Breast Self-Examination Practice in Yerevan Women

Abstract

Breast Cancer is one of the leading causes of death for women in the world. It is an important public health problem in Armenia as well, where both the morbidity and the mortality rates of breast cancer remain rather high. Breast cancer is a critical target for secondary prevention, because it is one of the cancers that can be cured by current means if detected at early stages. Breast Self-Examination (BSE) is a low-cost, low-risk self-performed screening, which, according to the evidence from the literature, improves the prospects for women's survival. Despite this, there are no large-scale, properly designed BSE educational programs in Armenia currently. Besides, no detailed investigation concerning the patterns of BSE practice and the knowledge of different factors affecting it was carried out in Armenia. Hence, to identify Armenian women's BSE and other breast cancer screening behaviors and the factors of decisive importance for Armenian women's BSE practice, and to assess the need for the future educational programs in this sphere, a Knowledge-Attitude-Practice (KAP) cross-sectional survey was conducted with Yerevan women in two age categories (from 25 to 50 and over 50). The women were surveyed by telephone interviewing, with using Random Digit dialing technique to generate the sample of women for the study. Random Digit dialing, which was not used in Armenia previously, proved to be a rather effective technique, resulted in the sample of 201 women from different city districts. The information on women's sociodemographics, health habits, family history of cancer, breast-problem related care, breast cancer screening practices, breast cancer screening knowledge, exposure to the information regarding breast cancer, screening methods and risk-perception was obtained. By the means of STATA analysis, it was revealed that relatively a small proportion of Yerevan women (0.20-0.33) perform some form of BSE and an even smaller proportion performs BSE as it is specified by BSE guidelines (0.06-0.15). Of those practicing BSE, the majority does it once a month or more often. Income, employment, education, number of children, family history of cancer, BSE training in the past, and the source of BSE learning were shown to affect BSE behavior in Yerevan women. The association between BSE and mammography screening in terms of both women's awareness and practice was revealed. No major differences in BSE practice were noticed in different age strata. The investigation found the risk-perception and attitude-related factors not to be decisive for women's practice of BSE. It was shown that there is a substantial lack of knowledge in Yerevan women regarding BSE in general and BSE techniques. Based on the survey findings, some recommendations about the design and the implementation of the corresponding BSE training programs are suggested, with the emphasis put on the availability of these programs for the large population of women and on the mechanisms, which would ensure their long-term effect.