Women's knowledge about risk factors of breast cancer in a Brazilian community.

Knowledge about risk factors for breast cancer was identified as an important variable that affects women's avoidance behavior and their screening performance. The present study assessed women's knowledge about risk factors and associated socio-economic variables. Data from 417 women aged 20-86 years were obtained in Caicó, Rio Grande do Norte, Brazil. In agreement with the recognition of 26 potential risk factors and prevention behaviors, two groups with good (N = 203) and poor (N = 214) knowledge were formed, respectively. Having a close relative with cancer remained the unique significant variable in the adjusted model. Women without any close relative with cancer, were 1.54 (95% confidence interval [CI] 1.036-2.288) times as likely to have poor knowledge, compared to women who had a close relative with cancer (p = 0.033). Other socio-economic variables, including income, employment status and educational level had no significant association with knowledge (p = 0.450, p = 0.914, p = 0.639, respectively). Of 417 women, 302 (72.42%), 339 (81.29%), and 309 (74.10%), respectively, did not identify "physical inactivity," "overweight after menopause," and "no breastfeeding of children" as risk factors. Knowledge could help to avoid risk factors and motivate prevention behavior. Information about risk factors should be disseminated in health campaigns.

Risk factors of breast cancer and knowledge about the disease: an integrative revision of Latin American studies.

The aim of this integrative review was to compare Latin American literature about risk and knowledge on breast cancer. Of 47 studies selected, 20 were about knowledge or awareness and 27 about risk of breast cancer. English was the dominant language in studies about risk, whereas studies about knowledge were mainly written in Spanish or Portuguese. Studies about knowledge were all cross- sectional, whereas case- control studies dominated authors' interest about risk of breast cancer. Studies about knowledge were mainly focused on early detection of the disease and the most common study objective was breast self- examination (N = 14). In contrast, few studies about risk of breast cancer focused on early detection (N = 5). Obesity and overweight (N = 14), family history (N = 13), decreased parity (N = 12), and short breastfeeding duration (N = 10) were among the most frequent identified risk factors. Socio- economic factors such as income and educational level had variable effects on breast cancer risk and affected also knowledge of women about risk factors and early detection. Present results indicated that studies about risk of breast cancer were more often based on a better sound analytical background, compared to studies about knowledge, which were mostly descriptive.

Risk factors of breast cancer and knowledge about the disease: an integrative revision of Latin American studies / Fatores de risco do câncer de mama e o conhecimento sobre a doença: revisão integrativa de estudos Latino Americanos

Abstract The aim of this integrative review was to compare Latin American literature about risk and knowledge on breast cancer. Of 47 studies selected, 20 were about knowledge or awareness and 27 about risk of breast cancer. English was the dominant language in studies about risk, whereas studies about knowledge were mainly written in Spanish or Portuguese. Studies about knowledge were all cross- sectional, whereas case- control studies dominated authors’ interest about risk of breast cancer. Studies about knowledge were mainly focused on early detection of the disease and the most common study objective was breast self- examination (N = 14). In contrast, few studies about risk of breast cancer focused on early detection (N = 5). Obesity and overweight (N = 14), family history (N = 13), decreased parity (N = 12), and short breastfeeding duration (N = 10) were among the most frequent identified risk factors. Socio- economic factors such as income and educational level had variable effects on breast cancer risk and affected also knowledge of women about risk factors and early detection. Present results indicated that studies about risk of breast cancer were more often based on a better sound analytical background, compared to studies about knowledge, which were mostly descriptive.

Resumo Esta revisão teve por objetivo comparar a literatura Latino-Americana sobre o conhecimento da neoplasia mamária e seus fatores de risco. Foram selecionados 47 estudos, dos quais 27 eram sobre o risco de desenvolver câncer de mama e 20 sobre o conhecimento ou a consciência sobre a doença. Os estudos sobre fatores de risco eram principalmente do tipo caso-controle e sua maioria estava no idioma Inglês. Já as pesquisas sobre conhecimento eram, sobretudo, do tipo transversal e foram publicadas nos idiomas Português e Espanhol. As pesquisas sobre conhecimento destacaram o diagnóstico precoce da neoplasia mamária, e o autoexame da mama foi o método de detecção mais abordado (N = 14). Por outro lado, os estudos sobre fatores de risco avaliaram, principalmente, sobrepeso (N = 14), historia familiar (N = 13), baixa paridade (N = 12) e curto período de amamentação (N = 10). Fatores socioeconômicos, como a renda e o nível educacional tiveram efeitos variáveis e afetaram também o conhecimento das mulheres sobre fatores de risco e detecção precoce. Os resultados da pesquisa indicaram que os estudos sobre fatores de risco do câncer de mama apresentaram melhor delineamento metodológico e fundamentação teórica, comparado com os estudos sobre conhecimento que foram na maioria dos casos descritivos.

Knowledge about Risk Factors for Breast Cancer and Having a Close Relative with Cancer Affect the Frequency of Breast Self-Examination Performance.

