Mapping the supportive care needs and quality of life of adult survivors of childhood cancer at a comprehensive cancer center in the Middle East.

Assessing unmet needs is crucial to achieving quality care and patient satisfaction. Between September and December 2021, we assessed unmet supportive care needs in a consecutive sample of adult survivors of childhood cancer at KHCC (King Hussien Cancer Center). Two hundred and ninety-seven adult survivors of childhood cancer completed the study questionnaire. The average needs score across all domains was 24.80 (SD = 19.65), with the financial domain scoring the highest 30.39 (SD = 31.95) and sexuality scoring the lowest 7.67 (SD = 19.67). Using a multivariate linear regression model, female gender was independently associated with significantly high scores in all need domains (p < 0.001), except for sexuality. Monthly income, comorbidities, socioeconomic challenges, time since diagnosis, and age at diagnosis have emerged as predictors of needs in many domains. Mean quality of life (QoL) was significantly and inversely associated with the mean score in multiple domains: psychological (p < 0.001), sexuality (p = 0.038), financial (p < 0.001), and overall needs (p = 0.004). Following a content analysis of qualitative data, educational difficulties, and work-related challenges were identified as other unmet needs. Cancer experiences during childhood significantly influence supportive care needs in adulthood. There is a need for more tailored studies assessing different populations of cancer survivors and avoiding the one-size-fits-all survivorship care.

Attitudes of Jordanian Nurses Toward Caring for Dying Patients.

Hospital nurses are expected to care for dying patients. Such care provokes many undesired emotions and attitudes that affect the quality of care. This study aims to assess the attitudes of Jordanian nurses toward caring for dying patients in addition to examining the relationship between nurses' attitudes toward caring for dying patients and their selected characteristics. A quantitative descriptive cross-sectional research design was used to recruit a total of 290 Jordanian nurses from two hospitals in Jordan. The findings of this study revealed a significant correlation between nurses' attitudes toward caring for dying patients and receiving educational courses on palliative care (p = .008). Also, the study found a correlation between nurses' attitudes toward caring for dying patients and prior experience attending death cases (p = .004). The attitudes nurses have toward caring for dying patients are affected by educational courses, which make these attitudes adjustable toward the positive.

Pathogenic germline variants in patients with breast cancer: conversations across generations, practices and patients' attitude.

Background: Breast cancer susceptibility genes such as BRCA1, BRCA2, PALB2, CHEK2 and many others are increasingly recognized among our patient population. In addition to their impact on treatment decisions of tested patients themselves, identifying at-risk family members offer opportunities for cancer preventive measures. Methods: This is an observational cross-sectional study of adult breast cancer patients with positive breast-cancer-susceptibility germline variants who received treatment at our institution. Patients with variants of uncertain significance (VUS), or who refused to give consent, were excluded. The data was collected from an eligible sample of breast cancer patients using a structured questionnaire developed by the study team and tested for validity and reliability, as well as a clinical chart review form. Patients were invited to participate in the study during their scheduled oncology clinics visit. Results: 169 patients were enrolled, including 42 (24.9%) with pathogenic/likely pathogenic (P/LP) BRCA1 variants, 84 (49.7%) with BRCA2 and 43 (25.4%) with non-BRCA variants. All patients were female and the mean age was 45 ± 9.9 years. Among 140 eligible patients, 104 (74.3%) underwent prophylactic mastectomy, while 79 (59.0%) of 134 eligible patients had prophylactic bilateral salpingo-oophorectomy (BSO). Results were communicated with family members by majority (n = 160, 94.7%), including 642 first degree female relatives, and 286 (44.5%) of them have taken no action. Fear of positive test results, cost of testing, unwillingness to undergo preventive measures, and social stigma were cited as barriers to genetic testing in 54%, 50%, 34% and 15%, respectively. Conclusion: Risk-reducing interventions including mastectomy and BSO were carried by majority of patients with P/LP variants. However, though the rate of communication of genetic testing results with family members was high, proper preventive measures were relatively low. Cost and fear of cancer diagnosis, were the leading causes that prevented cascade testing in our cohort.

Needlestick and sharps injuries among healthcare workers in an oncology setting: a retrospective 7-year cross-sectional study.

