MATERIALS AND METHODS: A cross-sectional study was conducted among 508 women aged 18 to 55 years from four non-governmental organizations (NGO) in Baghdad city, Iraq. A self-administered questionnaire on breast cancer knowledge and practice was distributed to participants during weekly activity of the NGO.
RESULTS: A total of 61.2% of the respondents had poor knowledge, only 30.3% performed breast self-examination (BSE) and 41.8% said that they did not know the technique to perform BSE. Associations between knowledge and marital status and age were significant. For practice, working status, education, age and family income were significant. After controlling for cofounders, the most important contributing factors for poor knowledge among respondents were marital status and not performing BSE, with adjusted odds ratio of 1.6 and 1.8 respectively.
CONCLUSIONS: Breast cancer knowledge and practice of BSE are poor among women in Baghdad city, Iraq. More promotion regarding breast cancer signs and symptoms and also how to perform BSE should be conducted using media such as television and internet as these constituted the main sources of information for most women in our study.
DESIGN: Individual participant meta-analysis using data from 25 cohorts participating in the CHANCES consortium. Data were harmonised, analysed separately employing Cox proportional hazard regression models, and combined by meta-analysis.
RESULTS: Overall, 503,905 participants aged 60 and older were included in this study, of whom 37,952 died from cardiovascular disease. Random effects meta-analysis of the association of smoking status with cardiovascular mortality yielded a summary hazard ratio of 2.07 (95% CI 1.82 to 2.36) for current smokers and 1.37 (1.25 to 1.49) for former smokers compared with never smokers. Corresponding summary estimates for risk advancement periods were 5.50 years (4.25 to 6.75) for current smokers and 2.16 years (1.38 to 2.39) for former smokers. The excess risk in smokers increased with cigarette consumption in a dose-response manner, and decreased continuously with time since smoking cessation in former smokers. Relative risk estimates for acute coronary events and for stroke events were somewhat lower than for cardiovascular mortality, but patterns were similar.
CONCLUSIONS: Our study corroborates and expands evidence from previous studies in showing that smoking is a strong independent risk factor of cardiovascular events and mortality even at older age, advancing cardiovascular mortality by more than five years, and demonstrating that smoking cessation in these age groups is still beneficial in reducing the excess risk.