Document Type : Original Article
Authors
1 Department of Radiology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
2 Social Determinants of Health Research Center, Departments of Epidemiology and Biostatistics, School of Health, Birjand University of Medical Sciences, Birjand, Iran
3 Social Determinants of Health Research Center, Department of Health Promotion and Education, School of Health, Birjand University of Medical Sciences, Birjand, Iran
Abstract
BACKGROUND: Breast cancer is a preventable disease, using three secondary preventive methods
of mammography, clinical breast examination (CBE), and breast self‑examination (BSE) that can
lead to early detection of breast cancer. This study was designed to assess breast cancer screening
behavior and its associated factors in females employed in South Khorasan.
MATERIALS AND METHODS: In this analytic‑descriptive study, 2256 female personnel of
governmental organizations were investigated in Birjand city in 2016–2017. The data collection tool
was a three‑part questionnaire: sociodemographic characteristics, knowledge about breast cancer
screening methods plus women’s performance, and stage of change regarding screening behaviors
of mammography, CBE, and BSE. The data were analyzed by SPSS 16 and one‑way analysis
variance, Tukey’s post hoc, and multiple logistic regression model statistical tests.
RESULTS: The mean ± standard deviation score of knowledge of the women was 3.45 ± 1.5. There
was a significant difference of the mean score of knowledge between the single and married (P = 0.03)
and age group (P = 0.04). The stage action of mammography, CBE, and BSE was 6.8%, 12.3%,
and 16.8%, respectively. Logistic regression model showed that variables such as age and family
history of breast cancer were highly significant related to mammography and also CBE. Knowledge
was also highly significant in mammography, CBE, and BSE. Education level in CBE, marital status
in BSE and mammography, and job in BSE were also significant (P < 0.001).
CONCLUSIONS: This study reveals insufficient knowledge of female workers about breast cancer
and the negative influence of low knowledge on the practice of breast cancer screening behavior.
Therefore, the establishment and maintenance of regular educational courses for female employees
is essential.
Keywords
breast cancer and BSE in Iranian women. Procedia Soc Behav Sci
2012;46:2561‑5.
2. Atuhairwe C, Amongin D, Agaba E, Mugarura S, Taremwa IM.
The effect of knowledge on uptake of breast cancer prevention
modalities among women in Kyadondo County, Uganda. BMC
Public Health 2018;18:279.
3. Ahmadian M, Samah AA. Application of health behavior theories
to breast cancer screening among Asian women. Asian Pac J
Cancer Prev 2013;14:4005‑13.
4. ShamsM, FayazbakhshA, SafariM. Areview of studies conducted
on efficacy of health educational interventions to correct women’s
behavior in performing breast self‑examination. Basic Clin Cancer
Res 2014;6:2‑9.
5. Nindrea RD, Aryandono T, Lazuardi L. Breast cancer risk from
modifiable and non‑modifiable risk factors among women in Southeast Asia: A meta‑analysis. Asian Pac J Cancer Prev
2017;18:3201‑6.
6. Opoku SY, Benwell M, Yarney J. Knowledge, attitudes, beliefs,
behaviour and breast cancer screening practices in Ghana, West
Africa. Pan Afr Med J 2012;11:28.
7. Farajzadegan Z, Fathollahi‑Dehkordi F, Hematti S, Sirous R,
Tavakoli N, Rouzbahani R. The transtheoretical model, health
belief model, and breast cancer screening among Iranian women
with a family history of breast cancer. J Res Med Sci 2016;21:122.
8. Shah TA, Guraya SS. Breast cancer screening programs: Review
of merits, demerits, and recent recommendations practiced across
the world. J Microsc Ultrastruct 2017;5:59‑69.
9. Ghazali SM, Othman Z, Cheong KC, Hock L K ,
Wan Mahiyuddin WR, Kamaluddin MA, et al. Non‑practice of
breast self examination and marital status are associated with
delayed presentation with breast cancer. Asian Pac J Cancer Prev
2013;14:1141‑5.
10. Elkazeh E, Elsaay O. Applying the transtheoretical model of
change and the health belief model to breast self‑examination
in females undergraduate students in Faculty of Nursing Tanta
University. J Am Sci 2012;8:804‑14.
11. Moodi M, Rezaeian M, Mostafavi F, Sharifirad G. The study
of mammography screening behavior based on stage of
change model in Isfahanian women of age 40 and older:
A population‑based study. ZUMS J 2013;21:24‑35.
12. Rakowski W, Clark MA, Pearlman DN, Ehrich B, Rimer BK,
Goldstein MG, et al. Integrating pros and cons for mammography
and Pap testing: extending the construct of decisional balance to
two behaviors. Prev Med 1997;26:664‑73.
13. Musugire V. Factors Influencing Self‑Breast Cancer Screening
Practrices among Nurses and Midwives Working at King Faisal
Hospital, University of Rwanda; 2020.