OBJECTIVE: To assess the prevalence of needlestick and sharps injuries (NSSIs) and associated factors among healthcare workers (HCWs) at King Hussein Cancer Centre (KHCC), Amman, Jordan. METHODS: This retrospective cross-sectional study undertook a chart review of all HCWs that reported an NSSI between January 2015 and December 2021. Data collected included sociodemographic factors including age, sex, qualifications, and predictors of NSSIs such as working hours, work shift, and specific job roles within the oncology setting, work experience in KHCC, overall work experience and occupational category. RESULTS: A total of 355 NSSIs were included in this study with a peak prevalence in 2019 (81 of 355; 22.8%). Nurses (220 of 355; 62.0%), housekeeping staff (59of 355; 16.6%) and physicians (45 of 355; 12.7%) were the most affected occupations. NSSIs were most common in the surgical floor (65 of 355; 18.3%) and operating rooms (56 of 355; 15.8%). Blood collection (94 of 355; 26.5%) and waste collection (65 of 355; 18.3%) were the two primary procedures resulting in NSSIs. The risk of injury was significantly associated with the locations of NSSIs, procedure that caused NSSIs, shift and overall experience. CONCLUSION: NSSIs remain common among HCWs, which highlights the need for targeted education.

Validation of the Arabic Version of the Edmonton Symptom Assessment System.

Quality cancer care is a team effort. In addition, patients' symptoms change over the course of treatment. As such, the Edmonton Symptom Assessment System (ESAS) is a simple tool designed to quickly monitor symptom change. Here, we present the results from a two-phase study aimed at validating the Arabic version of the ESAS (ESAS-A). Phase one involved the creation of two versions of the ESAS with both reverse and forward translations by bilingual, native Arabic speakers as well as evaluation by an expert panel. The reconciled version was then administered to 20 patients as a pilot from which to create the final version, which was then used with 244 patients. Phase two for the ESAS-involved an ESAS-based validation of 244 adults aged 18 years and older who were diagnosed with advanced cancer; then, further validation was completed in conjunction with two other symptom survey tools, the EORTC-Pal 15 and the HADS. The ESAS-A items possessed good internal consistency with an average Cronbach's alpha of 0.84, ranging from 0.82 to 0.85. Moreover, the results of ESAS-A showed good agreement with those of EORTC QLQ- 15 PAL (r = 0.36 to 0.69) and HADS (r = 0.60 and 0.57) regarding anxiety and depression. We found the ESAS-A to be responsive to symptom change and a median time to completion of 3.73 min. The results of our study demonstrate that the ESAS-A is a reliable, valid, and feasible tool for the purposes of monitoring symptom change over the course of cancer treatment.

The impact of having a relative or a friend with cancer on person's modifiable cancer-related risk factors.

BACKGROUND: It is known that targeting cancer-related modifiable risk factors is the best way to fight cancer. Behavioral and lifestyle changes can significantly reduce the burden of cancer. AIMS: We aim to assess the impact of having a relative/friend with cancer on the number of cancer-related modifiable risk factors a participant might have. METHODS: A survey-based cross-sectional study was conducted at King Hussein Cancer Center from June 2020 until July 2020. The survey was distributed via social media platforms, where we targeted adults who have never been diagnosed with cancer. We asked about modifiable cancer-related risk factors and compared between participants with and without relatives or friends with cancer. RESULTS: A total of 1486 participants were considered for analysis, with a mean age of 30.62 (SD 11.19) years. Participants who had a relative with cancer had a mean of 0.31 (p = 0.007; 95% CI: 0.08-0.54) fewer risk factors, with smoking and extra sun exposure were significantly lower among participants with a cancer relative. No significant difference in modifiable risk factors was found between participants with a friend who have cancer and those who do not (p = 0.193). CONCLUSION: People who have relatives with cancer had less modifiable risk factors, which might reflect on their willingness to modify their cancer-related risk factors.

Stress, resilience, and moral distress among health care providers in oncology during the COVID-19 pandemic.

