• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5349-5357
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• 2015

Background: Breast cancer is the most common cancer and the leading cause of cancer mortality among women of all ethnic and age groups in Malaysia. Delay in seeking help for breast cancer symptoms is preventable and by identifying possible factors for delayed diagnosis, patient prognosis and survival rates could be improved. Objectives: This narrative review aimed to understand and evaluate the level of in-depth breast cancer knowledge in terms of clinical breast examination and breast self-examination, and other important aspects such as side-effects and risk factors in Malaysian females. Since Malaysia is multicultural, this review assessed social perceptions, cultural beliefs and help-seeking behaviour in respect to breast cancer among different ethnic groups, since these may impinge on efforts to 'avoid' the disease. Materials and Methods: A comprehensive literature search of seven databases was performed from December 2015 to January 2015. Screening of relevant published journals was also undertaken to identify available information related to the knowledge, perception and help-seeking behaviour of Malaysian women in relation to breast cancer. Results: A total of 42 articles were appraised and included in this review. Generally, women in Malaysia had good awareness of breast cancer and its screening tools, particularly breast self-examination, but only superficial in-depth knowledge about the disease. Women in rural areas had lower levels of knowledge than those in urban areas. It was also shown that books, magazines, brochures and television were among the most common sources of breast cancer information. Delay in presentation was attributed mainly to a negative social perception of the disease, poverty, cultural and religion practices, and a strong influence of complementary and alternative medicine, rather than a lack of knowledge. Conclusions: This review highlighted the need for an intensive and in-depth breast cancer education campaigns using media and community health programmes, even with the existing good awareness of breast cancer. This is essential in order to avoid misconceptions and to frame the correct mind-set about breast cancer among women in Malaysia. Socio-cultural differences and religious practices should be taken into account by health care professionals when advising on breast cancer. Women need to be aware of the risk factors and symptoms of breast cancer so that early diagnosis can take place and the chances of survival improved.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.3849-3854
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• 2016

Background: Breast cancer is the most prevalent malignancy in women worldwide; lack of awareness of symptoms and delay on diagnosis of breast cancer are the main causes of mortality among women. This study was conducted with the purpose of assessing the effect of educational consulting for breast self-examination (BSE) based on the health belief model (HBM) on the knowledge and performance of women over 40 years attending health care centers in Hamadan, Iran. Materials and Methods: In this quasi-experimental study, eligible women admitted to health centers in Hamadan city in 2015 were randomly assigned to intervention and control groups (n=75 in each group). The intervention group received 4 weekly sessions of breast cancer screening consulting based on the HBM. Control group received only routine care. Knowledge, HBM constructs, and BSE practice were compared between the groups before, immediately after and three months after the consultation. Results: Before the intervention, no significant differences were observed in knowledge, health belief and practice between two groups. However, after the intervention a significant difference was observed between two groups in mean scores of perceived benefits, perceived barriers, self-efficacy and the health motivations (p <0.05). Significant differences were also observed in terms of knowledge and BSE practice (p <0.01). Conclusions: The results indicate the importance of consultation on knowledge and beliefs to improve BSE performance and prevention of breast cancer in Iranian women.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4829-4834
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• 2013

Background: Breast self examination (BSE), performed regularly every month, is one of the most important methods in the early diagnosis of breast cancer. This study was performed with the aim of establishing the knowledge, attitudes, and behavior of women working in government hospitals within the province of Samsun regarding BSE. Materials and Methods: This cross-sectional study was conducted between January-March 2012, on a total of 550 women (500 health personnel, and 50 general administration services (GAS) workers) from 7 government hospitals and the Cancer Early Diagnosis, Screening, and Education Centre (CEDSEC). Percentages were used for the descriptive statistics, and the chi-square test for the evaluation of statistical importance. Values of p<0.05 were accepted as significant. Results: The mean age of the participants was $36.2{\pm}15.3$, and 42.5% were in the 30-39 year old age group, 78.0% being married. Seventy-eight point four percent (78.4%) of the health personnel and 76.0% of the GAS workers performed BSE. However, the rates of performing BSE regularly every month were only 25.6% and 5.0%. Within the health personnel, 1.4% stated that they did not perform BSE because they found it unnecessary as they had no history of breast cancer in their family, 3.6% did not do so due to fear and stress, 13.2% because they forgot, and 14.6% because they had no complaints. Some 22.2% of the health personnel and 52.0% of the GAS workers had undergone mammographic evaluation, the difference being significant (p<0.05), 84.1% of the health personnel and 61.9% of the GAS workers knowing symptoms of breast cancer. Conclusions: Women in society should be brought to a certain level of awareness and knowledge regarding BSE. It is of the utmost importance that health personnel, who carry the responsibility for counseling and enlightening society, should interiorize the necessary knowledge, attitudes and behavior.

