Displaying publications 1 - 20 of 67 in total

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  1. Yusof A, Chia YC, Hasni YM
    Asian Pac J Cancer Prev, 2014;15(19):8095-9.
    PMID: 25338990
    BACKGROUND: Worldwide, over half a million women died of breast cancer in 2011 alone. Mammography screening is associated with a reduction of 20 to 35% in breast cancer mortality. The aim of this study was to determine the awareness and practice of mammography screening and predictors of its uptake in Malaysian women attending a primary care clinic.

    MATERIALS AND METHODS: A cross-sectional study was carried out among women aged 40 to 74 years attending a primary care clinic in Selangor, Malaysia. An assisted structured questionnaire included questions on socio-demography, source of information and level of knowledge. An adapted version of the revised Champion Health Belief Model Scale plus other associated factors for mammography screening up-take were also included as part of the questionnaire. Predictors for mammography screening uptake were only determined in those who were aware about mammography screening. Significant predictors were determined by logistic regression.

    RESULTS: 447 women were recruited for this study; 99.1% of them (n: 411) were aware about breast cancer. Only 50.1% (n: 206) had knowledge about mammography screening. Prevalence of clinical breast-examination (CBE) was 23.3% (n: 104) and mammography screening up-take was 13.2% (n: 59). The predictors for the latter were those who have had clinical breast-examination (aOR=17.58, 95%CI: 7.68-39.82) and those aged between 50 to 59 years (aOR=3.94, 95%CI: 1.61-9.66) as well as those aged 60 years and above (aOR=6.91, 95%CI: 2.28-20.94). Good knowledge and positive beliefs about mammography screening were not associated with mammography screening uptake.

    CONCLUSIONS: Half of our Malaysian women were aware about mammography screening. However, the uptake of mammography was low. Previous CBE and older age were significant predictors of mammography screening uptake. Increasing CBE services may increase compliance with guidelines.
    Matched MeSH terms: Breast Self-Examination
  2. Subramanian P, Oranye NO, Masri AM, Taib NA, Ahmad N
    Asian Pac J Cancer Prev, 2013;14(11):6783-90.
    PMID: 24377606
    BACKGROUND: Breast cancer is the commonest type of cancer among women, and in Malaysia 50-60% of the new cases are being detected at late stages. Do age, education level, income, ethnicity, relationship with breast cancer patients and knowledge of breast cancer risk factors influence breast screening practices? This study revealed interesting but significant differences.

    OBJECTIVES: To assess the knowledge of breast cancer risk factors and early detection measures among women in a high risk group.

    MATERIALS AND METHODS: A cross sectional survey of one hundred and thirty one women relatives of breast cancer patients was carried out. Participants were selected through purposive sampling, during hospital visits. A self-administered questionnaire was used for data collection.

    RESULTS: The majority of the respondents (71%) had poor knowledge of the risk factors for breast cancer. Income, relationship with a patient and practise of breast cancer screening predicted performance of mammography, R2=0.467, F=12.568, p<0.0001.

    CONCLUSIONS: The finding shows inadequate knowledge of breast cancer risk factors and poor cancer screening practise among women with family history of breast cancer. Poor knowledge and practise of breast screening are likely to lead to late stage presentation of breast cancer disease. Some important predictors of breast cancer screening behaviour among women with positive family history of breast cancer were identified. An understanding of the strengths and significance of the association between these factors and breast screening behaviour is vital for developing more targeted breast health promotion.
    Matched MeSH terms: Breast Self-Examination
  3. Devi BC, Tang TS, Corbex M
    Ann. Oncol., 2007 Jul;18(7):1172-6.
    PMID: 17434897 DOI: 10.1093/annonc/mdm105
    BACKGROUND:
    The registry of the Oncology Departmental in Sarawak General Hospital showed that 79% of nasopharyngeal, 77% of breast and 70% of cervix cancer patients were diagnosed at an advanced stage (stages III and IV) for year 1993. Hence, a low cost Early Cancer Surveillance Program was started in 1994, with the intent of downstaging these three most common cancers in Sarawak.

