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ORIGINAL ARTICLE
Year : 2022  |  Volume : 11  |  Issue : 1  |  Page : 52-56

Knowledge and awareness of breast cancer in Muslim population of Belagavi city: A population survey


Department of Oncology Physiotherapy, KAHER Institute of Physiotherapy, Belagavi, Karnataka, India

Date of Submission21-May-2021
Date of Decision16-Jul-2021
Date of Acceptance16-Jul-2021
Date of Web Publication23-May-2022

Correspondence Address:
Ms. Saira Khan
Department of Oncology Physiotherapy, KAHER Institute of Physiotherapy, Belagavi - 590 010, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdrntruhs.jdrntruhs_60_21

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  Abstract 


Introduction: Breast cancer is a common cancer seen in women. The awareness of breast cancer plays an important role in the early detection and prevention of the disease, but due to lack of awareness regarding breast cancer screening, most of the cases are detected at later stages, which leads to lower rates of recovery. The presently aimed to evaluate the knowledge and awareness of breast cancer among the Muslim female population in Belagavi city, Karnataka.
Materials and Methods: A cross-sectional survey was conducted on 97 Muslim Women, and a direct semi-structured questionnaire was administered to collect data.
Results: Our results indicated a low knowledge about breast cancer, breast self-examination, mammogram, and clinical breast examination. In total, 29% of women had knowledge regarding breast self-examination, but due to lack of practice, they never performed self-examination. The most common barrier for screening methods of breast cancer was that women were unaware of half of the screening methods and other barriers were related to their religious beliefs. Social media was found to be the main source of information among the female.
Conclusions: In conclusion, the majority of women showed poor knowledge about breast cancer and screening methods. Additional effort should be put forth through women to increase the awareness of breast cancer screening, indicating the need to continue emphasizing the importance of early detection of breast cancer in the early stages.

Keywords: Breast cancer knowledge, breast cancer screening, breast clinical examination, mammogram, self-examination


How to cite this article:
Pattanshetty R, Huddar VS, Khan S. Knowledge and awareness of breast cancer in Muslim population of Belagavi city: A population survey. J NTR Univ Health Sci 2022;11:52-6

How to cite this URL:
Pattanshetty R, Huddar VS, Khan S. Knowledge and awareness of breast cancer in Muslim population of Belagavi city: A population survey. J NTR Univ Health Sci [serial online] 2022 [cited 2022 Jun 26];11:52-6. Available from: https://www.jdrntruhs.org/text.asp?2022/11/1/52/345806




  Introduction Top


Breast Cancer is a common malignancy seen in women, and it is the second most reason of cancer death after lung cancer in Asia.[1] In Urban areas, 1 in 22 women is likely to develop breast cancer during her lifetime.[2]

The risk factors for breast cancer are modifiable and nonmodifiable. The modifiable risk factors are body mass index, menopausal hormonal therapy, menstrual history, alcohol consumption, and smoking.[3] The nonmodifiable risk factors are family history, age, gender, and genetic factors. At a younger age, that is before 12 years of age, there is an increased risk of breast cancer, and also in women attaining menopause at an older age.[4],[5]

The specific symptoms of breast cancer are a lump in the breast, skin changes around the breast, nipple discharge or bleeding, and breast pain. Among specific symptoms, a breast lump is the main symptom, which contributes 83% of the symptoms, nipple abnormalities 7%, breast pain 7%, and skin changes are 2%. The nonspecific breast cancer symptoms are back pain, musculoskeletal problems, chest pain, fatigue, and weakness.[6],[7]

Early detection of breast cancer can reduce the incidence of cancer in women. There are several screening tools and tests for diagnostic and screening purposes, which include breast self-examination (BSE), clinical breast examination (CBE), and mammography.[8]

In developed countries, there is a decrease in the mortality rate due to breast cancer because of awareness programs and early detection and treatment for the same. In low-middle countries, the survival rate is poor due to late diagnosis and limited resources for treatment. Studies have shown that there is an increase in the mortality rate of breast cancer in Muslim countries due to the lack of early detection programs and limited treatment facilities.[9]

Some of the factors which are responsible for late diagnosis of breast cancer in Muslim population are self-consciousness regarding discussing symptoms related to breast, ignorance of symptoms, and no information about breast cancer and self-breast examination.[10] For CBE, Muslim women prefer to be examined by a female physician because of religious beliefs and due to the obligation that Muslim women should not be with a nonrelated man. In the Asian Indian Muslim population, preservation of modesty is a cultural barrier that negatively influences breast cancer screening.[11]

The importance of screening is early diagnosis, early intervention, and good prognosis. Thereby reducing the mortality by 20% of breast cancer.[12]

The awareness of breast cancer plays an important role in the early detection and prevention of the disease. Therefore, our study aimed to evaluate the knowledge, attitude, and practice of breast cancer screening methods among Muslim females of Belagavi city.


