BARRIERS TO BREAST CANCER SCREENING IN THE POPULATION OF EAST KAZAKHSTAN REGION
Background: Breast cancer is a major public health problem and one of the leading causes of cancer deaths among women worldwide, including the Republic of Kazakhstan. Early detection significantly reduces mortality because breast cancer detected at early stages has a better prognosis. Lack of knowledge or incorrect knowledge about mammography and mammography screening recommendations can hinder adherence to recommendations and is an important barrier to breast cancer screening.
Aim: to identify barriers to breast cancer screening among the population of the East Kazakhstan region.
Methodology: The cross-sectional study was conducted among 767 women in the East Kazakhstan region of the Republic of Kazakhstan. Statistical analysis was conducted using the program StatTech v. 4.1.7 (developer - StatTech LLC, Russia). Comparison of percentages in the analysis of multipole contingency tables was performed using Pearson's chi-square test. Differences were considered statistically significant at p < 0.05.
Results: According to the results of the study, respondents with secondary and higher education are most aware of such breast cancer risk factors as early menstruation, severe anxiety and stress, frequent abortions, smoking, and alcohol (p=0.026). The awareness of rural women about breast cancer risk factors (p=0.027) and self examination skills was much lower than urban women (p=0.009). The results of the survey showed that 33.0% of respondents by age and 28.8% by call from their polyclinic had undergone breast cancer screening. 30.6% of respondents indicated that they needed information about the benefits of screening, 24.3% of women needed to be released from their place of work, and 13.4% of respondents chose to have a medical professional visit their workplace.
Conclusion: Thus, women face simultaneous barriers to screening mammography at multiple levels. When trying to understand why women are reluctant to undergo mammography, barriers at each level, including barriers created by the patient herself, her social network, and the health care infrastructure, must be considered simultaneously. Researchers can continue to play an important role in elucidating the barriers to screening mammography, as well as addressing these barriers through interventions and policies.
Yerzat N. Aymuhambetov1, https://orcid.org/0000-0002-9597-470X
Zaituna A. Khismetova1, https://orcid.org/0000-0001-5937-3045
Nazym S. Iskakova1, https://orcid.org/0000-0001-5631-5499
Venera S. Rakhmetova2, https://orcid.org/0000 -0001-5721-6409
Kamila M. Akhmetova2, https://orcid.org/0009-0009-6257-4337
1 NCJSC «Semey medical university», Semey, Republic of Kazakhstan;
2 NCJSC «Astana medical university», Astana, Republic of Kazakhstan.
1. Жолдыбай Ж.Ж., Жылкайдарова А.Ж., Жакенова Ж.К., Ткачева А.М., Хамзин А.Х., Талаева Ш.Ж., Соколенко Е.Г., Байпеисов Д.М. Руководство по проведению скрининга целевых групп женского населения на раннее выявление рака молочной железы и обеспечению его качества. Алматы, 2012. 135 c.
2. Холматова К.К., Горбатова М.А., Харькова О.А., Гржибовский А.М. Поперечные исследования: планирование, размер выборки, анализ данных. Экология человека. 2016. 2: 49–56.
3. Alshahrani M., Alhammam S.Y., AlMunyif H.A., Alwadei A.M., Alwadei A.M., Alzamanan S.S. et al. Knowledge, attitudes, and practices of breast cancer screening methods among female patients in primary healthcare centers in Najran, Saudi Arabia. J Cancer Educ. 2019. 34(6):1167–72.
4. American Cancer Society. Breast Cancer Facts and Figures 2009, 2010. Atlanta: Am Cancer Society, Inc. 2009. p. 28.
5. Breast Cancer Screening (PDQ®)–Health Professional Version. 2020 Retrieved July 03, 2020, from https://www.cancer.gov/types/breast/hp/breast-screening-pdq. (accessed November 4, 2023).
6. Clarke T.C., Endeshaw M., Duran D., Saraiya M. Breast cancer screening among women by nativity, birthplace, and length of time in the United States. Natl Health Stat Rep. 2019. (129):1–14.z.
7. Gesink D., Filsinger B., Mihic A., Norwood T., Sarai Racey C., Perez D. et al. Cancer screening barriers and facilitators for under and never screened populations: a mixed methods study. Cancer. 2016. 45:126–34.
8. Gotzsche P.C., Jorgensen K.J., Geisel J., Raghu M., Hooley R. Screening for breast cancer with mammography. Cochrane Database Syst Rev. 2013. 6. The role of ultrasound in breast cancer screening: the case for and against ultrasound. Semin Ultrasound CT MRI. 2018. 39(1):25–34. https://doi.org/10.1053/j.sult.2017.09.006.