    MATERIALS AND METHODS:
    The program consisted of (i) training health staff in hospital and rural clinics to improve their skills in early cancer detection, (ii) raising public awareness through pamphlets, posters and sensitization by health staff.

    RESULTS:
    Data analysis revealed that the program achieved downstaging in two of the cancers. Breast cancer in stage III and IV was reduced from 60% (1994) to 35% (1998) (P < 0.0001) and cervical cancer in stage III and IV from 60% (1994) to 26% (1998) (P < 0.0001). No reduction was observed for nasopharyngeal cancer at 88% (1994) to 91% (1998).

    CONCLUSIONS:
    The overall cost of this program was
    Matched MeSH terms: Breast Self-Examination
  4. Elghazaly H, Aref AT, Anderson BO, Arun B, Yip CH, Abdelaziz H, et al.
    Int J Cancer, 2021 08 01;149(3):505-513.
    PMID: 33559295 DOI: 10.1002/ijc.33506
    In low-middle income countries (LMICs) and the Middle East and North Africa (MENA) region, there is an unmet need to establish and improve breast cancer (BC) awareness, early diagnosis and risk reduction programs. During the 12th Breast, Gynecological & Immuno-oncology International Cancer Conference - Egypt 2020, 26 experts from 7 countries worldwide voted to establish the first consensus for BC awareness, early detection and risk reduction in LMICs/MENA region. The panel advised that there is an extreme necessity for a well-developed BC data registries and prospective clinical studies that address alternative modalities/modified BC screening programs in areas of limited resources. The most important recommendations of the panel were: (a) BC awareness campaigns should be promoted to public and all adult age groups; (b) early detection programs should combine geographically distributed mammographic facilities with clinical breast examination (CBE); (c) breast awareness should be encouraged; and (d) intensive surveillance and chemoprevention strategies should be fostered for high-risk women. The panel defined some areas for future clinical research, which included the role of CBE and breast self-examination as an alternative to radiological screening in areas of limited resources, the interval and methodology of BC surveillance in women with increased risk of BC and the use of low dose tamoxifen in BC risk reduction. In LMICs/MENA region, BC awareness and early detection campaigns should take into consideration the specific disease criteria and the socioeconomic status of the target population. The statements with no consensus reached should serve as potential catalyst for future clinical research.
    Matched MeSH terms: Breast Self-Examination
  5. Rosmawati NH
    Asian Pac J Cancer Prev, 2010;11(6):1503-8.
    PMID: 21338188
    INTRODUCTION: Breast cancer is the most frequently diagnosed cancer in Malaysian women, irrespective of age group and ethnicity. The observed low survival rates are related to late stage at presentation despite the availability of breast self examination (BSE) as a reliable screening method for early detection.

    MATERIALS AND METHODS: This cross-sectional study was designed to determine the knowledge, attitude and practice towards BSE amongst women aged 15 years old and above. Systemic random sampling was applied and information gathered through guided interview by using a structured questionnaire.

    RESULTS: A total of 86 respondents were recruited, with a mean age of 40.5 years (SD: 15.51), more than 80% having a secondary or tertiary level of education. The total score was 16.9 (total mean percent: 60.4%) for knowledge, 37.1 (77.3%) for attitude and 9.56 (34.1%) for practice. The proportions of respondents with good score for knowledge, attitude and practice were 38.4%, 73.3% and 7.0%, respectively. Not knowing the correct method of BSE, lack of knowledge on cancer signs and lack of motivational support from parents, spouse or friends appeared to be related with the poor practices.

    CONCLUSION: Enhancement of breast cancer awareness and focusing on recognized barriers by health care professionals with the involvement of spouses, family and community would have a substantial beneficial impact on BSE practice.
    Matched MeSH terms: Breast Self-Examination
  6. Al-Dubai SA, Qureshi AM, Saif-Ali R, Ganasegeran K, Alwan MR, Hadi JI
    Asian Pac J Cancer Prev, 2011;12(10):2531-8.
    PMID: 22320951
    OBJECTIVES: The aim of this study was to assess awareness and knowledge of breast cancer and mammography among Malaysian women in Shah Alam.