• Health Policy and Management
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• v.29 no.4
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• pp.399-411
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• 2019

Background: This study aimed to explore the associations of social-demographic, health-behavioral, and woman-specific factors with the non-screening status of the cervical cancer screening test in Korean adult women. Methods: This study was a cross-sectional analysis of 9,698 Korean adult women aged 20 years or more who participated in the Korea National Health and Nutrition Examination Surveys V (2010-2012). Rao-Scott chi-square tests and survey logistic regression analyses were employed respectively to analyze the difference in the non-screening status of the cervical cancer screening test by each characteristic and to explore the factors related to the non-screening status. Results: The rate of the non-screening status of the cervical cancer screening test was 53.5% over the previous 2 years. In the survey logistics regression analysis, age, marital status, educational levels, income levels, residential area, occupation, private health insurance, smoking, alcohol, obesity, menstrual status, pregnancy experience, and hormone replacement therapy were significantly associated with the non-screening status of the cervical cancer screening test. Conclusion: On the basis of the results of this study, some social-demographic, health-behavioral, and woman-specific characteristics of Korean adult women seem to affect the non-screening status of the cervical cancer screening test. Therefore, appropriate health policies need to be designed, implemented, monitored, and evaluated to reduce the non-screening status of the cervical cancer screening test of them.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6067-6072
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• 2012

Background: Breast cancer in developing countries is on the rise. There are currently no guidelines to screen women at risk in India. Since mammography in the western world is a well-accepted screening tool to prevent late presentation of breast cancer and improve mortality, it is intuitive to adopt mammography as a screening tool of choice. However, it is expensive and fraught with logistical issues in developing countries like India. Materials and Methods: Our breast cancer screening camp was done at a local district hospital in India after approval from the director and administrators. After initial training of local health care workers, a one-day camp was held. Clinical breast examination, mammograms, as well as diagnostic evaluation with ultrasound and fine needle aspiration biopsy were utilized. Results: Out of total 68 women screened only 2 women with previous history of breast cancer were diagnosed with breast cancer recurrence. None of the women in other groups were diagnosed with breast cancer despite suspicious lesions either on clinical exam, mammogram or ultrasound. Most suspicious lesions were fibroadenomas. The average cost of screening women who underwent mammography, ultrasound and fine needle aspiration was $30 dollars, whereas it was $16 in women who had simple clinical breast examination. Conclusions: Local camps act as catalysts for women to seek medical attention or discuss with local health care workers concerns of discovering new lumps or developing breast symptoms. Our camp did diagnose recurrence of breast cancer in two previously treated breast cancer patients, who were promptly referred to a regional cancer hospital. Further studies are needed in countries like India to identify the best screening tool to decrease the presentation of breast cancer in advanced stages and to reduce mortality.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.5817-5823
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• 2013

Background: It is important to understand the perceptions of oncologists to understand the comprehensive picture of clinical presentation of breast cancer. In the absence of clear evidence, clinical practice involving patients of breast cancer in India should provide insights into stages of breast cancer with which women present to their clinics and mode of screening of breast cancer prevalent in Andhra Pradesh. Materials and Methods: A qualitative study was conducted to understand the perceptions of oncologists regarding clinical presentation of breast cancer, stages at which women present to clinics, and mode of screening of breast cancer prevalent in Andhra Pradesh. In-depth interviews (IDI) were conducted with ten practising oncologists from various public and private cancer hospitals in Hyderabad city to understand their perspectives on breast cancer and screening. The data were triangulated to draw inferences suitable for the current public Health scenario. Results: Late presentation was indicated as the most important cause of decreased survival among women. Most women present at Stage 3 and 4 when there is no opportunity for surgical intervention. The results indicate that there is a huge gap in awareness about breast cancer, especially in rural areas and among poor socioeconomic groups. Even despite knowledge, most women delay in reporting due to reasons like fear, embarrassment, cost, ignorance, negligence, and easy going attitude. Conclusions: It is important to improve awareness about breast cancer and screening methods for promoting early screening. The study inferred that it would be beneficial to establish cancer registries in rural areas. Also, the policymakers need to make key decisions which among three methods (breast self examination (BSE), clinical breast examination and mammography) can best be used as a screening tool and how to successfully implement population wide screening program to prevent mortality and morbidity from breast cancer in India.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.28 no.2
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• pp.186-196
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• 2021

