Kizilkaya Mehmet Celal, Kilic Sarah, Dagistanli Sevinc, Eren Mehmet Fuat, Basaran Ceren, Ohri Nisha, Sayan Mutlay
Acibadem University Atakent Hospital, Istanbul, Türkiye.
Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
EClinicalMedicine. 2023 Jul 20;62:102094. doi: 10.1016/j.eclinm.2023.102094. eCollection 2023 Aug.
Refugee populations have low levels of cancer awareness, low cancer screening rates, and a high rate of advanced or metastatic cancer at diagnosis. Educational interventions to improve cancer awareness and screening have been successful in other nationality refugee populations but have never been implemented in Afghan refugee populations. We aimed to estimate the level of breast cancer awareness among Afghan refugee women and test the feasibility of a telehealth breast cancer educational intervention to increase breast cancer awareness in this population.
A cross-sectional survey of Afghan refugee women residing in Istanbul, Türkiye who had no personal history of breast cancer and who presented to outpatient primary clinics for care between August 1, 2022, and February 10, 2023 was performed. Participant awareness of breast cancer (BC) was assessed using the validated BC awareness tool, Breast Cancer Awareness Measure (BCAM), during a telehealth encounter. After this baseline assessment, a BC educational intervention was administered to each participant during the telehealth encounter. Six months after the initial assessment and education, a follow-up BCAM was administered via telehealth in order to determine the effectiveness of the education intervention.
One hundred participants were accrued to the study. Median age was 49 years (range: 40-64). All participants had no formal education, were married, and were not employed. Prior to the educational intervention, BC awareness was low; none of the participants were able to identify some common signs/symptoms and risk factors for BC. Prior to the educational intervention, zero participants had ever had a mammogram or seen a physician for a breast-related concern. Six months after the educational intervention, up to 99 percent of participants (99 of 100 participants) were able to correctly identify common signs or symptoms and risk factors for BC. Six months after the educational intervention, all one hundred participants had accepted the offer of a screening mammogram.
A telehealth BC education intervention meaningfully increased BC awareness in Afghan refugee women. This increase in BC awareness was associated with a strong increase in completion of BC screening. Further implementation of educational interventions is warranted in order to increase participant awareness and improve screening rates.
Dana Farber Cancer Institute Jay Harris Junior Faculty Research Grant.
难民群体的癌症知晓水平较低，癌症筛查率低，且诊断时晚期或转移性癌症的发生率较高。提高癌症知晓率和筛查率的教育干预措施在其他国籍的难民群体中已取得成功，但从未在阿富汗难民群体中实施过。我们旨在评估阿富汗难民妇女对乳腺癌的知晓水平，并测试远程医疗乳腺癌教育干预措施在提高该群体乳腺癌知晓率方面的可行性。
对居住在土耳其伊斯坦布尔、无乳腺癌个人病史且于2022年8月1日至2023年2月10日期间到门诊初级诊所就诊的阿富汗难民妇女进行了一项横断面调查。在远程医疗会诊期间，使用经过验证的乳腺癌知晓工具“乳腺癌知晓度测量法”（BCAM）评估参与者对乳腺癌（BC）的知晓情况。在这项基线评估之后，在远程医疗会诊期间对每位参与者进行了乳腺癌教育干预。在初次评估和教育六个月后，通过远程医疗进行了一次随访BCAM，以确定教育干预的效果。
共有100名参与者纳入该研究。中位年龄为49岁（范围：40 - 64岁）。所有参与者均未接受过正规教育，已婚且无工作。在教育干预之前，乳腺癌知晓率较低；没有参与者能够识别一些乳腺癌的常见体征/症状和风险因素。在教育干预之前，没有参与者进行过乳房X光检查或因乳房相关问题看过医生。教育干预六个月后，高达99%的参与者（100名参与者中的99名）能够正确识别乳腺癌的常见体征或症状以及风险因素。教育干预六个月后，所有100名参与者都接受了筛查乳房X光检查的提议。
远程医疗乳腺癌教育干预显著提高了阿富汗难民妇女对乳腺癌的知晓率。乳腺癌知晓率的提高与乳腺癌筛查完成率的大幅提高相关。有必要进一步实施教育干预措施，以提高参与者的知晓率并改善筛查率。
达纳 - 法伯癌症研究所杰伊·哈里斯初级教员研究基金。