    METHODS: This cross sectional study was conducted among 250 Malaysian women. Data were collected using a self administrated questionnaire which included questions on socio-demographic data, knowledge of breast cancer and awareness of mammography.

    RESULTS: Mean age of respondents was 28 ± 9.2 with 69.2% aged 18 to 29 years. The majority had heard about breast cancer (81.2%) and indicated books, magazines and brochures as their source of information (55.2%). However, most did not know about signs and symptoms of breast cancer and many of its risk factors. On multivariate analysis, significant predictors of breast cancer knowledge were age, race, marital status, level of education, occupation, family size and family history of other cancers (p<0.05). Fifty percent of women were aware of mammography, significant predictors being age, occupation, marital status and knowledge of breast cancer (p<0.05).

    CONCLUSION: Most women were aware of breast cancer. However, the knowledge about signs and symptoms of breast cancer and awareness of mammography were inadequate. It is recommended that the level of knowledge should be raised among Malaysian women, particularly in the less educated young.

    Matched MeSH terms: Breast Self-Examination
  7. Taib NA, Yip CH, Low WY
    Asian Pac J Cancer Prev, 2011;12(6):1601-8.
    PMID: 22126506
    INTRODUCTION: Advanced presentation of breast cancer and the problem of late diagnosis is well documented. Patient delay beyond three months has been shown to reduce survival. This paper aims to explore the experience of Malaysian women presenting with advanced breast cancer with regards to their interpretation of breast symptoms.

    METHOD: Purposive sampling of 19 breast cancer patients presenting with delayed treatment and/ or advanced cancer diagnosed within two years at the University Malaya Medical Centre, Kuala Lumpur were carried out. In-depth interviews were conducted using a self-devised interview guide. The interview guide covered the journey of the patient from discovering of symptoms to their present state. The audiotaped interviews were transcribed verbatim. NVivo 8 qualitative software was utilised for data management. Grounded theory with thematic analysis was utilised.

    RESULTS: Nine women delayed seeking diagnosis although recognizing the symptom, five did not recognize symptom, three delayed treatment and two did not delay health attention. Themes that emerged with regards to triggering help seeking behavior were: a) poor symptom knowledge and recognition; b) importance of knowledge of the disease and its' outcomes; c) role of coping mechanisms and affect; and lastly d) role of significant others in appraising a breast symptom.

    CONCLUSION: Symptom recognition remains an important public health issue in Malaysia. Educating women, their significant others and primary health and primary care providers in detecting early staged breast cancer are needed. Supporting and sanctioning women with breast symptoms are important. The psycho-social-cultural model of symptom appraisal may serve as an important addition to the fight against cancer in countries that do not have the resources for population based screening mammogram programmes.
    Matched MeSH terms: Breast Self-Examination
  8. Dahlui M, Ramli S, Bulgiba AM
    Asian Pac J Cancer Prev, 2011;12(6):1631-4.
    PMID: 22126511
    Breast cancer is the most common cancer in Malaysian females. The National Cancer Registry in 2003 and 2006 reported that the age standardized incidence of breast cancer was 46.2 and 39.3 per 100,000 populations, respectively. With the cumulative risk at 5.0; a woman in Malaysia had a 1 in 20 chance of developing breast cancer in her lifetime. The incidence of cancer in general, and for breast cancer specifically was highest in the Chinese, followed by Indians and Malays. Most of the patients with breast cancers presented at late stages (stage I: 15.45%, stage II: 46.9%, stage III: 22.2% and stage IV: 15.5%). The Healthy Lifestyles Campaign which started in the early nineties had created awareness on breast cancer and after a decade the effort was enhanced with the Breast Health Awareness program to promote breast self examination (BSE) to all women, to perform annual clinical breast examination (CBE) on women above 40 and mammogram on women above 50. The National Health Morbidity Survey in 2006 showed that the prevalence rate of 70.35% by any of three methods of breast screening; 57.1% by BSE, 51.8% by CBE and 7.6% by mammogram. The current screening policy for breast cancer focuses on CBE whereby all women at the age of 20 years and above must undergo breast examination by trained health care providers every 3 years for age between 20-39 years, and annually for age 40 and above. Several breast cancer preventive programs had been developed by various ministries in Malaysia; among which are the RM50 subsidy for mammogram by the Ministry of Women, Family and Community Development and the SIPPS program (a call-recall system for women to do PAP smear and CBE) by the Ministry of Health. Measures to increase uptake of breast cancer screening and factors as to why women with breast cancer present late should be studied to assist in more development of policy on the prevention of breast cancer in Malaysia.
    Matched MeSH terms: Breast Self-Examination
  9. Hadi MA, Hassali MA, Shafie AA, Awaisu A
    Pharm Pract (Granada), 2010 Jan;8(1):29-34.
    PMID: 25152790
    Breast cancer is the most common cancer and the leading cause of cancer death among women of all ethnic and age groups in Malaysia.

