English Abstract
Objectives :
To assess breast cancer knowledge, determine the current screening practices, calculate breast cancer risk and describe the perception of breast cancer risk among Bahraini women.
Method:
300 Bahraini women aged 20 and more attending primary health care centers were interviewed. A questionnaire was used as a tool. Modified Gail model was used to calculated breast cancer risk, and part of Health belief model was used to determine breast cancer risk perception.
Results:
Overall, breast cancer knowledge was poor as 5.6% of women knew more than half of the correct answers, and the mean "Percent Knowledge Index" was 32.1% ± 12.7. Newspapers, television, radio, were identified as the main source of knowledge of breast cancer. Highly educated women were more knowledgeable about total breast cancer (p=0.002), diagnostic modalities (p=0.008), and risk factors (p<0.0001). Breast cancer screening practices were as follows: 79% practiced BSE during the last year; approximately one third of them did it once every month, corresponding to only 16% of the women in the study. 34.7% of the study group practiced CBE during the last year. Furthermore, the practice of mammography was far below the recommended national standards as only 12% of the sample had mammography before, and 27% of them were done for screening. There were highly significant associations between the practice of BSE, CBE and marital status, where ever married women practiced BSE and CBE more than never married women.
Women who did BSE during the last year were more knowledgeable regarding breast cancer knowledge than those who did BSE more than one year ago or never did BSE (P<0.0001), this was not the case for CBE or mammography. Women with positive family history of breast cancer had a better knowledge of breast cancer treatment modalities than those with negative family history (p=0.017).
A mean 5- years risk of 0.7% ± 0.37 and a mean lifetime risk of 9.3% ± 3.0 were calculated for women aged 35 and older using the modified Gail model. Of women, 35 years and older, 4% had a high risk (≥ 1.76%) which makes them eligible candidates for breast cancer health prevention strategies. Breast cancer health beliefs showed that 50% of responses disagreed for their susceptibility for breast cancer. 78.8% of responses agreed for the general health motivation while 44.7% of responses believed of breast cancer seriousness.
Conclusions:
The overall, breast cancer knowledge was poor. Furthermore, highly educated women were more knowledgeable about breast cancer. The adherence to the available local and global screening recommendations was inadequate. Four percent of women 35 years and older had high breast cancer risk by Gail model which makes these women eligible candidates for preventive strategies. About half of Bahraini women in this study disagreed about their susceptibility to breast cancer; however, uncertainty could be clearly seen in the susceptibility section of HBM. In general, women agreed on general health motivation part, although their performance at breast cancer screening practices was not optimal. The maximum use of media should be encouraged in any proposed breast cancer campaign in the Kingdom of Bahrain (KOB).
The Kingdom of Bahrain (KOB) needs a comprehensive program at the primary care level to assess breast cancer risk for women 35 years and older and a follow up program at the secondary care level for those of high risk.
