Analysis. International Journal of Cancer Management. 2020 ;13(9).
Kaur K, Jajoo R, Naman S, Kandwal T, Brar GS, Garg P et al. Identifying barriers to early diagnosis of breast cancer and perception of women in Malwa region of Punjab, India. Global Health Journal.2023 March;7(1): 34-42.
D'almeida D, Latha T. Barriers for Early Detection of Breast Cancer among South Indian Women. Indian J Community Med. 2021 Oct-Dec;46(4):706-709.
Muhammed NS, Al Dabbagh AM. Determinant of unwillingness for breast cancer screening in a sample of female attending primary health center in Baghdad al-kharkh directorate 2016. A Thesis submitted to the Iraqi Board of Health Specialization 2017
Authors
Copyright (c) 2024 Journal of Current Medical Research and Opinion
This work is licensed under a Creative Commons Attribution 4.0 International License.