Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
BMC Public Health. 2020 Jun 15;20(1):930. doi: 10.1186/s12889-020-09010-y.
Breast Cancer is the most common cancer in women worldwide. Since 2008, Mwanza, Tanzania, has worked to provide comprehensive cancer services through its Zonal consultant hospital. New national guidelines focused on clinical breast exam requires that women be aware of and seek care for breast concerns. Therefore, this study aims to understand breast cancer awareness in Mwanza and describe women-level barriers, care-seeking behavior, and perspectives on breast cancer.
A community-based survey was administered to conveniently sampled women aged 30 and older to assess women's perspectives on breast cancer and care-seeking behavior.
Among 1129 women with a median age of 37 (IQR: 31-44) years, 73% have heard of cancer and 10% have received breast health education. Women self-evaluated their knowledge of breast cancer (from 1-none to 10-extremely knowledgeable) with a median response of 3 (IQR: 1-4). Only 14% felt they knew any signs or symptoms of breast cancer. Encouragingly, 56% of women were fairly-to-very confident they would notice changes in their breasts, with 24% of women practicing self-breast examination and 21% reporting they had received a past breast exam. Overall, 74% said they would be somewhat-to-very likely to seek care if they noticed breast changes, with 96% noting severity of symptoms as a motivator. However, fear of losing a breast (40%) and fear of a poor diagnosis (38%) were most frequent barriers to care seeking. In assessing knowledge of risk factors, about 50% of women did not know any risk factors for breast cancer whereas 42% of women believed long term contraceptive use a risk factor. However, 37% and 35% of women did not think that family history or being older were risk factors, respectively.
The success of efforts to improve early diagnosis in a setting without population-based screening depends on women being aware of breast cancer signs and symptoms, risks, and ultimately seeking care for breast concerns. Fortunately, most women said they would seek care if they noticed a change in their breasts, but the low levels of cancer knowledge, symptoms, and common risk factors highlight the need for targeted community education and awareness campaigns.
乳腺癌是全球女性最常见的癌症。自 2008 年以来，坦桑尼亚姆万扎一直在通过其地区顾问医院提供全面的癌症服务。新的国家指南侧重于临床乳房检查，要求妇女意识到并寻求乳房问题的护理。因此，本研究旨在了解姆万扎的乳腺癌意识，并描述妇女层面的障碍、寻求护理的行为以及对乳腺癌的看法。
对方便抽样的 30 岁及以上妇女进行了一项基于社区的调查，以评估妇女对乳腺癌和护理寻求行为的看法。
在 1129 名中位年龄为 37 岁（IQR：31-44 岁）的妇女中，73%听说过癌症，10%接受过乳房健康教育。妇女自我评估对乳腺癌的知识（从 1-一无所知到 10-非常了解）的中位数为 3（IQR：1-4）。只有 14%的妇女认为自己知道任何乳腺癌的症状或体征。令人鼓舞的是，56%的妇女非常有信心能注意到乳房的变化，24%的妇女进行过自我乳房检查，21%的妇女报告曾接受过乳房检查。总体而言，如果她们注意到乳房变化，74%的妇女表示会有些可能会非常愿意寻求护理，96%的妇女表示症状的严重程度是一个促进因素。然而，害怕失去乳房（40%）和害怕诊断结果不佳（38%）是寻求护理的最常见障碍。在评估危险因素的知识方面，约 50%的妇女不知道任何乳腺癌的危险因素，而 42%的妇女认为长期使用避孕药具是一个危险因素。然而，分别有 37%和 35%的妇女认为家族史或年龄较大不是危险因素。
在没有基于人群的筛查的情况下，努力改善早期诊断的效果取决于妇女对乳腺癌的体征和症状、风险因素的认识，最终取决于她们是否为乳房问题寻求护理。幸运的是，大多数妇女表示如果注意到乳房有变化，她们会寻求护理，但癌症知识、症状和常见危险因素水平较低突出表明需要有针对性的社区教育和宣传活动。