  Materials and Methods Top


The present cross-sectional study was an interviewer-administered, semi-structured questionnaire-based survey method. The study covered Muslim female subjects of Belagavi city, Karnataka. All Muslim females who resided in Belagavi city, where the Muslim population is high, and agreed to participate in the study were included in the study. The study was conducted for 3 months in 2019. A total of 97 participants were included, with a margin of error of 5% and a confidence interval of 95%. An Institutional Ethical letter was obtained from IERB.

The researcher used a self-structured questionnaire consisting of the following: (1) socio-demographic data, including age, educational level, and gynecology history; (2) knowledge of breast cancer, mammograms, clinical breast examinations, and BSEs; self; (3) attitude, practice, and barrier for breast cancer screening; and (4) source of information. Data were obtained by the researcher who gave the questionnaire directly to the Muslim females. Each participant took 5–7 min to complete the questionnaire.

Statistical analysis

Statistical analysis for the present study was done using statistical package of social sciences (SPSS) version 23 so as to verify the results obtained. Various statistical measures like mean, mean difference, and standard deviation were used. Nominal data such as patients' demographic data, i.e., age, education, occupation, and marital status, were analyzed. Chi-Square goodness of fit test was used to analyze the normality of the variables.


  Results Top


The present study included ninety-seven (97) Muslim women above 18 years of age who were administered a self-structured questionnaire regarding breast cancer awareness.

The mean age of the 97 Muslim women was 33.57 ± 11.83 years. Maximum subjects included in this study were married (68.7%) and housewives (61.90%) who completed their education up to the pre-university level (n = 71) [Table 1] and [Figure 1], [Figure 2].
Figure 1: Demographic data of all subjects (marital status and education upto pre-university

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Figure 2: Descriptive statistics

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Table 1: Demographic Data of all Subjects in the Study

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It was found that 81% of the subjects had awareness regarding breast cancer. However, 71.1%, 94.8%, and 88% of the total study subjects had no knowledge regarding breast self-examination, CBE, and mammogram, respectively [Table 2] and [Figure 3].
Figure 3: Breast cancer awareness and screening in all subjects in the study

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Table 2: Breast Cancer Awareness and Screening in all Subjects in the Study

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Among the barriers to breast cancer examination, embarrassment with exposing body in front of a male doctor was found to be the most significant barrier among all the subjects (100%), followed by the fear of pitying and religious ban on exposing the body (97.9% and 96.9%), respectively, with statistical significance of P = 0.001 [Table 3].
Table 3: Barriers for Breast Cancer Examination Observed in the Study

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  Discussion Top


Breast cancer is the second most common cancer worldwide, and it is the second most reason of cancer death after lung cancer in Asia.[1] The awareness of breast cancer plays an important role in the early detection and prevention of the disease, but due to lack of awareness regarding breast cancer screening, most of the cases are detected at later stages, which leads to lower rates of recovery.[13] The majority of the women participating in the research were middle-aged, married, and had a primary level of education. According to the findings obtained in this research, the women who had information about breast cancer, and the primary sources of this information were television/radio and health care personnel. This finding lends support to the literature on television as an effective means of providing information on breast cancer and screening methods.[14] Other factors that were frequently found to be positively associated with less knowledge of breast cancer screening include the level of education and occupation. Breast cancer and self-examination were known to those with a higher degree of education in the current study. Although the present results are in agreement with previous studies that reported a positive effect of education on cancer screening behavior,[15] the present study showed a low-level knowledge of breast cancer, mammogram, CBE, and BSE among Muslim females. Our findings can be compared with a previous study in Abha (Saudi Arabia) that demonstrated that less than half of the women have heard of BSEs and mammograms, respectively. Another study of female teachers in Buraidah (Saudi Arabia) showed that they had limited knowledge about breast cancer. In this study, 29% of females knew about breast self-examination but did not perform it as they did not know how to do it. This finding can be compared with a previous study done by Montazeri et al. in 2008 in which they found that respondents cited a lack of knowledge of how to do BSE as the main reason for not doing it.[15] To improve the awareness of breast cancer in women, healthcare providers teach women the correct way to perform breast self-examinations and inform them of the normal structure of the breast to enhance their ability to identify abnormalities and how to report the abnormalities to healthcare providers.

With respect to CBE in our study, 97% of Muslim women would feel embarrassed to be examined by a male health care worker and instead they would prefer to be examined by a female physician. This is probably informed by the religious imperative for modesty and the belief that a man and a Muslim woman who are not related should not be alone together.

The present study findings were similar to previous studies that indicated a low percentage of women have had a mammogram. In Saudi Arabia, the government provides mammograms free to the population through healthcare providers and other charity organizations, such as the Zahra Breast Cancer Association. Even though the government provides mammograms for free, the majority of women do not utilize these services.