Background: The coronavirus pandemic has potential implications for stress levels and resilience among oncology healthcare professionals (HCPs). This study aims to assess perceived stress, resilience, and moral distress levels among oncology HCPs in Jordan during the pandemic and identify associated risk factors. Methods: An online cross-sectional survey was conducted among oncology HCPs in Jordan using three validated tools: Perceived Stress Scale (PSS), Connor-Davidson Resilience Scale (CD-RSIC), and Moral Distress Thermometer (MDT). Seven items were used to assess sources of stress. Results: A total of 965 participants enrolled with a 74% response rate. The participants' ages ranged from 20 to 74 (mean = 32.74, SD = 5.197), with 79.1% males, 45.1% were physicians, 32.6% were public hospital workers, 57.1% were married, and 56.6% had children below 18 years. Findings indicated moderate perceived stress (Mean = 15.87, SD = 5.861), low resilience (Mean = 29.18, SD = 5.197), and high moral distress (Mean = 4.72, SD = 2.564). Females, unmarried individuals, and younger age groups exhibited higher PSS (p = 0.009, p < 0.001, and P<0.001) and lower resilience (p = 0.024, p = 0.034, and p = 0.001). Not having children below 18 years correlated with higher perceived stress (P < 0.001). In linear regression analysis, age and gender emerged as significant predictors of both perceived stress and resilience. Female participants reported stress related to the risk of contracting COVID-19 (p = 0.001), transmitting it to others (p = 0.017), social isolation (P < 0.001), and having children at home due to school closures (p = 0.000). A cohort of 239 participants repeated the survey within a two-month interval, revealed a statistically significant decrease in the CD-RISC scores (p < 0.001). Conclusion: Oncology HCPs in Jordan experienced moderate stress, high moral distress, and poor resilience during the COVID-19 pandemic. These factors may negatively affect the quality of oncology care. Urgent measures are necessary to support HCPs in coping with unforeseen circumstances in the future.

An update on the impact of SARS-CoV-2 pandemic public awareness on cancer patients' COVID-19 vaccine compliance: Outcomes and recommendations.

Background: Aside from the pandemic's negative health effects, the world was confronted with public confusion since proper communication and favorable decisions became an ongoing challenge. As a result, the public's perceptions were influenced by what they knew, the many sources of COVID-19 information, and how they interpreted it. With cancer patients continuing to oppose COVID-19 vaccines, we sought to investigate the COVID-19 pandemic and vaccine sources of this information in adult cancer patients, which either helped or prevented them from taking the vaccine. We also assessed the relevance and impact of their oncologists' recommendations in encouraging them to take the vaccine. Methods: From June to October 2021, an online survey was conducted at King Hussein Cancer Center. A total of 441 adult cancer patients took part in the study. Patients who had granted their consent were requested to complete an online questionnaire, which was collected using the SurveyMonkey questionnaire online platform. Descriptive analysis was done for all variables. The association between categorical and continuous variables was assessed using the Pearson Chi-square and Fisher Exact. Results: Our results showed that 75% of the patients registered for the COVID-19 vaccine, while 12% refused vaccination. The majority of participants acquired their information from news and television shows, whereas (138/441) got their information through World Health Organization websites. Because the SARS-CoV-2 vaccines were made in such a short period, 54.7 % assumed the vaccines were unsafe. Only 49% of the patients said their oncologists had informed them about the benefits of SARS-CoV-2 vaccines. Conclusions: We found that SARS-CoV-2 vaccine hesitancy in cancer patients might be related to misinformation obtained from social media despite the availability of supportive scientific information on the vaccine's benefits from the physicians. To combat misleading and unreliable social media news, we recommend that physicians use telehealth technology to reach out to their patients in addition to their face-to-face consultation, which delivers comprehensive, clear, and high-quality digital services that guide and help patients to better understand the advantages of COVID-19 vaccines.

Knowledge, Attitudes, and Practices of Healthcare Workers in Jordan towards the COVID-19 Vaccination.

The rapid development of COVID-19 vaccines raises concerns over vaccine hesitancy among healthcare workers (HCWs) and the general public, which made understanding the factors influencing hesitancy crucial in the maintenance of a solid healthcare system. This cross-sectional study investigated the knowledge, attitudes, and perceptions (KAP) of Jordanian HCWs to the COVID-19 vaccine from February to March 2021, using a self-administered questionnaire validated by a panel of public health experts. A total of 364 Jordanian HCWs were included in the final analysis, in which women accounted for 48.8% of the total sample. HCWs subjected to the seasonal flu vaccine were significantly more likely to uptake the COVID-19 vaccine. In comparison to nurses, physicians were significantly more likely to take or register for the vaccine. They demonstrated significantly higher knowledge of the vaccine's effectiveness, side effect profile, recommended doses, and target population. Among our participants, the most common reasons for vaccine hesitancy include a lack of confidence, inadequate knowledge, and disbelief in effectiveness. Vaccine hesitancy among Jordanian HCWs is low, with discrepancies between nurses and physicians. It is pertinent for independent committees and trusted authorities to provide interventions and raise awareness regarding the vaccine's safety and efficacy.

