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).
Cancer screening is an important part of any cancer control program and the success of any screening program is partly dependent on having large numbers of the high risk population availing themselves of the service. The purpose of this study was to assess the cancer screening behavior of fulbtime employed women staff of an institute of higher learning using the Health Belief Model (HBM) construct. The results showed that the rate of reported regular cancer screening behavior (Pap smear screening, breast self examination (BSE), clinical breast examination (CBE) and mammography screening) were low. The rates for regular screening were 42.5% (Pap smear), 20.9% (BSE), 15.5% (CBE) and 9.4% (mammography). There were differences in the dimensions of the HBM between the women who reported regular screening and those that did not. The perceived barriers", "perceived benefits” and “motivation” dimensions were different in Pap smear screening, whereas the "confidence” dimension was different in BSE. Recommendations were made for a health education program targeting both women and men to increase uptake of cancer screening services by women.
This is a retrospective descriptive study done to look at common presentation and method of detection of breast cancer. A total of 366 case records of patients attending the Breast and Endocrine Clinic at Hospital Kuala Lumpur were reviewed. The peak age of breast cancer presentation was 40 to 49 years (39.6%). Most (81.4%) patients presented with a lump in the breast and the lump was mainly self-detected (97.3%). The mean tumour diameter on presentation was 4.7± 3 cm. Medical staff detected the disease in 1.6% cases and 1.1% of cases were detected by mammogram. Most women detected the lump themselves, suggesting that Breast Self Examination (BSE) can be used for detection of the disease in places where there is cost and availability constrains for mammogram. Early detection with BSE can possibly offer better treatment options and quality of life despite the evidence that it does not reduce the mortality due to breast cancer.
Study site: Breast and Endocrine Clinic at Hospital Kuala Lumpur
A total of 486 Malaysian women electronics workers participated in a study of reproductive health knowledge and cancer screening. The practice of Breast Self Examination (BSE) was found to be related to educational attainment; while ever having had a Pap smear was found to be related to being older than 30 years old, being ever married, living with family or relatives, and not staying in hostels. Knowledge on reproductive health was found to be higher for older women, married women, living with family or relatives, not staying in hostels, ever having done BSE and ever having had a Pap smear.
The National Health Morbidity Survey 1996 showed only 34.2% of women aged 20 years and above had done breast self examination (BSE). This data showed the practice of BSE is still low despite of various awareness programmes and activities carried out. A cross sectional study through Systematic Random Sampling was done at Out Patient Department, Kuantan Health Office to know the knowledge and practice of BSE among women aged 20~60 years. The results showed 94.9% respondents had received information about BSE, however only 31.6% knew the appropriate time to do BSE, 14.7% knew the purpose of doing at that time and only 29.9% knew how frequent they should do BSE. 74% of respondents did BSE, however 70.2% of them did not do monthly and 67.2% did not do at the suggested time. There was an association between the practice of BSE with the knowledge and sociodemographic characteristics i.e. educational level, income, ethnic group and marital status.
Key word: Breast self-examination, breast cancer, Kuantan.
Study site: Klinik Kesihatan, Kuantan, Pahang, Malaysia
The practice of breast self-examination (BSE) amongst 1,303 women registered with the Well Person's Clinic, Outpatient Department, Hospital Ipoh between April 1995 and March 1997 were assessed through a questionnaire. Majority (98.2%) were never taught and did not practise BSE, 17(1.3%) practised BSE while 6 (0.5%) were taught BSE but failed to put it into practice. Only 5.8% of 52 women with past/family history of breast cancer/lump and 2.9% of 207 women with past/family history of other cancers were practising BSE regularly. Three out of 64 women with breast lumps found on clinical breast examination discovered the lumps themselves. Five of the 64 women were subsequently confirmed to have breast carcinoma.
Study site: Outpatient clinic, Hospital Ipoh, Perak, Malaysia