Knowledge of Breast Cancer and its Association with Preventive Practice Among Malaysian School Teachers
Keywords:Breast Cancer, Breast Self- Examination, Clinical Breast Examination, Malaysia
Objective: The study aim was to investigate the association betweenÂ knowledge of breast cancer and practice of breast self-examination
(BSE) and having clinical breast examination (CBE) in a crosssectionalÂ sample of 700 Malaysian secondary school teachers.
Methodology: A two-stage sampling frame was used; a simpleÂ random sample of 10 out of 24 schools was selected and all teachersÂ within those schools were invited to participate. The followingÂ data were collected using a self-administered questionnaire (i) sociodemographicÂ data, (ii) five knowledge categories: general knowledgeÂ of breast cancer, signs and symptoms, risk factors, mammography,Â recommended frequency of BSE and CBE, and (iii) practiceof BSE and
Results: The response rate was 74% (518/700). Level of exerciseÂ was associated with BSE (p=0.02) and CBE (p=0.01), with exerciseÂ twice a week showing the strongest association compared to neverÂ exercising, OR=2.71 (95% CI=1.38-5.33, p=0.004) for BSE, OR=2.40Â (95% CI=1.27-4.55, p=0.007) for CBE. Self-report of having an annualÂ medical check up was associated with BSE, OR=2.13, (95% CI=1.29-Â 3.52, p<001) and CBE, OR=2.41, (95% CI=1.57-3.70, p<001). LikelihoodÂ of practicing BSE improved with increasing total knowledgeÂ score (quartiles) in a dose dependent manner, Q2, OR =1.78 (95% CI
0.97-3.27), Q3OR =1.89 (95% CI 1.06-3.36), Q4OR =2.2 (95% CI 1.15-Â 3.91, p=0.02) compared to the lowest quartile Q1 when adjusted forexercise
and annual checkup. Knowledge of symptoms and signs wasÂ associated with BSE practice, OR =1.25 (95% CI 1.06-1.48, p=0.009)Â and CBE, OR =1.3 (95% CI 1.08-1.57, p=0.005) having adjusted forÂ exercise and annual checkup (BSE and CBE) and age and marital statusÂ (CBE). General knowledge was also positively associated with BSE,Â OR=1.39 (95% CI 1.07-1.81, p=0.01) after adjustment though not withÂ CBE (p=0.41). Knowledge of mammography was inversely associated with BSE however the association was not statistically significant OR =0.77 (95% CI 0.56-1.05, p=0.10).
Conclusion: Correct knowledge of symptoms and signs of breastÂ cancer is the most important factor associated with BSE and CBE inÂ Malaysian women after adjustment for other positive health behaviors.Â Knowledge of risk factors, mammography and recommended frequencyÂ of BSE and CBE were not associated with practice of BSE and CBE.
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