Abdel-Aziz S B, Amin T Tawfik, Al-Gadeeb M Baqir, Alhassar A I, Al-Ramadan A, Al-Helal M, Bu-Mejdad M, Al-Hamad L Abdulaziz, Alkhalaf E Hussain
Public Health and Community Medicine, Faculty of Medicine, Cairo University, Egypt.
College of Medicine, King Faisal University, Saudi Arabia.
J Prev Med Hyg. 2018 Mar 30;59(1):E20-E29. doi: 10.15167/2421-4248/jpmh2018.59.1.689. eCollection 2018 Mar.
Screening for breast cancer (BC) is of low rate in Saudi Arabia; although it is provided in the country free of charge to the population. This cross-sectional study aimed at investigating the perceived barriers towards BC screening in Al Hassa, Saudi Arabia.. A total of 816 adult Saudi women aged ≥ 30 years attending for routine primary health services or accompanying patients at the selected primary health care centers (PHCs) were randomly selected from 12 PHCs (8 urban and four rural) using multi-stage sampling method. Participants were invited to personal interview using semi-structured data collection instrument including inquiries about socio-demographics, reproductive history, previous histories of diagnosed breast lesions and breast cancer. The perceived individual barriers towards screening, their attitudes, the reasons for not attending previously held screening campaigns in Al Hassa, were also included.
Low utilization of BC screening being significantly positively associated with woman's age, higher educational status, higher family income, using hormonal contraception and positive history of previous breast as shown by the results of the logistic regression model. Exploratory factor analysis showed that personal fears (especially fear of doctors/examiners, fear of hospitals and health facilities and fear of consequences/results) were the major factors that hinder women from utilizing the free of charge BC screening with high loading eigenvalue of 3.335, explaining 30.4% of the barriers.
Educational interventions aim at improving breast cancer knowledge and addressing barriers should be incorporated as core component of the screening program in Saudi Arabia.
在沙特阿拉伯，乳腺癌筛查率较低；尽管该国为民众免费提供此项服务。本横断面研究旨在调查沙特阿拉伯哈萨地区乳腺癌筛查的感知障碍。采用多阶段抽样方法，从12个初级卫生保健中心（8个城市中心和4个农村中心）中随机选取了816名年龄≥30岁的成年沙特女性，她们要么前来接受常规初级卫生服务，要么在选定的初级卫生保健中心陪伴患者。参与者被邀请进行个人访谈，使用半结构化数据收集工具，包括询问社会人口统计学、生殖史、既往诊断的乳腺病变和乳腺癌病史。还包括对筛查的感知个人障碍、她们的态度以及此前未参加哈萨地区筛查活动的原因。
逻辑回归模型结果显示，乳腺癌筛查利用率低与女性年龄、较高的教育程度、较高的家庭收入、使用激素避孕以及既往乳腺阳性病史显著正相关。探索性因素分析表明，个人恐惧（尤其是害怕医生/检查人员、害怕医院和卫生设施以及害怕后果/结果）是阻碍女性利用免费乳腺癌筛查的主要因素，其特征值负荷较高，为3.335，解释了30.4%的障碍。
旨在提高乳腺癌知识并解决障碍的教育干预措施应纳入沙特阿拉伯筛查计划的核心组成部分。