14. Abeje S, Seme A, Tibelt A. Factors associated with breast cancer
screening awareness and practices of women in Addis Ababa,
Ethiopia. BMC Womens Health 2019;19:4.
15. Salmani F, Moodi M, Yousefi A, Norozi E. Healthy beliefs
regarding breast cancer screening in iranian women health
volunteers: A path analysis. Korean J Fam Med 2020;InPress.
16. Azaiza F, Cohen M, Awad M, Daoud F. Factors associated
with low screening for breast cancer in the Palestinian
Authority: Relations of availability, environmental barriers, and
cancer‑related fatalism. Cancer 2010;116:4646‑55.
17. Shirzadi S, Allahverdipour H, Sharma M, Hasankhani H.
Perceived barriers to mammography adoption among women
in Iran: A qualitative study. Korean J Fam Med 2020;41:20‑7.
18. Kwok C, Lee MJ, Lee CF. Breast cancer perceptions and screening
behaviours among korean women in Australia. J Immigr Minor
Health 2020;22:126‑33.
19. Shiryazdi SM, Kholasehzadeh G, Neamatzadeh H, Kargar S.
Health beliefs and breast cancer screening behaviors among
Iranian female health workers. Asian Pac J Cancer Prev
2014;15:9817‑22.
20. Kotepui M, Piwkham D, Chupeerach C, Duangmano S.
Knowledge, attitudes and practice of breast cancer screening
among female personnel of Walailak University. Health Expect
2015;18:3069‑78.
21. Cruz‑Castillo AB, Hernández‑Valero MA, Hovick SR,
C a m p u z a n o ‑ G o n z á l e z M E , K a r a m ‑ C a l d e r ó n M A ,
Bustamante‑Montes LP. A study on the knowledge, perception,
and use of breast cancer screening methods and quality of
care among women from central Mexico. J Cancer Educ
2015;30:453‑9.
22. Haghighi F, Portaghali P, Rafaty Javanbakht L, Ghanbarzadeh N,
Hosseini SM. Knowledge, attitude, and practice of female
teachers regarding breast cancer screening in Birjand. Mod Care
J 2012;9:146‑55.
23. Farhadifar F, Taymoori P, Bahrami M, Zarea S. The relationship of
social support concept and repeat mammography among Iranian
women. BMC Womens Health 2015;15:92.
24. Hanske J, Meyer CP, Sammon JD, Choueiri TK, Menon M,
Lipsitz SR, et al. The influence of marital status on the use of
breast, cervical, and colorectal cancer screening. Prev Med
2016;89:140‑5.
25. Fouladi N, Pourfarzi F, Mazaheri E, Asl HA, Rezaie M, Amani F,
et al. Beliefs and behaviors of breast cancer screening in women
referring to health care centers in northwest Iran according to
the champion health belief model scale. Asian Pac J Cancer Prev
2013;14:6857‑62.
26. Yıldırım AD, Özaydın AN. Sources of breast cancer knowledge
of women living in Moda/İstanbul and their attendance to breast
cancer screening. J Breast Health 2014;10:47‑56.
27. Vishwakarma G, Ndetan H, Das DN, Gupta G, Suryavanshi M,
Mehta A, et al. Reproductive factors and breast cancer risk:
A meta‑analysis of case‑control studies in Indian women. South
Asian J Cancer 2019;8:80‑4.
28. Elobaid YE, Aw TC, Grivna M, Nagelkerke N. Breast cancer
screening awareness, knowledge, and practice among arab
women in the United Arab Emirates: a cross‑sectional survey.
PLoS One 2014;9:e105783.
29. Watson‑Johnson LC, DeGroff A, Steele CB, Revels M, Smith JL,
Justen E, et al. Mammography adherence: A qualitative study.
J Womens Health (Larchmt) 2011;20:1887‑94.
30. Tolma EL, Stoner JA, Li J, Kim Y, Engelman KK. Predictors of
regular mammography use among American Indian women
in Oklahoma: A cross‑sectional study. BMC Womens Health
2014;14:101.
31. González P, Borrayo EA. The role of physician involvement in
Latinas’ mammography screening adherence. Womens Health
Issues 2011;21:165‑70.
32. El Asmar M, Bechnak A, Fares J, Al Oweini D, Alrazim A,
El Achkar A, et al. Knowledge, attitudes and practices regarding
breast cancer amongst Lebanese females in Beirut. Asian Pac J
Cancer Prev 2018;19:625‑31.
33. Haber G, Ahmed NU, Pekovic V. Family history of cancer and
its association with breast cancer risk perception and repeat
mammography. Am J Public Health 2012;102:2322‑9.
34. Kırca N, Tuzcu A, Gözüm S. Breast cancer screening behaviors of
first degree relatives of women receiving breast cancer treatment
and the affecting factors. Eur J Breast Health 2018;14:23‑8.
35. Taymoori P, Berry T, Farhadifar F. Predicting mammography
stage of adoption among Iranian women. J Educ Health Promot
2012;1:13.
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