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Global Perceptions of Women on Breast Cancer and Barriers to Screening

  • Breast Cancer (AS Zimmer, Section Editor)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Breast cancer (BC) is a public health dilemma across the globe and a leading cause of mortality for women. Approximately 2.1 million newly diagnosed female BC cases occurred in 2018, comprising nearly 1 in 4 cancer cases among women. When BC is recognized in its early stages, successful treatment results can be achieved. Therefore, screening for BC is of paramount significance and routine screening mammography has been shown to be effective in reducing mortality from BC. Despite being considered a global health issue, national screening programmes are offered only in developed countries and BC is still often diagnosed in advanced stages.

Recent Findings

Disparities in screening exist not only between different countries but also between local and immigrant populations within a particular country. Low screening is attributed to low public awareness as well as numerous social, psychological, and geographical barriers to screening.

Summary

This review addresses (a) the differences in BC awareness and screening across the globe, (b) the most important barriers and facilitators to screening, and (c) the potential role of health education programmes to increase BC awareness and promote BC screening programmes with the ultimate goal to achieve earlier stage diagnosis of BC.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Akram M, Iqbal M, Daniyal M, Khan AU. Awareness and current knowledge of breast cancer. Biol Res. 2017;50(1):1–23.

    Google Scholar 

  2. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.

    Google Scholar 

  3. Kumar V, Abbas A, Aster J. Robbins Basic pathology. 10th ed. Philadelphia: Elsevier; 2018.

    Google Scholar 

  4. What Is Breast Cancer? (2018) Retrieved July 06, 2020, from https://www.cdc.gov/cancer/breast/basic_info/what-is-breast-cancer.htm

  5. Baade P. Geographical variation in breast cancer outcomes. Int J Environ Res Public Health. 2017;14(5):10–2.

    Google Scholar 

  6. Youlden DR, Cramb SM, Dunn NAM, Muller JM, Pyke CM, Baade PD. The descriptive epidemiology of female breast cancer: an international comparison of screening, incidence, survival and mortality. Cancer Epidemiol. 2012;36(3):237–48. https://doi.org/10.1016/j.canep.2012.02.007.

    Article  PubMed  Google Scholar 

  7. 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.

    PubMed  Google Scholar 

  8. Zurrida S, Veronesi U. Milestones in breast cancer treatment. Breast J. 2014;21(1):3–12.

    PubMed  Google Scholar 

  9. McDonald ES, Clark AS, Tchou J, Zhang P, Freedman GM. Clinical diagnosis and management of breast cancer. J Nucl Med. 2016;57:9S–16S.

    PubMed  Google Scholar 

  10. Eby PR. Evidence to support screening women annually. Radiol Clin. 2017;55(3):441–56.

    Google Scholar 

  11. Clarke TC, Endeshaw M, Duran D, Saraiya M. Breast cancer screening among women by nativity, birthplace, and length of time in the United States. Natl Health Stat Rep. 2019;2019(129):1–14.z.

    Google Scholar 

  12. Tabár L, Vitak B, Chen TH, Yen AM, Cohen A, Tot T, et al. Swedish two-county trial: impact of mammographic screening on breast cancer mortality during Purpose : Methods : Results. Radiology. 2011;260(3):658–63.

    PubMed  Google Scholar 

  13. Breast Cancer Screening (PDQ®)–Health Professional Version. (2020) Retrieved July 03, 2020, from https://www.cancer.gov/types/breast/hp/breast-screening-pdq

  14. Hubbard RA, Kerlikowske K, Flowers CI, Yankaskas BC, Zhu W, Miglioretti DL. Cumulative probability of false-positive recall or biopsy recommendation after 10 years of screening mammography: a cohort study. Obstet Gynecol Surv. 2012;67(3):162–3.

    Google Scholar 

  15. Gøtzsche PC, Jørgensen KJ. Screening for breast cancer with mammography. Cochrane Database Syst Rev. 2013;2013(6).

  16. Geisel J, Raghu M, Hooley R. The role of ultrasound in breast cancer screening: the case for and against ultrasound. Semin Ultrasound CT MRI. 2018;39(1):25–34. https://doi.org/10.1053/j.sult.2017.09.006.

    Article  Google Scholar 

  17. Smith RA, Andrews KS, Brooks D, Fedewa SA, Manassaram-Baptiste D, Saslow D, et al. Cancer screening in the United States, 2019: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin. 2019;69(3):184–210.

