Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH.
Ministry of Health, Gaza, Palestine.
JCO Glob Oncol. 2022 Dec;8:e2200087. doi: 10.1200/GO.22.00087.
This study aimed to assess awareness of Palestinian women about breast cancer (BC) age-related and lifetime risks and its risk factors and to identify factors associated with good awareness.
Adult women were recruited from government hospitals, primary health care centers, and public spaces in 11 governorates in Palestine. Recognition of 14 BC risk factors was assessed using a translated-into-Arabic version of the validated BC awareness measure. The level of BC risk factor awareness was determined on the basis of the number of risk factors recognized: poor (0-4), fair (5-9), and good (10-14).
Of 6,269 potential participants approached, 5,434 agreed and completed the questionnaire (response rate = 86.7%). A total of 5,257 questionnaires were included: 2,706 from the West Bank and Jerusalem and 2,551 from the Gaza Strip. Only 173 participants (3.3%) recognized the age-related risk of BC. More than one quarter (n = 1,465; 27.9%) recognized the lifetime risk of BC. The most recognized modifiable risk factor was not breastfeeding (n = 4,937; 93.9%), whereas the least recognized was having children later on in life or not at all (n = 1,755; 33.4%). The most recognized nonmodifiable risk factor was radiation exposure (n = 4,579; 87.1%), whereas the least recognized was starting the periods at an early age (n = 1,030; 19.6%). In total, 2,024 participants (38.4%) demonstrated good BC risk factor awareness. Participants from the Gaza Strip had a higher likelihood than participants from the West Bank and Jerusalem to have good awareness (42.0% 35.2%). Age ≥ 40 years, postsecondary education, and visiting hospitals and primary health care centers were all associated with an increase in the likelihood of having good BC risk factor awareness.
The awareness of BC risk factors was suboptimal. These findings highlight the need for implementing health education programs combined with consistent use of ad hoc opportunities to raise awareness by health care providers.
本研究旨在评估巴勒斯坦女性对乳腺癌（BC）年龄相关和终身风险及其危险因素的认知程度，并确定与良好认知相关的因素。
从巴勒斯坦 11 个省的政府医院、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评估对 14 个 BC 危险因素的识别。根据识别的危险因素数量确定 BC 风险因素意识水平：差（0-4）、一般（5-9）和良好（10-14）。
在接触的 6269 名潜在参与者中，有 5434 人同意并完成了问卷（应答率=86.7%）。共有 5257 份问卷被纳入：2706 份来自西岸和耶路撒冷，2551 份来自加沙地带。只有 173 名参与者（3.3%）认识到 BC 的年龄相关风险。超过四分之一（n=1465；27.9%）认识到 BC 的终身风险。最被识别的可改变危险因素是不母乳喂养（n=4937；93.9%），而最少被识别的是以后生育或根本不生育（n=1755；33.4%）。最被识别的不可改变危险因素是辐射暴露（n=4579；87.1%），而最少被识别的是早期开始月经（n=1030；19.6%）。共有 2024 名参与者（38.4%）表现出良好的 BC 风险因素意识。来自加沙地带的参与者比来自西岸和耶路撒冷的参与者更有可能具有良好的意识（42.0%比 35.2%）。年龄≥40 岁、中学后教育以及访问医院和初级保健中心均与增加良好 BC 风险因素意识的可能性相关。
BC 风险因素的认知程度不理想。这些发现强调需要实施健康教育计划，并结合卫生保健提供者的临时机会提高认识。