    OBJECTIVE: The objectives of this study were to evaluate the knowledge of breast cancer risk factors, symptoms and methods of screening among female university students and their perception towards the disease treatment outcomes.

    METHODS: A cross-sectional survey was conducted from February to March 2008 at Universiti Sains Malaysia. Two hundred participants from 10 randomly selected faculties were interviewed face to face by a trained pharmacist using a validated questionnaire. In addition to their demographic characteristics, participants were required to answer 22 questions concerning knowledge of breast cancer and five questions related to their perception of breast cancer management and treatment outcomes. Data were analyzed using SPSS version 15.

    RESULTS: The mean age of the respondents was 26.7 (SD=1.9) years. The results showed that the vast majority of the female university students had inadequate knowledge of breast cancer. The mean total knowledge score of the students was 60.7%. Indian students had significantly less knowledge of breast cancer compared to their Chinese and Malay counterparts (p<0.05). However, more than two third of the students were aware of breast self examination (BSE) and clinical breast examination (CBE) recommendations. Furthermore, the students had positive perceptions towards the treatment outcomes of breast cancer.

    CONCLUSION: This study has highlighted the need of a breast cancer awareness campaign, which should also stress the importance of early detection and reporting of breast cancer.
    Matched MeSH terms: Breast Self-Examination
  10. Khana R, Mahinderjit Singh M, Damanhoori F, Mustaffa N
    JMIR Med Inform, 2020 Sep 23;8(9):e21584.
    PMID: 32965225 DOI: 10.2196/21584
    BACKGROUND: Breast cancer is the leading cause of mortality among women worldwide. However, female patients often feel reluctant and embarrassed about meeting physicians in person to discuss their intimate body parts, and prefer to use social media for such interactions. Indeed, the number of patients and physicians interacting and seeking information related to breast cancer on social media has been growing. However, a physician may behave inappropriately on social media by sharing a patient's personal medical data excessively with colleagues or the public. Such an act would reduce the physician's trustworthiness from the patient's perspective. The multifaceted trust model is currently most commonly used for investigating social media interactions, which facilitates its enhanced adoption in the context of breast self-examination. The characteristics of the multifaceted trust model go beyond being personalized, context-dependent, and transitive. This model is more user-centric, which allows any user to evaluate the interaction process. Thus, in this study, we explored and evaluated use of the multifaceted trust model for breast self-examination as a more suitable trust model for patient-physician social media interactions in breast cancer screening.

    OBJECTIVE: The objectives of this study were: (1) to identify the trustworthiness indicators that are suitable for a breast self-examination system, (2) design and propose a breast self-examination system, and (3) evaluate the multifaceted trustworthiness interaction between patients and physicians.

    METHODS: We used a qualitative study design based on open-ended interviews with 32 participants (16 outpatients and 16 physicians). The interview started with an introduction to the research objective and an explanation of the steps on how to use the proposed breast self-examination system. The breast self-examination system was then evaluated by asking the patient to rate their trustworthiness with the physician after the consultation. The evaluation was also based on monitoring the activity in the chat room (interactions between physicians and patients) during daily meetings, weekly meetings, and the articles posted by the physician in the forum.