Supportive Care Needs Assessment for Cancer Survivors at a Comprehensive Cancer Center in the Middle East: Mending the Gap.

BACKGROUND: Cancer survivors are often underprepared for what to expect post-treatment, and there are knowledge gaps regarding cancer survivors' supportive care needs in Jordan and neighboring Arab countries. This study aimed to identify gaps in supportive care needs among adult cancer survivors seen at King Hussein Cancer Center in Amman, Jordan, and explore predictors of unmet needs. METHODS: This was an observational cross-sectional study using a modified version of the Supportive Care Needs Survey 34 item short form (SCNS-SF34). RESULTS: Two hundred and forty adult cancer survivors completed the study questionnaire. The assessed needs were highest in the financial domain, including covering living expenses, managing cancer treatment adverse effects and co-morbidities. The least prevalent reported needs were in sexuality and reproductive consultations. Late-stage diagnosis was independently associated with higher physical, psychological, health system/information, financial and overall need scores, with p-values of 0.032, 0.027, 0.052, 0.002 and 0.024, respectively. The overall quality of life score was independently and inversely associated with physical, psychological, health system/information, financial and overall need domains, with p-values of 0.015, <0.0001, 0.015, 0.004 and 0.0003, respectively. CONCLUSIONS: This needs assessment identified problem areas for targeting interventions across the Jordanian cancer survivor population, and understanding these findings highlights opportunities for intervention to address gaps in care.

Waterpipe Smoking among Bladder Cancer Patients: A Cross-Sectional Study of Lebanese and Jordanian Populations.

BACKGROUND: Bladder cancer (BC) is the second most reported cancer in Lebanon and the fifth in Jordan. Its risk factors are mainly smoking and occupational exposure to aromatic amines. In these countries where smoking and bladder cancer are highly prevalent, the role of waterpipe smoking (WPS) in bladder cancer is less investigated. We aim to compare two sets of patients between Lebanon and Jordan, focusing on their smoking habits, WP use, occupational exposure, and the grade/invasiveness of their bladder cancer. METHODS: This is a cross-sectional study that compares the smoking culture between two sets of populations with bladder cancer, from two different countries. We recruited 274 bladder cancer patients over the 18 years of age at the American University of Beirut Medical Center (AUBMC), and 158 bladder cancer patients over the age of 18 years at the King Hussein Cancer Center (KHCC). RESULTS: 7.7% of Lebanese patients had significantly more positive family history of bladder cancer compared to 13.9% of Jordanian patients (p = 0.045). Another significant finding is that the majority of Lebanese patients 70.7% reported being frequently exposed to secondhand smoking, mainly cigarettes, versus only 48.6% of Jordanian patients (p < 0.001). The increasing smoking trend among Lebanese females is remarkably the highest in the region, which contributed to the overall increase in smoking rates in the country. 17.1% of the Lebanese smoking patients are mainly but not exclusively WP smokers of which 6.3% are daily WP smokers, similarly 17.1% of the Jordanian patients of which 3.2% are daily WP smokers. There were 71.5% of Lebanese patients who had a noninvasive BC versus 40% of Jordanian patients (p < 0.001), and more than one-third reported an occupational exposure to one of the risk factors of BC in both groups. CONCLUSIONS: Bladder cancer incidence is on the rise in both Jordan and Lebanon along with different smoking types. It is necessary to impose prevention policies to prevent and control the high smoking prevalence. Bladder cancer invasiveness is higher in Jordan compared to universal data.

Spiritual Beliefs of Jordanian Adult Patients Receiving Palliative Care.

This study aimed to explore spiritual beliefs held by Jordanian patients receiving palliative care. In order to accomplish this aim, three objectives were specified: 1) identify the spiritual beliefs of adult patients receiving palliative care, 2) to develop an Arabic version of the beliefs and values scale, and 3) to identify the perception of spirituality of adult patients receiving palliative care. Cross-sectional descriptive research design was used to describe the spiritual beliefs. The response rate was 70%; non-probability convenience sampling method was used for (N = 119) adult palliative patients who are receiving care at specialized oncology Center in Jordan. The findings revealed that the spirituality religious beliefs aspect total mean score (3.38 ± .33) was higher than the spirituality non-religious beliefs aspect total mean score (2.49 ± .50). There was a significant impact on enhancing spirituality score with patient who had attended a course about spirituality (p = .007) or had been visited by religious adviser (p = .022). Statistically significant differences were found between the religious beliefs score and age (p = .014), educational level (p = .015), and the patient who had attended a course about spirituality (p = .27). The conceptualizations of spirituality highly cultural are marked, and it differs from populations to others; it appears that spirituality among Middle East population is different than Western populations.