Purpose: Breast cancer is becoming increasingly prevalent among young Korean women. During pregnancy, women's concern regarding their breasts heightens. Thus, pregnancy provides a window of opportunity for breast cancer prevention and management along with antenatal care. This study developed and evaluated an integrated breast health program for pregnant women. Methods: This study employed a non-equivalent control group and non-synchronized design (22 experimental, 29 control). Women pregnant for over 28 weeks participated. The two-session integrated breast health program focused on breast management during breastfeeding and education about breast cancer prevention and early screening. Results: During the early postpartum period (within three months after the program), there were statistically significant differences in knowledge and attitude about breast cancer and breast self-examination before and after the program. There were also statistically significant differences in BSE at 6 and 12 months after the program and mammography at 12 months after the program. However, there were no statistically significant differences in clinical breast examination and breast ultrasonography at 6 and 12 months after the program. Conclusion: The integrated breast health management program was effective in increasing knowledge and improving attitudes regarding breast cancer, BSE, and early screening practices among pregnant women. Further studies should consider providing breast health programs differently for each phase of pregnancy and continuing the same after delivery.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6547-6552
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• 2014

Background: Cancer is a major life event that imposes huge economic and mental burdens on patients and families. In addition, the diagnosis of cancer also causes significant family discordance that can lead to marital problems such as divorce or separation. The aim of this study was to investigate the association and any related gender differences between cancer diagnosis and marital disruption among cancer survivors. Materials and Methods: We used the recent cross-sectional Korea National Health and Nutrition Examination Survey ($4^{th}$ and $5^{th}$; Years 2008-2012). The study participants were 623 married cancer survivors over the age of 19. A multivariate logistic regression analysis was conducted to estimate odds ratios. Results: After adjusting for socioeconomic status and health-related behaviors, the odds ratio of marital disruption among female cancer survivors compared with male cancer survivors was 3.94 (95%CI 1.30-11.94; p=0.02). The odds ratio of marital disruption for the below-average economic level compared with the above-average economic level was 5.64 (95%CI: 1.03-31.02; p=0.05). When compared with the non-smoking cancer survivors, the smoking cancer survivors had an OR of marital disruption equal to 2.94 (95%CI: 1.08-8.00; p=0.03). Conclusions: The findings of this study suggest that the odds of marital disruption among female cancer survivors are higher than those among their male couterparts. Medical practitioners should be sensitive to early signs of marital discord in couples affected by a cancer diagnosis. Early identification and psychosocial intervention might reduce the frequency of divorce and separation and thus improve quality of life and quality of care for cancer survivors.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4647-4650
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• 2013

Background: Breast illumination was suggested as a simple method for breast cancer screening. BreastLight is a simple apparatus for this purpose. Objective: To evaluate the diagnostic performance of BreastLight as a screening tool of breast cancer in comparison to mammography and histopathology. Materials and Methods: This hospital-based cross sectional study was conducted in the mammography unit of the radiodiagnosis department at National Cancer Institute, Cairo University. All participants were subjected to breast examination with the BreastLight tool, mammography and ultrasonography. Suspicious cases were biopsied for histopathological examination which is considered as a gold standard. Results: The mean age of the participants was $46.3{\pm}12.4$ years. Breast illumination method had sensitivity, specificity, positive predictive value, negative predictive value and total accuracy of 93.0%, 73.7%, 91.4%, 77.8% and 88.2%, respectively in detection of breast cancer. Conclusions: Breast illumination method with BreastLight apparatus is a promising easy-to-use tool to screen for breast cancer suitable for primary health care physician or at-home use. It needs further evaluation especially in asymptomatic women.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1355-1360
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• 2015

Background: The number of cancer survivors is increasing globally and recently, higher rates of comorbidities in cancer survivors have been reported. However, no studies have investigated whether cancer survivors have a higher risk of chronic kidney disease (CKD). Accordingly, our study evaluated the association between cancer survivors and the risk of CKD using the 2010-2012 Korean National Health and Nutrition Examination Survey. Materials and Methods: A total of 11,407 participants aged 40 years and over were categorized into two groups according to cancer experience. Multiple variables were compared and the odds ratios (ORs) for CKD prevalence were calculated using a weighted logistic regression analysis between the two groups. Results: Cancer survivors were older than were those in the non-cancer group, on average, the percentages of glomerular filtration rate(GFR) lower than $60mL/min/1.73m^2$, proteinuria, and CKD were significantly higher in cancer survivors when compared to controls. Weighted logistic regression analyses demonstrated that cancer survivors had a higher risk for CKD after adjusting for multiple variables (OR (95% confidence interval), 2.88 (1.48-5.59)). Conclusions: Our study demonstrated a possible association between CKD and cancer survival in Korean adults. Identifying and correcting risk factors for cancer survivors would positively affect prevention of CKD and result in a better cancer prognosis.