    RESULTS: Based on the interview sessions with 16 physicians and 16 patients on using the breast self-examination system, honesty had a strong positive correlation (r=0.91) with trustworthiness, followed by credibility (r=0.85), confidence (r=0.79), and faith (r=0.79). In addition, belief (r=0.75), competency (r=0.73), and reliability (r=0.73) were strongly correlated with trustworthiness, with the lowest correlation found for reputation (r=0.72). The correlation among trustworthiness indicators was significant (Pbreast self-examination system. Evaluation of trustworthiness indicators helps to ensure a trustworthy system and ethical interaction between a patient and physician. A new patient can obtain a consultation by referring to the best physician according to preference of other patients. Patients can also trust a physician based on another patient's recommendation regarding the physician's trust level. The correlation analysis further showed that the most preferred trustworthiness indicator is honesty.

    Matched MeSH terms: Breast Self-Examination
  11. Aaina Mardhiah Binti Abdul Mutalib, Soo-Foon Moey, Nur Nadira Aiza Binti Kamarudin
    MyJurnal
    In Malaysia, breast cancer is the commonest cancer among women indicating that early diagnosis and screening practice is important to increase the survival rate. Breast self-examination (BSE), clinical breast examination (CBE) and mammography are the main screening practices for breast cancer. Knowledge and awareness of breast cancer can play an important role in aiding early detection of breast cancer. Little is known about the knowledge of breast cancer and screening practices among the non-academic staff in IIUM, Kuantan. As such this study aims to determine the knowledge and screening practices of breast cancer amongst the non-academic staff at the International Islamic University Malaysia (IIUM), Kuantan Campus. A cross-sectional study was conducted on 100 nonacademic staff from ten different departments in IIUM, Kuantan from March to April 2017. Data were collected using a self-administered questionnaire on knowledge of breast cancer and screening practices. The relationship between socio-demographic characteristics and knowledge of breast cancer and breast cancer screening practices were carried out using chi-square. No significance difference was found between knowledge of breast cancer and socio-demographic factors. However significant relationships were found between the age of respondents and BSE as well as the level of education of respondents and CBE. Most non-academic staff possessed an average level of knowledge on breast cancer and screening practices due to possibly ease of access to information. Low performance of breast screening practices was indicated possibly due to lack of awareness, misconception of the need and benefits derived from such screening practices.
    Matched MeSH terms: Breast Self-Examination
  12. Raadshini Vejayakumar, Jagjit Kaur Najar Singh, Thavamalar Paramasivam, Lim Pek Hong, Fong Ka Ling, Mohammed Abdul Razzaq Jabbar
    MyJurnal
    Introduction: The incidence of breast cancer is high among Malaysian females especially those aged 25-59 years old and from Chinese ethnic background.Breast Self-Examination (BSE) is a traditional, cost-free screening method to identify breast abnormalities likegrowth and cancer. If performed correctly and consistently, it can facilitate early detection, early treatment and better prognosis. Despite having high risk, there is insufficient evidence about the BSE knowledge level and practiceamong Malaysian Chinese females. This research determines the association between BSE knowledge level, practice and selected socio-demographic variables among the Chinese female students of a private university in Kajang. Methods: Quantitative, correlation study was conducted among 192 Chinese female students in a private university. Purposive sampling method was utilized to recruit participants. Data were collected using self-administered questionnaire and analysed in terms of frequency and percentage. Chi-Square test was used for inferential analysis with significance level, p, set at
    Matched MeSH terms: Breast Self-Examination
  13. Norhaini, M., Norazlanshah, H., Khairil Anuar, M.I., Fazlyla Nadya, M.F., Mashita, M., Mohamad, G.M.
    MyJurnal