Disclosure of medical errors: physicians' knowledge, attitudes and practices (KAP) in an oncology center.

BACKGROUND: Between the need for transparency in healthcare, widely promoted by patient's safety campaigns, and the fear of negative consequences and malpractice threats, physicians face challenging decisions on whether or not disclosing medical errors to patients and families is a valid option. We aim to assess the knowledge, attitudes and practices (KAP) of physicians in our center regarding medical error disclosure. METHODS: This is a cross-sectional self-administered questionnaire study. The questionnaire was piloted and no major modifications were made. A day-long training workshop consisting of didactic lectures, short and long case scenarios with role playing and feedback from the instructors, were conducted. Physicians who attended these training workshops were invited to complete the questionnaire at the end of the training, and physicians who did not attend any training were sent a copy of the questionnaire to their offices to complete. To assure anonymity and transparency of responses, we did not query names or departments. Descriptive statistics were used to present demographics and KAP. The differences between response\s of physicians who received the training and those who did not were analyzed with t-test and descriptive statistics. The 0.05 level of significance was used as a cutoff measure for statistical significance. RESULTS: Eighty-eight physicians completed the questionnaire (55 attended training (62.50%), and 33 did not (37.50%)). Sixty Five percent of physicians were males and the mean number of years of experience was 16.5 years. Eighty-Seven percent (n = 73) of physicians were more likely to report major harm, compared to minor harm or no harm. Physicians who attended the workshop were more knowledgeable of articles of Jordan's Law on Medical and Health Liability (66.7% vs 45.5%, p-value = 0.017) and the Law was more likely to affect their decision on error disclosure (61.8% vs 36.4%, p-value = 0.024). CONCLUSION: Formal training workshops on disclosing medical errors have the power to positively influence physicians' KAP toward disclosing medical errors to patients and possibly promoting a culture of transparency in the health care system.

The Fair Allocation of Scarce Medical Resources: A Comparative Study From Jordan.

The allocation strategies during challenging situations among the different social groups is based on 9 principles which can be considered either individually: sickest first, waiting list, prognosis, youngest first, instrumental values, lottery, monetary contribution, reciprocity, and individual behavior, or in combination; youngest first and prognosis, for example. In this study, we aim to look into the most important prioritization principles amongst different groups in the Jordanian population, in order to facilitate the decision-making process for any potential medical crisis. We conducted an online survey that tackled how individuals would deal with three different scenarios of medical scarcity: (1) organ donation, (2) limited hospital beds during an influenza epidemic, and (3) allocation of novel therapeutics for lung cancer. In addition, a free-comment option was included at the end of the survey if respondents wished to contribute further. Seven hundred and fifty-four survey responses were gathered, including 372 males (49.3%), and 382 females (50.7%). Five groups of individuals were represented including religion scholars, physicians, medical students, allied health practitioners, and lay people. Of the five surveyed groups, four found "sickest-first" to be the most important prioritization principle in all three scenarios, and only the physicians group documented a disagreement. In the first scenario, physicians regarded "sickest-first" and "combined-criteria" to be of equal importance. In general, no differences were documented between the examined groups in comparison with lay people in the preference of options in all three scenarios; however, physicians were more likely to choose "combination" in both the second and third scenarios (OR 3.70, 95% CI 1.62-8.44, and 2.62, 95% CI 1.48-4.59; p < 0.01), and were less likely to choose "sickest-first" as the single most important prioritization principle (OR 0.57, CI 0.37-0.88, and 0.57; 95% CI 0.36-0.88; p < 0.01). Out of 100 free comments, 27 (27.0%) thought that the "social-value" of patients should also be considered, adding the 10th potential allocation principle. Our findings are concordant with literature in terms of allocating scarce medical resources. However, "social-value" appeared as an important principle that should be addressed when prioritizing scarce medical resources in Jordan.

Fertility counseling and sperm banking among adolescents and adults treated for cancer with curative intent in a developing country.

