br Keywords Awareness Breast Cancer
Keywords: Awareness, Breast Cancer, Ghail-Bawazir, Screening Practice, Yemen
Funding: This study has not received funds.
1Department of Community and Environmental Health, College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia 2Community Medicine and Social Sciences, College of Medicine and Health Sciences, Aden University, Yemen
3Department of Community Medicine, College of Medicine and Health Sciences, Hadhramout University of Science and Technology, Mukalla, Yemen
Address for correspondence: Amen Bawazir, PhD, Associate professor, Community and
Environmental Health Department, College of Public health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, B O Pox: 3660, Riyadh 11481, Saudi Arabia E-mail contact: [email protected]
Breast cancer (BC) is the leading cancer in women worldwide and is increasing particularly in developing countries where the majority of cases are diagnosed in late stages.1,2 It is the most common cancer in women worldwide, with an estimated 1.7 million cases occurring globally in 2012 and a remarkable 20% reported increase in incidence since 2008.3 BC is the leading cause of cancer mortality in women and constitutes 14% of female cancer deaths. It is antici-pated that 41,070 deaths due to BC occurred in the year 2017.4,5 The increasing global incidence of malignant diseases has been documented by World Health Organization (WHO) and is an issue of serious concern, particularly in developing countries where the increase seems to be more preponderant.1 By 2035, it Nigericin is estimated that more than 2.5 million new cases of BC will occur annually. Although the majority of BC deaths occur in low- and medium-income countries (LMICs), wealthier countries have higher
incidence rates of BC.6 In Arab countries, BC is the most common form of cancer among women. Furthermore, BC incidence rates among Arab women have increased during the last 24 years, and women are currently being diagnosed with BC at more advanced stages of the disease.7 In Yemen, BC has one of the highest inci-dence rates among females. According to Globocan statistics in 2012, BC incidence rates are estimated to reach 27.4 per 100,000 females in Yemen.8 Previous studies focusing on populations from the Aden and Sana’a areas of Yemen have reported that BC accounts for 30% and 26.9% of cancer cases in women, respectively.9,10 According to data reported from Hadhramout Cancer Registry (HCR) between the years 2000 and 2011, BC is the most commonly occurring type of cancer in women (28.4%).11 The highest age-specific incidence rate of BC in the female Yemeni population was 27.2 cases per 100,000 females and was observed in the age group of 50-54 years.
The high rate of BC mortality among women of the Middle Eastern countries was primarily due to the delay in the diagnosis of the disease.12 However, mortality rate could be effectively reduced by the early detection of BC through early detection activities.13
The poor knowledge of and wrong beliefs about BC prevention among women are responsible for a negative perception of the curability of the cancer detected early and of the efficacy of the screening tests.14 As observed from daily practice in the local community, many women diagnosed with BC and referred for more advanced screening procedures such as mammograms and biopsies refused to continue with the required final diagnosis.15 Such behavior usually generates a lot of questions as to whether these women are aware of BC, its risk factors, and its screening methods. These questions, among others, drive our investigation into the Hadhramout Governorate. We seek to obtain evidence from Hadhrami women regarding BC screening practices for evaluating the level of awareness and practices. The aim of this study was to assess the level of awareness and the practices of women attending primary health care centers (PHCCs) in the Ghail Bawazir District of Yemen regarding BC screening. In addition, we seek to identify the barriers to BC screening among the study group.
Setting and Design
A cross-sectional descriptive study was carried out from November 1 to January 31 of 2017 in the Ghail Bawazir District, which is located in the coastal part of Hadhramout Governorate, Yemen. Usually, women residing in this district attend the PHCCs, which are located in different areas of the country, as patients seeking medical advice or antenatal care (ANC), as caregivers seeking medical care for family members, and as mothers bringing in their children for vaccination.
Sample Size and Technique