    Students in tertiary level education are mostly young adults that are transiting from the teenage years to adulthood. Since there is less restriction as compared to their teenage years, university and college students might involve in risky behaviours that may affect their health, social and academic performance. Thus, the purpose of this study is to investigate and identify the differences of health risk factors and health promoting behaviour that have been practiced by students in Malaysia. A cross sectional study was conducted using closed-ended questionnaires distributed to university and college students via emails. The results showed that 77.0% students claimed they have no health problem. However 49.0% of the non-medical students did not know whether they have normal BMI. Among the medical students, 62.0% rarely do physical exercise even though most are seriously concern about their fat consumption (95.0%). Only 30.0% of the total students have awareness of wearing seat belt. For health promoting behaviour, 33.0% of female students have never perform breast self examination (BSE), while 65.0% of male students have never perform testicular self examination (TSE). These findings confirmed that there are differences in health risk factors and health promoting behaviour that have been practiced by the students.
    Matched MeSH terms: Breast Self-Examination
  14. Kirubakaran R, Chee Jia T, Mahamad Aris N
    Asian Pac J Cancer Prev, 2017 01 01;18(1):115-120.
    PMID: 28240018
    Background: Breast cancer is the commonest cancer among women worldwide. About one in nineteen women in
    Malaysia are at risk, compared to one in eight in Europe and the United States. The objectives of this study were: (1) to
    assess patients’ knowledge on risk factors, symptoms and methods of screening of breast cancer; and (2) to determine
    their perceptions towards the disease treatment outcomes. Methods: A cross-sectional survey using a validated selfadministered
    questionnaire was conducted among 119 consecutive surgical female patients admitted from 1st of
    September to 8th of October 2015 in Hospital Sultan Abdul Halim, Kedah. Data were analyzed using General linear
    regression and Spearman’s correlation with Statistical Package for Social Science (SPSS) version 20. Results: Mean (SD)
    age was 40.6 (15.1) years and majority of the patients were Malay (106, 89.1%). Mean scores for general knowledge,
    risk factors and symptoms of breast cancer were 50.2 (24.0%), 43.0 (22.9%) and 64.4 (28.4%) respectively. Mean
    total knowledge score was 52.1(19.7%). 80 (67.2%) and 55 (46.2%) patients were aware of breast self-examination
    and clinical breast examination recommendations, respectively. Generally, patients had positive perceptions towards
    breast cancer treatment outcomes. However, majority (59.7%) considered that it would be a long and painful process.
    Knowledge was significantly better among married women with spouses (p=0.046), those with personal history of
    breast cancer (p=0.022) and with monthly personal income (p=0.001) with the coefficient of determination, R2=0.16.
    Spearman’s correlation test showed a significant positive relationship between monthly personal income and breast
    cancer awareness (r = 0.343, p <0.001). Conclusion: Awareness on breast cancer among our patients was average. Thus,
    there is a need for more awareness programs to educate women about breast cancer and promote its early detection.
    Matched MeSH terms: Breast Self-Examination
  15. Norlaili AA, Fatihah MA, Daliana NF, Maznah D
    Asian Pac J Cancer Prev, 2013;14(12):7161-4.
    PMID: 24460269
    Breast cancer is the most common cancer among women globally. This study was conducted to compare the awareness of breast cancer and the practice of breast self-examination (BSE), clinical breast examination (CBE) and mammography screening among rural females in Pahang and Perak. A cross-sectional study was carried out in five selected rural districts of Pahang and Perak. Two hundred and fifty households were randomly selected and interviewed face to face using a semi-structured questionnaire. The majority of residents from both states were Malay, aged between 50 and 60 years and had a secondary level of education. Malay women aged 40-49 years and women with a higher level of education were significantly more aware of breast cancer (p<0.05). About half of these women practiced BSE (60.7%) and CBE (56.1%), and 7% had underwent mammography screening. The results of this study suggest that women in Pahang and Perak have good awareness of breast cancer and that more than half practice BSE and CBE. The women's level of education appears to contribute to their level of knowledge and health behaviour. However, more effort is needed to encourage all women in rural areas to acquire further knowledge on breast cancer.
    Matched MeSH terms: Breast Self-Examination/statistics & numerical data*
  16. Al-Naggar RA, Al-Naggar DH
    Asian Pac J Cancer Prev, 2012;13(1):243-6.
    PMID: 22502677
    OBJECTIVE: While the relatively common nature of female breast cancer has resulted in a high level of general awareness, male breast cancer is still comparatively unknown to the general public and to healthcare professionals. The objective of this study is to explore the perceptions and opinions about male breast cancer and male breast self-examination among male university students.