PURPOSE: In developing countries, a higher percentage of patients develop cancer at a younger age. Cancer survival rates have significantly improved, highlighting the importance of survivorship programs that address late complications related to cancer itself or its treatment. The purpose of this study is to estimate the prevalence of fertility counseling and sperm banking and related factors among at-risk males newly diagnosed with cancer and planning to receive a potentially curative anticancer therapy. METHODS: Medical records and hospital database of young male patients with newly diagnosed cancers and planned to start chemotherapy were reviewed for fertility counseling and sperm cryopreservation. Additionally, a self-administered questionnaire was utilized. RESULTS: A total of 186 patients, mean age 32.9 (range: 18-53) years, were included. Non-Hodgkin's lymphoma 59 (31.7%), leukemia 48 (25.8%), and Hodgkin's lymphoma 26 (14.0%) were the most common tumors encountered. A total of 129 (75.0%) respondents received fertility counseling prior to their treatment, and this rate was higher among patients with early-stage disease (82.4% vs. 58.1%, p = 0.038). However, sperm banking was performed by 33.1% of the whole study group but was significantly higher among single patients (53.4% vs. 17.7%, p < 0.001), those who had no children (51.8% vs. 14.3%, p < 0.001), and among highly educated patients (47.6% vs. 17.1%, p = 0.001). Patients failed to do sperm banking because they were not informed about the risk of infertility (26.2%) or service availability (25.4%). Fear of treatment delay was a reason in 20.0%. CONCLUSIONS: Fertility counseling and sperm banking among cancer patients are not optimal. Many patients failed to do sperm banking because of avoidable reasons. Better communication and patients' education will probably improve the utilization of this vital service.

Global celebrities' effect on health awareness among Jordanians: A study using the case of Angelina Jolie.

Celebrities' health decisions have long been associated with heightened awareness and health trend changes. This is the first study conducted in an Arab population investigating the impact of international celebrity news on local communities using the case of Angelia Jolie's (AJ) prophylactic mastectomy and oophorectomy surgeries. The objective was to measure the effect of publicized medical information on cancer genetic testing knowledge, attitudes, and practices (KAP). This is a cross-sectional study using a semi-structured, self-administered questionnaire for clinic visitors at the King Hussein Cancer Center (KHCC). We had predominantly female (n = 262, 66.3%) and healthy participants (n = 248, 66.5%). Approximately 80.7% (n = 330) recognized AJ, the actress, and of these, 71% (n = 232) were aware of her recent diagnosis and prophylactic surgeries. Males reported a higher knowledge score (p < .001). However, females had more initiative to seek information (18.3% vs. 10.1%; p = .04). People aware of Angelina's prophylactic procedures were inclined to seek information regarding cancer genetics (20.8% vs. 9.6% p = .003). Breast and ovarian cancer patients were more likely than other cancer patients to encourage family members to undergo prophylactic surgery in case of BRCA1/2 mutations (39.2% vs. 17.1% p = .03). Ninety-three percent of the sample lacked knowledge regarding the availability of cancer genetic testing in Jordan. Results highlight a clear effect of celebrity medical news on our population, as well as openness to consider genetic testing as an early detection tool for women with a family history of breast and/or ovarian cancer. Generalization of these results to the population of Jordan requires further studies.

Oral contraceptive and breast cancer: do benefits outweigh the risks? A case - control study from Jordan.

BACKGROUND: Oral contraceptives (OCs) use has been linked to increased risk of breast cancer (BC) in several reports from the world. Limited number of similar studies have been conducted in the Middle Eastern female population. This study aimed to explore any possible correlation between the contemporary and duration of OCs use among Jordanian women and the risk of breast cancer. METHODS: A case control study was conducted in 450 Jordanian women (225 as cases and 225 as controls), aged 18 to 65. Chi-square test was used to study the association between risk of breast cancer and different factors. Mann Whitney-U test was employed to evaluate the relation between time-dependent risk factor and breast cancer. RESULTS: Our results indicated that regular use of OCs exhibited association with increased risk of breast cancer (OR = 2.25, 95% CI 1.34-2.79; p = 0.002), while the duration of OCs use was not associated with the increased risk of breast cancer (p > 0.05). In addition, other factors demonstrated significant association with the increased risk of breast cancer such as age at puberty, age at menopause, previous pregnancies, menopausal status, and family history of cancer. CONCLUSIONS: regular use of OCs may be associated with increased risk of breast cancer in Jordanian women. A larger sample size in multi-center setting study is required to confirm this finding among the Jordanian female population.