BACKGROUND: Breast cancer incidence and mortality rates are increasing in North-Eastern Brazil and the patients with the disease often presented at advanced stages. The present study was focused on identifying variables that affect women's frequency of breast self- examination (BSE) performance. MATERIALS AND METHODS: Data on BSE, socio-economic parameters and risk factors for breast cancer were obtained from 417 women from a community in North-Eastern Brazil by a self-informant method. To identify independent variables that affect frequency of BSE, nominal logistic regression analysis was performed. RESULTS: Of 417 women, 330 (79.3%) reported performing BSE. Compared to high-income women, BSE performance by low-income women every month was 7.69 (OD=0.130; CI 95%: 0.044- 0.0386; p=0.000) times lower. Women who did not live in a stable union performed BSE each month 2.73 (OD=0.366; CI 95%: 0.171-0.782; p=0.010) less often than those living in a stable union. BSE performance every month and every six months or every year by women with poor knowledge about risk factors for breast cancer was 3.195 (OD=0.313; CI 95%: 0.141- 0.695; p=0.004) times and 2.028 (OD=0.493; CI 95%: 0.248- 0.979; p=0.043) times lower, compared to women with good knowledge. Participants who had a close relative with cancer performed BSE every month and every six months or every year 2.132 (OD=0.469; CI 95%: 0.220-0.997; p=0.049) times and 2.337 (OD=0.428; CI 95%: 0.219-0.836; p=0.013) times less often, compared to those women without close relatives with cancer. CONCLUSIONS: The results of this study indicated that income, marital status, knowledge about risk factors and having a close relative with breast cancer, affect the frequency of BSE performance. Information about risk factors in public health campaigns could additionally strengthen avoidance behaviour and also motivate BSE performance.

Patient delays and system delays in breast cancer treatment in developed and developing countries.

Delays in treating breast cancer have been associated with a more advanced stage of the disease and a decrease in patient survival rates. The scope of this integrative review was to analyze the main causal factors and types of patient and system delays. The underlying causal factors of delays were compared among studies conducted in developing and developed countries. Of the 53 studies selected, 24 were carried out in developing countries and 29 in developed countries, respectively. Non-attribution of symptoms to cancer, fear of the disease and treatment and low educational level were the most frequent causes of patient delay. Less comprehensive health insurance coverage, older/younger age and false negative diagnosis tests were the three most common causal factors of system delay. The effects of factors such as age were not decisive per se and depended mainly on the social and cultural context. Some factors caused both patient delay and system delay. Studies conducted in developing countries identified more causal factors of patient delay and had a stronger focus on patient delay or the combination of both. Studies conducted in developed countries had a stronger focus on aspects of system delay during treatment and guidance of breast cancer patients in the health care system.

Patient delays and system delays in breast cancer treatment in developed and developing countries / O atraso de paciente e atraso de sistema no tratamento do câncer de mama nos países desenvolvidos e em desenvolvimento

AbstractDelays in treating breast cancer have been associated with a more advanced stage of the disease and a decrease in patient survival rates. The scope of this integrative review was to analyze the main causal factors and types of patient and system delays. The underlying causal factors of delays were compared among studies conducted in developing and developed countries. Of the 53 studies selected, 24 were carried out in developing countries and 29 in developed countries, respectively. Non-attribution of symptoms to cancer, fear of the disease and treatment and low educational level were the most frequent causes of patient delay. Less comprehensive health insurance coverage, older/younger age and false negative diagnosis tests were the three most common causal factors of system delay. The effects of factors such as age were not decisive per se and depended mainly on the social and cultural context. Some factors caused both patient delay and system delay. Studies conducted in developing countries identified more causal factors of patient delay and had a stronger focus on patient delay or the combination of both. Studies conducted in developed countries had a stronger focus on aspects of system delay during treatment and guidance of breast cancer patients in the health care system.

ResumoO atraso no tratamento de câncer de mama foi associado com o aumento do palco da doença e a diminuição da sobrevida do paciente. O objetivo desta revisão integrativa foi a analise dos principais fatores causais e dos tipos de atraso. Sendo estes comparados entre estudos de países em desenvolvimento e desenvolvidos. Dos 53 estudos selecionados, 24 eram de países em desenvolvimento e 29 de países desenvolvidos, respectivamente. A não atribuição dos sintomas ao câncer, o medo e a menor escolaridade foram as causas mais citadas do atraso de paciente ao tratamento. Seguro menos abrangente, idade e testes diagnósticos falsos negativos foram às causas mais comuns identificadas do atraso do sistema. O efeito de vários fatores como o fator idade, dependeu principalmente do contexto social e cultural. Alguns fatores causaram tanto atraso relacionado ao paciente quanto ao sistema. Os estudos dos países em desenvolvimento identificaram mais fatores causais do atraso relacionado ao paciente, focando mais forte neste referido fator ou na combinação com o de sistema. Enquanto estudos de países desenvolvidos enfocaram com maior frequência aspectos do atraso de sistema durante o tratamento e a orientação de pacientes no sistema de saúde.