    METHODOLOGY: In-depth interviews were conducted among 36 male university students from the Management and Science University, Malaysia, selected by simple random sampling. The themes of the interview were: knowledge of male breast cancer and male breast self-examination, sources of knowledge and attitudes towards male BSE. The data obtained were classified into various categories and analyzed manually.

    RESULTS: The majority of participants mentioned that there is a low possibility for males to get breast cancer. They also believed that the cause of breast cancer among men is due to the carcinogens from cigarettes. The majority of participants mentioned that they know about breast self-examination from the mass media and that the presence of a lump in the breast is the main symptom of breast cancer in men. The majority of participants mentioned that they encourage their family members to practice breast self-examination but considered that BSE is not important for men because they have a low probability of getting breast cancer.

    CONCLUSIONS: Misconceptions regarding male breast cancer and breast self-examination among men still exist among male university students. Therefore special attention should be given to educate men about male breast cancer and male BSE.

    Matched MeSH terms: Breast Self-Examination*
  17. Parsa P, Kandiah M
    Asian Pac J Cancer Prev, 2010;11(3):681-8.
    PMID: 21039036
    Breast cancer is the most common cancer among Malaysian women and early detection can play an important role in reducing cancer morbidity and mortality. The aim of this cross-sectional study was to determine the rates and factors related to clinical breast examination (CBE) and mammography among 425 female teachers in Selangor, Malaysia. A self-administered questionnaire that included questions on socio-demography, cancer-related knowledge and practice and an adapted version of Champion's revised Health Belief Model Scale was employed. The mean age of participants was 37.2 ± 7.16 years. Only 25% of the women ever had a CBE. Of women over the age 40 (n=138), 13.6% reported having had a mammography. The results showed higher susceptibility to breast cancer, higher benefits of doing CBE and regular visits with a physician to be significant predictors for undergoing CBE (p < 0.05). In addition, higher a perceived susceptibility to breast cancer and regular undergoing CBE were significant predictors for having a mammography. The findings clearly suggest a need for improving women's awareness on breast cancer screening, its importance and recommended guidelines.

    Study site: Secondary school teachers in Selangor, Malaysia.
    Matched MeSH terms: Breast Self-Examination*
  18. Loh S, Packer TL, Yip CH, Passmore A
    Asian Pac J Cancer Prev, 2009 Oct-Dec;10(4):631-6.
    PMID: 19827884
    OBJECTIVE: Poor health literacy is positively associated with poorer quality of health decision-making and health outcomes in women facing a cancer diagnosis. In developing countries, poor access to complete and accurate information continues to pose a challenge for women. This paper describes the knowledge of Malaysian women with regard to breast cancer and how participation in a self-management program can improve the situation.

    METHODS: Secondary analysis of data collected during a clinical trial on women newly diagnosed with breast cancer (n=147) was performed to examine baseline knowledge of breast cancer profile. Knowledge levels of women in the experimental (n= 69) group attending a self-management program were compared to a control group (n= 78) to determine change in the level of knowledge over time.

    RESULTS: At baseline, a high percentage of women were unaware of their breast cancer profile. Not a single woman had knowledge of all six basic characteristics; 83% did not know their HER2 status, type of breast cancer (68%), grade of cancer cell (64%), hormonal receptor status (55%), size of breast cancer (18%) and/or their stage of breast cancer (13%). At post intervention, there was significantly better knowledge within the experimental group.