9. Han L. Overview of strategies for cervical and breast cancer screening. Beijing Med J. 2014. 36:893–4. doi: 10.15932/j.0253-9713.2014. 11.002
10. Hubbard R.A., Kerlikowske K., Flowers C.I., Yankaskas B.C., Zhu W., Miglioretti D.L. Cumulative probability of false-positive recall or biopsy recommendation after 10 years of screening mammography: a cohort study. Obstet Gynecol Surv. 2012. 67(3):162–3.
11. Islam R., Bell R.J., Hossain M.B., Davis S.R. A major flaw in “awareness of breast cancer and barriers to breast screening uptake in Bangladesh: a population based survey”. Maturitas. 2016. 88 (September 2013):45.
12. Khazir Z., Morowatisharifabad M.A., Vaezi A., Enjezab B., Yari F., Fallahzadeh H. Perceived behavioral control in mammography: a qualitative study of Iranian women’s experiences. Int J Cancer Manag. 2019.12(8).
13. Landy R., Pesola F., Castanon A., Sasieni P. Impact of cervical screening on cervical cancer mortality: estimation using stage-specific results from a nested case-control study. Br J Cancer. 2016. 115:1140e6. doi: 10.1038/bjc.2016.290
14. Latest Global Cancer Data: Cancer Burden Rises to 19.3 Million New Cases and10.0 Million Cancer Deaths. 2020. Available online at: https://www.iarc.who.int/wp-content/uploads/2020/12/pr292_E.pdf (accessed July 26, 2021).
15. Majidi A., Majidi S., Salimzadeh S., Khazaee-Pool M., Sadjadi A., Salimzadeh H. et al. Cancer screening awareness and practice in a middle income country: a systematic review from Iran. Asian Pac J Cancer Prev. 2017. 18(12):3187–94.
16. Malhotra C., Bilger M., Liu J., Finkelstein E. Barriers to breast and cervical cancer screening in Singapore: a mixed methods analysis. Asian Pac J Cancer Prev. 2016. 17(8):3887–95.
17. Onitilo A.A., Liang H., Stankowski R.V., Engel J.M., Broton M., Doi S.A. et al. Geographical and seasonal barriers to mammography services and breast cancer stage at diagnosis. Rural Remote Health. 2014. 14(3):1–12
18. Sankaranarayanan R. Screening for cancer in low- and middleincome countries. Ann Glob Heal. 2014. 80:412–7.
19. Tabar L., Yen M.F., Vitak B., Chen H.H., Smith R.A., Duffy S.W. Mammographyservice screening and mortality in breast cancer patients: 20-year follow-up before and after introduction of screening. Lancet. 2003. 361:1405–10. doi: 10.1016/S0140-6736(03)13143-1
20. Tabár L., Vitak B., Chen T.H., Yen A.M., Cohen A., Tot T. et al. Swedish two-county trial: impact of mammographic screening on breast cancer mortality during Purpose : Methods: Results. Radiology. 2011. 260(3):658–63.
21. The National Health and Family Planning Commission of the People’s Republic of China. Rural Women “Two Cancers” Examination Project Management Plan. Available online at: http://www.nhfpc.gov.cn/zwgkzt/wsbysj/200906/41534.shtml (accessed November 6, 2018).
References (1-2):
1. Zholdybai Zh.Zh., Zhylkaidarova A.Zh., Zhakenova Zh.K., Tkacheva A.M., Hamzin A.Kh., Talaeva Sh.Zh., Sokolenko E.G., Baypeisov D.M. Rukovodstvo po provedeniyu skrininga tselevykh grupp zhenskogo naseleniya na rannee vyyavlenie raka molochnoi zhelezy i obespecheniyu ego kachestva [Guidelines for screening the breast and ensuring its quality]. Almaty, 2012. 135 p. [in Russian]
2. Kholmatova K.K., Gorbatova M.A., Kharkova O.A., Grjibovski A.M. Poperechnye issledovaniya: planirovanie, razmer vyborki, analiz dannykh [Cross-sectional studies: planning, sample size, data analysis]. Ekologiya cheloveka [Human Ecology]. 2016. 2: 49–56. [in Russian]
Number of Views: 296
Category of articles:
10.34689/SH.2024.26.2.009
Bibliography link
Aymuhambetov Ye.N., Khismetova Z.A., Iskakova N.S., Rakhmetova V.S., Akhmetova K.M. Barriers to breast cancer screening in the population of East Kazakhstan region // Nauka i Zdravookhranenie [Science & Healthcare]. 2024. Vol.26 (2), pp. 68-75. doi 10.34689/SH.2024.26.2.009Related publications:
BARRIERS TO BREAST CANCER SCREENING IN THE POPULATION OF EAST KAZAKHSTAN REGION