Bachelor of Medicine and Bachelor of Surgery, King Edward Medical University, Lahore, Pakistan.
West Surgical Ward, Department of Surgery, King Edward Medical University, Lahore, Pakistan.
BMC Med Educ. 2020 Jul 14;20(1):222. doi: 10.1186/s12909-020-02132-2.
Breast cancer is the most common form of cancer in women and second most common cancer after lung cancer. The prognosis of breast cancer depends on early detection and intervention which in turn relies upon awareness. Health workers in all communities are responsible for educating the population at risk. This study evaluates the knowledge regarding breast cancer, personal judgment of confidence, perceived barriers to help seeking and breast self-examination practices among Pakistani female medical students and studies the impact of clinical training on the studied variables.
Descriptive cross-sectional study design using self-administered validated questionnaires (BCAM-Breast Cancer Awareness Measure designed by Cancer Research UK) was employed. Female medical students enrolled in clinical and pre-clinical classes of King Edward Medical University, Lahore were targeted and questioned regarding symptoms, risk factors and their practices regarding breast cancer. Possible barriers to seeking help were also studied.
The mean number of symptoms correctly identified was 6.7 ± 3.2 (5.5 ± 3.2 for pre-clinical and 7.8 ± 2.9 for clinical students) and for risk factors it was 4.3 ± 2.1 (3.7 ± 2.1 for pre-clinical and 4.7 ± 2.2 for clinical students). The difference in the level of perception of two groups was found to be significant (p < 0.001 for symptoms and p < 0.001 for risk factors). 38.7% of the subjects responded that they check their breasts rarely, 33.1% were fairly confident while 8.6% were very confident about detecting a change in their breast, 50.0% never noticed a change in their breast, and 77.4% will contact a doctor within a week or less of finding a change in their breast. Confidence about detecting a change significantly improved (p < 0.001) after the start of clinical training.
This study suggests that clinical training may have improved knowledge of female medical students regarding breast cancer; yet the knowledge related to the symptoms and risk factors of breast cancer and frequency of breast self-examination of female medical students is less than anticipated.
乳腺癌是女性最常见的癌症，也是仅次于肺癌的第二大常见癌症。乳腺癌的预后取决于早期发现和干预，而这又依赖于意识。所有社区的卫生工作者都有责任对高危人群进行教育。本研究评估了巴基斯坦女医学生对乳腺癌的认识、个人自信判断、寻求帮助的感知障碍以及乳房自我检查实践，并研究了临床培训对这些变量的影响。
采用描述性横断面研究设计，使用自行设计的经过验证的问卷（由英国癌症研究中心设计的 BCAM-乳腺癌意识量表）。以在拉合尔爱德华国王医科大学临床和预科班就读的女医学生为目标人群，询问她们有关乳腺癌的症状、危险因素以及她们在这方面的做法。还研究了寻求帮助的可能障碍。
正确识别出的症状平均数为 6.7±3.2（预科学生为 5.5±3.2，临床学生为 7.8±2.9），危险因素平均数为 4.3±2.1（预科学生为 3.7±2.1，临床学生为 4.7±2.2）。两组之间的感知水平差异具有统计学意义（症状方面 p<0.001，危险因素方面 p<0.001）。38.7%的受试者很少检查乳房，33.1%表示有一定信心，8.6%非常有信心能发现乳房的变化，50.0%从未注意到乳房的变化，77.4%会在发现乳房变化后的一周或更短时间内联系医生。临床培训开始后，对检测乳房变化的信心显著提高（p<0.001）。
本研究表明，临床培训可能提高了女医学生对乳腺癌的认识；然而，女医学生对乳腺癌的症状和危险因素以及乳房自我检查的频率的知识低于预期。