    PubMed  Google Scholar 

  18. Oeffinger KC, Fontham ETH, Etzioni R, Herzig A, Michaelson J, Shih Y-CT, et al. Guideline update from the American Cancer Society. Jama. 2015;314(15):1599–614.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Monticciolo DL, Newell MS, Hendrick RE, Helvie MA, Moy L, Monsees B, et al. Breast cancer screening for average-risk women: recommendations from the ACR Commission on Breast Imaging. J Am Coll Radiol. 2017;14(9):1137–43.

    PubMed  Google Scholar 

  20. National Health Service (2020) When it’s offered: breast cancer screening. Retrieved July 27, 2020, from https://www.nhs.uk/conditions/breast-cancer-screening/when-its-offered/

  21. National Health Service Breast Screening Programme (NHSBSP). Screening for breast cancer in England: past and future. J Med Screen. 2006;13:59–61.

  22. Massat NJ, Dibden A, Parmar D, Cuzick J, Sasieni PD, Duffy SW. Impact of screening on breast cancer mortality: the UK program 20 years on. Cancer Epidemiol Biomark Prev. 2016;25(3):455–62.

    Google Scholar 

  23. O’Hara J, McPhee C, Dodson S, Cooper A, Wildey C, Hawkins M, et al. Barriers to breast cancer screening among diverse cultural groups in Melbourne, Australia. Int J Environ Res Public Health. 2018;15(8):1–13.

    Google Scholar 

  24. Breast Screen Australia (2020). Accessed on August 20, 2020 fromhttp://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/breast-screening-1

  25. da Costa Vieira RA, Biller G, Uemura G, Ruiz CA, Curado MP. Breast cancer screening in developing countries. Clinics. 2017;72(4):244–53 This systematic review examined the indicators related to breast cancer awareness and screening access and availability in developing countries. The results demonstrate the use of BSE rather than imaging modalities for screening.

    PubMed  PubMed Central  Google Scholar 

  26. Anakwenze C, Coronado-Interis E, Aung M, Jolly P. A theory-based intervention to improve breast cancer awareness and screening in Jamaica. Prev Sci. 2014;16(4):578–85.

    Google Scholar 

  27. Noreen M, Murad S, Furqan M, Sultan A, Bloodsworth P. Knowledge and awareness about breast cancer and its early symptoms among medical and non-medical students of Southern Punjab, Pakistan. Asian Pac J Cancer Prev. 2015;16(3):979–84.

    PubMed  Google Scholar 

  28. Rasheed R. Breast cancer. J Coll Phys Surg Pak JCPSP. 2013;23(10):766–7.

    Google Scholar 

  29. Aydogan U, Doganer YC, Kilbas Z, Rohrer JE, Sari O, Usterme N, et al. Predictors of knowledge level and awareness towards breast cancer among Turkish females. Asian Pac J Cancer Prev. 2015;16(1):275–82 This study examined factors that impacted breast cancer knowledge and awareness in Turkey.

    PubMed  Google Scholar 

  30. Alshahrani M, Alhammam SYM, Al Munyif HAS, Alwadei AMA, Alwadei AMA, Alzamanan SSM, 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(6):1167–72 This survey demonstrated lacking knowledge and participation in BSE and CBE among women in Saudi Arabia.

    PubMed  Google Scholar 

  31. Rahman SA, Al-Marzouki A, Otim M, Khayat NEHK, Yousef R, Rahman P. Awareness about breast cancer and breast self-examination among female students at the University of Sharjah: a cross-sectional study. Asian Pac J Cancer Prev. 2019;20(6):1901–8.

    PubMed  PubMed Central  Google Scholar 

  32. Gesink D, Filsinger B, Mihic A, Norwood T, Sarai Racey C, Perez D, et al. Cancer screening barriers and facilitators for under and never screened populations: a mixed methods study. Cancer Epidemiol. 2016;45:126–34.

    PubMed  Google Scholar 

  33. Islam R, Bell RJ, Hossain MB, Davis SR. A major flaw in “awareness of breast cancer and barriers to breast screening uptake in Bangladesh: a population based survey”. Maturitas. 2016;88(September 2013):45.

