In a community such as Iran where late presentation is predominant and the majority of breast cancer patients are diagnosed at advanced stages of the disease, there is an urgent need for improving the level of awareness about breast cancer and early detection measures. Given that rural residents are at higher risk for late diagnosis of breast cancer because they have less education, income, and access to advanced screening technologies, this study was conducted to determine the effect of counseling on breast cancer awareness of rural Iranian women. This randomized clinical trial was conducted on 60 rural women from the Abish Ahmad area in northwestern Iran in 2017. The randomized cluster method was used for sampling. From 20 rural health houses and centers, about one third were selected randomly. From the six selected clusters, three were randomly allocated as the control group and three as the intervention group. Using convenience sampling, 30 women between the ages of 40 and 69 were selected from the control group and 30 from the intervention group. The intervention group attended six group counseling sessions. Data was gathered using a demographic and obstetrical information questionnaire and breast cancer awareness measures. The chi-square, independent t test and ANCOVA by controlling for the baseline scores were used to analyze the data. After counseling, the mean knowledge about breast cancer score was significantly higher in the intervention group than in the control group (adjusted mean difference, 17.02; confidence interval (CI) 95%, 15.44 to 18.59; p < 0.001). The mean barriers to breast cancer screening score showed a significant decrease in the intervention group compared to the control group (AMD, − 1.74; 95% CI − 3.12 to − 0.36, p < 0.001). After intervention, the frequency of breast self-exam showed a significant difference between groups (p < 0.001); but for confidence about noticing breast changes, no significant difference was observed between groups (p = 0.08). Group counseling had a significant effect on enhancing breast cancer awareness of rural Iranian women, except for confidence about noticing breast changes.
Breast cancer awareness Breast cancer screening Counseling
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This article is adopted from a Master’s thesis. The authors would like to express their sincere gratitude to the research deputy of the Tabriz University of Medical Sciences, the health network of Kaleybar County, the health care providers of the Abish Ahmad district, and all the participants for their cooperation.
Compliance with Ethical Standards
Conflict of Interests
The authors declare that they have no conflict of interest.
Research involved human participants. All procedures performed in studies involving human participants were in accordance with the ethical standards of the National Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from each individual participant.
Matovu A, Scheel JR, Shadrack PA, Ssembatya R, Njeri A, Galukande M et al (2016) Pilot study of a resource-appropriate strategy for downstaging breast cancer in rural Uganda. J Glob Radiol 2. https://doi.org/10.7191/jgr.2016.1021
Iranian Ministry of Health and Medical Education (2008) Iranian annual of National Cancer Registration Report 2006–2007. Ministry of Health and Medical EducationGoogle Scholar
Naghibi SA, Moosazadeh M, Shojaizadeh D, Montazeri A, Cherati JY (2015) The investigate factors on screening of the breast Cancer based on PEN-3 model in Iranian northern women. Journal of Community Health Research 4:79–90Google Scholar
Dreyhaupt J, Mayer B, Keis O, Öchsner W, Muche R (2017) Cluster-randomized studies in educational research: principles and methodological aspects. GMS J Med Educ 34(2). https://doi.org/10.3205/zma001103
Linsell L, Forbes LJL, Burgess C, Kapari M, Thurnham A, Ramirez AJ (2010) Validation of a measurement tool to assess awareness of breast cancer. Eur J Cancer 46:1374–1381CrossRefPubMedGoogle Scholar
Stubbings S, Robb K, Waller J, Ramirez A, Austoker J, Macleod U et al (2009) Development of a measurement tool to assess public awareness of cancer. Br J Cancer 101(S2):S13–S17CrossRefPubMedPubMedCentralGoogle Scholar
Tazhibi M, Feizi A (2014) Awareness levels about breast cancer risk factors, early warning signs, and screening and therapeutic approaches among Iranian adult women: a large population based study using latent class analysis. Biomed Res Int 2014:1–9. https://doi.org/10.1155/2014/306352CrossRefGoogle Scholar
Khazaee-pool M, Majlessi F, Foroushani AR, Montazeri A, Nedjat S, Shojaeizadeh D et al (2014) Perception of breast cancer screening among Iranian women without experience of mammography: a qualitative study. Asian Pac J Cancer Prev 15(9):3965–3971CrossRefPubMedGoogle Scholar
Karayurt O, Sarıkaya A, Malak A t (2009) Effects of peer and group education on knowledge, beliefs and breast self-examination practice among university students in Turkey. Turk J Med Sci 39:59–66. https://doi.org/10.3906/sag-0712-17Google Scholar