The uptake of Mammogram screening in Malaysia and its associated factors: A systematic review

ABSTRACT

Introduction: This review aimed to summarise the trend ofmammogram screening uptake published in local studiesbetween years 2006 and 2015 among the Malaysian womenaged 40 years and above, and identify the associated factorsand barriers, as well as discuss limitations of the studiesand research gaps.Methods: A systematic review was conducted on breastcancer screening studies among Malaysian women,published between January 2006 and December 2015.Online databases were searched using keywords“mammogram”, “mammography”, “uptake”, “breast cancerscreening” and “Malaysia”.Results: Thirteen original articles were reviewed. The rate ofmammography uptake ranged between 3.6% and 30.9%among the general population, and 80.3% among personnelof a tertiary hospital. Factors associated with mammogramscreening were clinical breast examination, age, income,knowledge on breast cancer and mammogram, perceivedsusceptibility to breast cancer, ethnicity and education level.Barriers to mammogram screening were lack of knowledge,embarrassment, fear of cancer diagnosis, perception thatbreast screening was unnecessary, lack of coping skills andpain during procedure. However, almost all of the studiescould not be generalised beyond the study sample becauseof the limited number of sites and respondents; and mostdata were self-reported with no objective measures of theresponses.Conclusion: Mammogram screening uptake among womenin selected communities were generally low. Further studiesinvolving the general population are essential. Futurestudies should also explore the availability, affordability andaccessibility of this service especially in the pursuit ofachieving universal health coverage in breast cancermanagement.