    Google Scholar 

  34. Majidi A, Majidi S, Salimzadeh S, Khazaee-Pool M, Sadjadi A, Salimzadeh H, et al. Cancer screening awareness and practice in a middle income country: a systematic review from Iran. Asian Pac J Cancer Prev. 2017;18(12):3187–94.

    PubMed  PubMed Central  Google Scholar 

  35. Malhotra C, Bilger M, Liu J, Finkelstein E. Barriers to breast and cervical cancer screening in Singapore: a mixed methods analysis. Asian Pac J Cancer Prev. 2016;17(8):3887–95.

    PubMed  Google Scholar 

  36. Seaman K, Dzidic PL, Castell E, Saunders C, Breen LJ. A Systematic review of women’s knowledge of screening mammography. Breast. 2018;42:81–93. https://doi.org/10.1016/j.breast.2018.08.102.

    Article  PubMed  Google Scholar 

  37. Nastasi A, Bryant T, Canner JK, Dredze M, Camp MS, Nagarajan N. Breast cancer screening and social media: a content analysis of evidence use and guideline opinions on Twitter. J Cancer Educ. 2018;33(3):695–702 This study examined quality of BC screening information on social media. The results found that only a small proportion of tweets were made by physicians with factually correct information. The majority of tweets were provided by non-healthcare users and were more likely to contain false information.

    PubMed  Google Scholar 

  38. Khazir Z, Morowatisharifabad MA, Vaezi A, Enjezab B, Yari F, Fallahzadeh H. Perceived behavioral control in mammography: a qualitative study of Iranian women’s experiences. Int J Cancer Manag. 2019;12(8) This study investigated barriers to BC screening and found that psychosocial barriers, mammography techniques, and structural barriers impact the screening participation.

  39. Sankaranarayanan R. Screening for cancer in low- and middle-income countries. Ann Glob Heal. 2014;80:412–7.

    CAS  Google Scholar 

  40. Ghoncheh M, Pournamdar Z, Salehiniya H. Incidence and mortality and epidemiology of breast cancer in the world. Asian Pac J Cancer Prev. 2016;17(Cancer Control in Western Asia Special Issue):43–6.

    PubMed  Google Scholar 

  41. Munzone E. Highlights from the ninth European breast cancer conference, Glasgow, 19-21 March 2014. Ecancermedicalscience. 2014;8(1):1–5.

    Google Scholar 

  42. Onitilo AA, Liang H, Stankowski RV, Engel JM, Broton M, Doi SA, et al. Geographical and seasonal barriers to mammography services and breast cancer stage at diagnosis. Rural Remote Health. 2014;14(3):1–12 This study demonstrated that geographical barriers, such as distance to the nearest mammography testing center and harsh climates have an inverse relationship with mammogram attendance.

    Google Scholar 

  43. Yao N, Hillemeier MM. Disparities in mammography rate among immigrant and native-born women in the US: progress and challenges. J Immigr Minor Health. 2014;16(4):613–21.

    PubMed  PubMed Central  Google Scholar 

  44. Salinas JJ, Byrd T, Martin C, Dwivedi AK, Alomari A, Salaiz R, et al. Change in breast cancer screening knowledge is associated with change in mammogram intention in Mexican-origin women after an educational intervention. Breast Cancer Basic Clin Res. 2018;12:117822341878290.

    Google Scholar 

  45. Kwok C, Lee MJ, Lee CF. Breast cancer perceptions and screening behaviours among Korean women in Australia. J Immigr Minor Health. 2020;22(1):126–33.

    PubMed  Google Scholar 

  46. Beckjord EB, Klassen AC. Cultural values and secondary prevention of breast cancer in African American women. Cancer Control. 2008;15(1):63–71.

    PubMed  Google Scholar 

  47. Banning M. Perceptions of breast health awareness in Black British women. Eur J Oncol Nurs. 2011;15:173–7.

    PubMed  Google Scholar 

  48. Kaiser K, Cameron K, Curry G, Stolley M. Black women’s awareness of breast cancer disparity and perceptions of the causes of disparity. J Community Health. 2013;38:766–72.

    PubMed  Google Scholar 

  49. Wallace R, Torres S, Beltran J, Cohen-Boyar C. Views of mammography screening among U.S. Black and Hispanic immigrant women and their providers. Health Care Women Int. 2014;35:1181–200.

