沙特阿拉伯女性乳腺癌筛查行为的影响因素:一项回顾性横断面研究

Factors Affecting Breast Cancer Screening Behavior Among Women in Saudi Arabia: A Retrospective Cross-Sectional Study.

作者信息

Alkarak Samer, Badheeb Ahmed M, Al-Dowais Ali, Alhabes Hessa, Almahwiti Khaled, Aman Abdelaziz A, Alhajlan Mana A, Seada Islam, Alshamrani Sarah A, Alhussein Bassam

机构信息

General Surgery, King Khalid University Hospital, Najran, SAU.

Oncology, Oncology Center, King Khalid University Hospital, Najran, SAU.

出版信息

Cureus. 2024 Apr 15;16(4):e58324. doi: 10.7759/cureus.58324. eCollection 2024 Apr.

Abstract

Background Early detection of breast cancer is crucial for effective treatment and minimizing mortality, requiring effective screening methods like self-examination, clinical examination, and mammography. However, not all women in Saudi Arabia comply with these examinations, and studies examining its practice and barriers of low uptake are scant. The aim of this study is to investigate factors influencing breast cancer screening behavior among women in Saudi Arabia. Methods This cross-sectional study involving 806 women from October to November 2022 used an online questionnaire for the data collection process, including questions about demographic characteristics, awareness assessment, breast cancer screening behavior, symptoms, risk factors, and screening programs. Factors affecting the screening behavior were analyzed using the logistic regression model with adjusted odds ratio (AOR) and 95% confidence interval (CI). Results Among the 806 women who participated in the study, 479 (59.4%) were under 40 years old, and half of them were urban residents (n = 394, 48.9%). Only 134 subjects (16.6%) had a history of breast screening. Social media (n = 519, 64.5%) was the predominant source of screening information. The primary obstacles to breast cancer screening were the absence of tumor symptoms (n = 333, 41.3%), insufficient knowledge about early detection (n = 249, 31%), lack of time (n = 245, 30%), fear of discovering a tumor (n = 187, 23%), and lack of awareness about screening centers (n = 155, 19%). In regression analysis, predictive factors for breast cancer screening behavior were as follows: age over 40 years old (AOR: 2.56; 95% CI: 1.70-3.87), residents of big cities (AOR: 3.57; 95% CI: 1.02-12.56), positive family history of breast cancer (AOR: 2.53; 95% CI: 1.50-4.28), proximity to the screening center (AOR: 2.56; 95% CI: 1.22-5.39), and using contraceptive pills for more than five years (AOR: 1.78; 95% CI: 1.04-3.04), and were statistically significant (all p-values < 0.05). Conclusions In this study, the most perceived barriers to BSE were the absence of tumor symptoms, followed by insufficient knowledge about early detection, lack of time, fear of discovering a tumor, and lack of awareness about screening centers. Additionally, the predictive factors for breast cancer screening behavior were as follows: age over 40 years old, residents of big cities, positive family history of breast cancer, proximity to the screening center, and using contraceptive pills for more than five years. Given the identified factors affecting breast self-examination behavior in this study, public education initiatives are crucial for raising awareness, facilitating self-examination, and ultimately improving health outcomes and reducing breast cancer treatment costs in society.

摘要

背景 早期发现乳腺癌对于有效治疗和降低死亡率至关重要,这需要自我检查、临床检查和乳房X线摄影等有效的筛查方法。然而,沙特阿拉伯并非所有女性都遵守这些检查,且研究其实施情况和低接受率障碍的研究很少。本研究的目的是调查影响沙特阿拉伯女性乳腺癌筛查行为的因素。方法 这项横断面研究在2022年10月至11月期间对806名女性进行,使用在线问卷进行数据收集,包括有关人口统计学特征、认知评估、乳腺癌筛查行为、症状、危险因素和筛查项目的问题。使用逻辑回归模型分析影响筛查行为的因素,并调整比值比(AOR)和95%置信区间(CI)。结果 在参与研究的806名女性中,479名(59.4%)年龄在40岁以下,其中一半是城市居民(n = 394,48.9%)。只有134名受试者(16.6%)有乳腺癌筛查史。社交媒体(n = 519,64.5%)是筛查信息的主要来源。乳腺癌筛查的主要障碍是没有肿瘤症状(n = 333,41.3%)、对早期发现的知识不足(n = 249,31%)、缺乏时间(n = 245,30%)、害怕发现肿瘤(n = 187,23%)以及对筛查中心缺乏了解(n = 155,19%)。在回归分析中,乳腺癌筛查行为的预测因素如下:40岁以上(AOR:2.56;95%CI:1.70 - 3.87)、大城市居民(AOR:3.57;95%CI:1.02 - 12.56)、乳腺癌家族史阳性(AOR:2.53;95%CI:1.50 - 4.28)、距离筛查中心较近(AOR:2.56;95%CI:1.22 - 5.39)以及使用避孕药超过五年(AOR:1.78;95%CI:1.04 - 3.04),且具有统计学意义(所有p值<0.05)。结论 在本研究中,人们认为乳腺自我检查的最大障碍是没有肿瘤症状,其次是对早期发现的知识不足、缺乏时间、害怕发现肿瘤以及对筛查中心缺乏了解。此外,乳腺癌筛查行为的预测因素如下:40岁以上、大城市居民、乳腺癌家族史阳性、距离筛查中心较近以及使用避孕药超过五年。鉴于本研究中确定的影响乳腺自我检查行为的因素,开展公众教育活动对于提高认识、促进自我检查并最终改善健康结果以及降低社会乳腺癌治疗成本至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d160/11095821/98df38d0a2bb/cureus-0016-00000058324-i01.jpg

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