Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Ministry of Health, Gaza, Palestine.
BMC Public Health. 2022 Apr 21;22(1):801. doi: 10.1186/s12889-022-13224-7.
Early diagnosis is crucial to reduce the morbidity and mortality associated with breast cancer (BC). Awareness of BC symptoms plays a key role in this. This study aimed to evaluate the Palestinian women's awareness of BC symptoms and determine factors associated with good awareness.
This was a national cross-sectional study conducted from July 2019 to March 2020 in Palestine. Convenience sampling was used to recruit adult women from hospitals, primary healthcare centers, and public spaces located in 11 governorates. A translated-into-Arabic version of the validated BC awareness measure was utilized for data collection. The awareness level was categorized based on the number of symptoms recognized into: poor (0 to 4), fair (5 to 9), and good (10 to 13).
Of 6269 approached, 5434 participants completed the questionnaire (response rate = 86.7%). A total of 5257 questionnaires were included in the analysis: 2551 from the Gaza Strip and 2706 from the West Bank and Jerusalem (WBJ). Participants living in the WBJ were more likely to be older, have higher monthly income, and suffer from more chronic diseases than participants living in the Gaza Strip. The most frequently identified BC symptom was 'lump or thickening in the breast' (n = 4887, 92.9%) followed by 'lump or thickening under the armpit' (n = 4394, 83.6%). The least frequently identified symptoms were 'pulling in of the nipple' (n = 2665, 50.7%) and 'change in the position of the nipple' (n = 2710, 51.6%). A total of 2191 participants (41.7%) demonstrated good awareness of BC symptoms. Participants from the Gaza Strip were more likely than participants from the WBJ to have good awareness (47.0.0% vs. 36.7%). On the multivariable analysis, being ≥ 40 years, completing a post-secondary education, knowing someone with cancer, and visiting hospitals and primary healthcare centers were all associated with an increase in the likelihood of having good awareness. However, living in the WBJ was associated with a decrease in the likelihood of having good awareness.
Less than half of women included in this study showed good awareness of BC symptoms. More targeted educational interventions are needed to promote Palestinian women's awareness of BC symptoms to facilitate early diagnosis.
早期诊断对于降低与乳腺癌（BC）相关的发病率和死亡率至关重要。对 BC 症状的认识在这方面起着关键作用。本研究旨在评估巴勒斯坦妇女对 BC 症状的认识，并确定与良好认识相关的因素。
这是一项 2019 年 7 月至 2020 年 3 月在巴勒斯坦进行的全国性横断面研究。采用方便抽样法，从 11 个省的医院、初级保健中心和公共场所招募成年女性。使用经过验证的 BC 意识测量的阿拉伯语翻译版进行数据收集。根据识别出的症状数量，将意识水平分为：差（0 到 4）、一般（5 到 9）和良好（10 到 13）。
在 6269 名受访者中，有 5434 名参与者完成了问卷调查（应答率为 86.7%）。共有 5257 份问卷纳入分析：加沙地带 2551 份，西岸和耶路撒冷（WBJ）2706 份。与居住在加沙地带的参与者相比，居住在 WBJ 的参与者年龄更大、月收入更高、患慢性病更多。最常被识别出的 BC 症状是“乳房有肿块或增厚”（n=4887，92.9%），其次是“腋窝下有肿块或增厚”（n=4394，83.6%）。最不常被识别出的症状是“乳头内陷”（n=2665，50.7%）和“乳头位置改变”（n=2710，51.6%）。共有 2191 名参与者（41.7%）对 BC 症状具有良好的认识。与来自 WBJ 的参与者相比，来自加沙地带的参与者更有可能具有良好的意识（47.0.0% vs. 36.7%）。在多变量分析中，年龄≥40 岁、完成中学后教育、认识癌症患者以及访问医院和初级保健中心均与增加良好意识的可能性相关。然而，居住在 WBJ 与降低良好意识的可能性相关。
本研究中纳入的女性中，不到一半对 BC 症状有良好的认识。需要更有针对性的教育干预措施来提高巴勒斯坦妇女对 BC 症状的认识，以促进早期诊断。