    CONCLUSION: Malaysian women in this cohort study demonstrated very low levels of knowledge of their cancer profile. Clinical implications for countering treatment-decision difficulties include the need for a shift in the way information and services are delivered to allow women to take a more active role in their own care. Multi-modal efforts including basic information dissemination to increase women's knowledge can contribute to narrowing of the gap in health disparity.
    Matched MeSH terms: Breast Self-Examination/utilization*
  19. Che Mohamed N, Moey SF, Lim BC
    Asian Pac J Cancer Prev, 2019 09 01;20(9):2865-2873.
    PMID: 31554389 DOI: 10.31557/APJCP.2019.20.9.2865
    Background: Early detection of breast cancer is essential in improving overall women’s health. The researchers
    sought to develop a comprehensive measure that combined the basic components of the health belief model (HBM)
    with a focus on breast self-examination (BSE) and screening mammogram amongst women. Methods: Questionnaire
    items were developed following a review of relevant literature of HBM on BSE and screening mammogram. The
    sampling frame for the study was Malaysian women aged 35 to 70 years old, living in Kuantan, Pahang and able to
    read or write in Bahasa Malaysia or English. As such, 103 women were randomly selected to participate in the study.
    Tests of validity using exploratory factor analysis (EFA) and reliability were subsequently performed to determine the
    psychometric properties of the questionnaire. Results: The EFA revealed nine factors (self-efficacy of mammogram,
    perceived barriers of BSE and mammogram, perceived susceptibility of breast cancer, perceived severity of breast
    cancer, cues to action for mammogram screening, perceived benefits of BSE, health motivation, perceived benefits
    of mammogram and self-efficacy of BSE) containing 54 items that jointly accounted for 74.2% of the observed
    variance. All nine factors have good internal consistency with Cronbach’s alpha ≥ 0.8. Fifty-four items remained in
    the final questionnaire after deleting 13 problematic items. The scale also showed good convergent and discriminant
    validity. Conclusion: The findings showed that the designed questionnaire was a valid and reliable instrument for the
    study involving women in Kuantan, Pahang. The instrument can help to assess women’s beliefs on BSE adoption and
    mammogram screening in health care practice and research.
    Matched MeSH terms: Breast Self-Examination/psychology*
  20. Lim JN, Potrata B, Simonella L, Ng CW, Aw TC, Dahlui M, et al.
    BMJ Open, 2015 Dec 21;5(12):e009863.
    PMID: 26692558 DOI: 10.1136/bmjopen-2015-009863
    OBJECTIVE: To explore and compare barriers to early presentation of self-discovered breast cancer in Singapore and Malaysia.

    DESIGN: A qualitative interview study with thematic analysis of transcripts.

    PARTICIPANTS: 67 patients with self-discovered breast symptoms were included in the analysis. Of these, 36% were of Malay ethnicity, 39% were Chinese and 25% Indian, with an average age of 58 years (range 24-82 years). The number of women diagnosed at early stages of cancer almost equalled those at advanced stages. Approximately three-quarters presented with a painless lump, one-quarter experienced a painful lump and 10% had atypical symptoms.

    SETTING: University hospital setting in Singapore and Malaysia.

    RESULTS: Patients revealed barriers to early presentation not previously reported: the poor quality of online website information about breast symptoms, financial issues and the negative influence of relatives in both countries, while perceived poor quality of care and services in state-run hospitals and misdiagnosis by healthcare professionals were reported in Malaysia. The pattern of presentation by ethnicity remained unchanged where more Malay delayed help-seeking and had more advanced cancer compared to Chinese and Indian patients.

    CONCLUSIONS: There are few differences in the pattern of presentation and in the reported barriers to seek medical care after symptom discovery between Singapore and Malaysia despite their differing economic status. Strategies to reduce delayed presentation are: a need to improve knowledge of disease, symptoms and causes, quality of care and services, and quality of online information; and addressing fear of diagnosis, treatment and hospitalisation, with more effort focused on the Malay ethnic group. Training is needed to avoid missed diagnoses and other factors contributing to delay among health professionals.

    Matched MeSH terms: Breast Self-Examination/psychology; Breast Self-Examination/statistics & numerical data*
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