    PubMed  Google Scholar 

  50. Forbes LJL, Atkins L, Thurnham A, Layburn J, Haste F, Ramirez AJ. Breast cancer awareness and barriers to symptomatic presentation among women from different ethnic groups in East London. Br J Cancer. 2011;105(10):1474–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  51. Jones CEL, Maben J, Jack RH, Davies EA, Forbes LJL, Lucas G, et al. A systematic review of barriers to early presentation and diagnosis with breast cancer among black women. BMJ Open. 2014;4(2).

  52. Russell KM, Monahan P, Wagle A, Champion V. Differences in health and cultural beliefs by stage of mammography screening adoption in African American women. Cancer. 2007;109(2 SUPPL):386–95.

    PubMed  Google Scholar 

  53. Sadler GR, Ko CM, Cohn JA, White M, Weldon RN, Wu P. Breast cancer knowledge, attitudes, and screening behaviors among African American women: the Black cosmetologists promoting health program. BMC Public Health. 2007;7:1–8.

    Google Scholar 

  54. Sheppard VB, Davis K, Boisvert M, Jennings Y, Montalvo B. Do recently diagnosed Black breast cancer patients find questions about cancer fatalism acceptable? A Preliminary report. J Cancer Educ. 2011;26:5–10.

    PubMed  Google Scholar 

  55. Kwok C, Sullivan G. Influence of traditional Chinese beliefs on cancer screening behaviour among Chinese-Australian women. J Adv Nurs. 2006;54(6):691–9.

    PubMed  Google Scholar 

  56. Shang C, Beaver K, Campbell M. Social cultural influences on breast cancer views and breast health practices among Chinese women in the United Kingdom. Cancer Nurs. 2015;385:343–50.

    Google Scholar 

  57. Sheppard VB, Christopher J, Nwabukwu I. Breaking the silence barrier: opportunities to address breast cancer in African-born women. J Natl Med Assoc. 2010;1026:461–8.

    Google Scholar 

  58. Muthoni A, Miller A. An exploration of rural and urban Kenyan women’s knowledge and attitudes regarding breast cancer and breast cancer early detection measures. Health CareWomen Int. 2010;31:801–16.

    Google Scholar 

  59. Kaltsa A, Holloway A, Cox K. Factors that influence mammography screening behaviour: a qualitative study of Greek women’s experiences. Eur J Oncol Nurs. 2013;17(3):292–301.

    PubMed  Google Scholar 

  60. Fouladi N, Pourfarzi F, Mazaheri E, Asl HA, Rezaie M, Amani F, et al. Beliefs and behaviors of breast cancer screening in women referring to health care centers in northwest Iran according to the champion health belief model scale. Asian Pac J Cancer Prev. 2013;14(11):6857–62.

    PubMed  Google Scholar 

  61. Charkazi A, Samimi A, Razzaghi K, Kouchaki GM, Moodi M, Meirkarimi K, et al. Adherence to recommended breast cancer screening in Iranian Turkmen women: the role of knowledge and beliefs. ISRN Prev Med. 2013;2013:1–8.

    Google Scholar 

  62. Ouyang YQ, Hu X. The effect of breast cancer he alth education on the knowledge, attitudes, and practice: a community health center catchment area. J Cancer Educ. 2014;29(2):375–81 The findings of this study imply that community-based intervention may be used to teach women about the general knowledge of breast cancer and how to perform breast self-examination correctly.

    PubMed  Google Scholar 

  63. Donnelly TT, Hwang J. Breast cancer screening interventions for Arabic women: a literature review. J Immigr Minor Health. 2015;17(3):925–39.

    PubMed  Google Scholar 

  64. Anastasi N, Lusher J. The impact of breast cancer awareness interventions on breast screening uptake among women in the United Kingdom: a systematic review. J Health Psychol. 2019;24(1):113–24.

    PubMed  Google Scholar 

  65. O’Mahony M, Comber H, Fitzgerald T, Corrigan MA, Fitzgerald E, Grunfeld EA, et al. Interventions for raising breast cancer awareness in women (review). Cochrane Database Syst Rev. 2017;(2):CD011396. https://doi.org/10.1002/14651858.CD011396.pub2.

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Correspondence to Constantina Constantinou.

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Mascara, M., Constantinou, C. Global Perceptions of Women on Breast Cancer and Barriers to Screening. Curr Oncol Rep 23, 74 (2021). https://doi.org/10.1007/s11912-021-01069-z

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