In this study, the other factors that were frequently found to be barriers for breast cancer examination were financial issues, family burden, and self-pitying.

In the present study, the main source of information about breast cancer was from social media and TV, which was similar to a previous study. These findings have led us to use social media to help increase the knowledge of breast cancer screening methods and to encourage the population to perform these methods.[16]

In the present study, we observed that the majority of Muslim women in Belagavi city demonstrated poor knowledge of breast cancer and breast cancer screening methods. Additional effort should be put forth through women's healthcare providers, social media, schools, universities, and hospitals to increase the awareness of breast cancer screening through the importance of primary healthcare for early detection of breast cancer in the early stages.

Acknowledgements

We are grateful to Mr. Prasad for helping us with the statistical analysis of the data. The authors are also thankful to all subjects for participating in the study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Ghoncheh M, Mahdavifar N, Darvishi E, Salehiniya H. Epidemiology, incidence and mortality of breast cancer in Asia. Asian Pac J Cancer Prev 2016;17:47-52.  Back to cited text no. 1
    
2.
Chaurasia V, Pal S. A novel approach for breast cancer detection using data mining techniques. International journal of innovative research in computer and communication engineering 2017;29;2.  Back to cited text no. 2
    
3.
Maas P, Barrdahl M, Joshi AD, Auer PL, Gaudet MM, Milne RL, et al. Breast cancer risk from modifiable and non-modifiable risk factors among white women in the United States. JAMA Oncol 2016;2:1295-302.  Back to cited text no. 3
    
4.
Breast Cancer Risk Factors and Prevention Methods. Cancer.org. 2020. Available from: https://www.cancer.org/cancer/breast-cancer/risk-and-prevention.html. [Last accessed on 2020 May 20].  Back to cited text no. 4
    
5.
Collaborative Group on Hormonal Factors in Breast Cancer. Menarche, menopause, and breast cancer risk: Individual participant meta-analysis, including 118 964 women with breast cancer from 117 epidemiological studies. Lancet Oncol 2012;13:1141-51.  Back to cited text no. 5
    
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Walker S, Hyde C, Hamilton W. Risk of breast cancer in symptomatic women in primary care: A case–control study using electronic records. Br J Gen Pract 2014;64:e788-93.  Back to cited text no. 6
    
7.
Koo MM, von Wagner C, Abel GA, McPhail S, Rubin GP, Lyratzopoulos G. Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis. Cancer Epidemiol 2017;48:140-6.  Back to cited text no. 7
    
8.
Othman A, Ahram M, Al-Tarawneh MR, Shahrouri M. Knowledge, attitudes and practices of breast cancer screening among women in Jordan. Health Care Women Int 2015;36:578-92.  Back to cited text no. 8
    
9.
Noor SR, Noor N, Haq MM. Breast cancer in Muslim countries: Risk reduction strategies. Br J Adv Med Med Res 2016;16:1-11.  Back to cited text no. 9
    
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Cohen M, Azaiza F. Developing and testing an instrument for identifying culture-specific barriers to breast cancer screening in Israeli Arab women. Acta Oncol 2008;47:1570-7.  Back to cited text no. 10
    
11.
Babu GR, Samari G, Cohen SP, Mahapatra T, Wahbe RM, Mermash S, et al. Breast cancer screening among females in Iran and recommendations for improved practice: A review. Asian Pac J Cancer Prev 2011;12:1647-55.  Back to cited text no. 11
    
12.
Marmot MG, Altman DG, Cameron DA, Dewar JA, Thompson SG, Wilcox M. The benefits and harms of breast cancer screening: An independent review. Br J Cancer 2013;108:2205.  Back to cited text no. 12
    
13.
Alshahrani M, Alhammam SY, Al Munyif HA, Alwadei AM, Alwadei AM, Alzamanan SS, et al. Knowledge, attitudes, and practices of breast cancer screening methods among female patients in primary healthcare centers in Najran, Saudi Arabia. J Cancer Educ 2019;34:1167-72.  Back to cited text no. 13
    
14.
Çam O, Gümüs AB. Breast cancer screening behavior in Turkish women: Relationships with health beliefs and self-esteem, body perception and hopelessness. Asian Pac J Cancer Prev 2009;10:49-56.  Back to cited text no. 14
    
15.
Montazeri A, Vahdaninia M, Harirchi I, Harirchi AM, Sajadian A, Khaleghi F, et al. Breast cancer in Iran: Need for greater women awareness of warning signs and effective screening methods. Asia Pac Fam Med 2008;7:6.  Back to cited text no. 15
    
16.
Mahfouz AA, Hassanein MH, Nahar S, Farheen A, Gaballah II, Mohamed A, et al. Breast cancer knowledge and related behaviors among women in Abha city, southwestern Saudi Arabia. J Cancer Educ 2013;28:516-20.  Back to cited text no. 16
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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