Women in Ayfon, Turkey wield an impressive knowledge of breast cancer, but screening compliance remains low, according to researchers from the Afyon Kocatepe University School of Medicine.
Dr. Aylin Yucel and colleagues surveyed 298 women, ages 29-79, who had come to their department for a mammogram. They reported their results in a poster presentation at the 2003 RSNA meeting in Chicago.
All of the participants were from or near the city of Afyon, which is located south of Istanbul and has a population of about 150,000 people. The majority of the women were at the medical center on the advice of a family physician, Yucel explained to AuntMinnie.com.
The women were interviewed prior to their exam using a 100-point questionnaire. More than half of the study population (63.1%) was not employed outside the home, while 38.6% had an elementary school education.
Questions were asked about the perception of susceptibility to breast cancer, severity of the disease, barriers to cancer screening, and perceived benefits of mammography. The women’s knowledge of breast cancer risk factors and breast self-examination (BSE) were also assessed. Statistical analysis was done with a T-test.
"Unexpectedly, the mean score of correct answers to our questions was 50%," the authors wrote. More than half of the respondents were aware of breast cancer risk factors. More important, 93% said that they knew women should periodically undergo mammographic evaluation. Also, 87.6% stated that mammography can catch early occult cancer that may not be detected with a routine BSE or clinical breast exam (CBE).
Finally, 71% said they conducted a BSE on a regular basis, and their scores were higher than the women who did not (p=0.014).
"It was found that BSE was more prevalent among non-metro women. This indicates these women are sensitive to breast cancer issues but may not have ready access to mammography and CBE," the researchers said.
On the other hand, 47% had never had a mammogram and 37% said they believed x-ray mammography could cause cancer. Also, the number one reason for not having breast cancer screening was cost, especially among women without insurance. Other reasons for skipping screening were concerns about discomfort, shyness around a male doctor, and religious restrictions. The majority of Turkey’s population is Sunni Muslim (99.8%), according to the CIA World Factbook, which may discourage women from disrobing around even medical professionals, Yucel said.
One solution to the latter issue would be to "include husbands in cancer education programs...to support their wives and prevail upon them to undergo screening," the authors wrote.
The group concluded that while public service campaigns through Afyon’s local media have raised awareness about breast cancer among the female population, these education campaigns need to go one step further and encourage active participation.
"In the scope of education programs, it is necessary to reach women...who have low education levels, don’t work, and pass most of their time at home," they said. Yucel added that the university plans to expand its public awareness program in conjunction with a local TV station. A follow-up study will be necessary to see if breast cancer screening compliance has improved, she said.
By Shalmali Pal
AuntMinnie.com staff writer
December 26, 2003
Related Reading
Part I: Breast cancer screening in Romania, October 21, 2003
Part II: Breast cancer screening in India, October 22, 2003
Part III: Breast cancer screening in Mexico, October 23, 2003
Racial disparities in breast cancer outcomes spark research, October 10, 2003
Doctors skip breast exam before mammo referral, April 24, 2002
Copyright © 2003 AuntMinnie.com
