Knowledge of Breast Cancer and its Association with Preventive Practice Among Malaysian School Teachers


  • Redhwan Ahmed Al-Naggar
  • Muhamed T Osman



Breast Cancer, Breast Self- Examination, Clinical Breast Examination, Malaysia


Objective: The study aim was to investigate the association between knowledge of breast cancer and practice of breast self-examination
(BSE) and having clinical breast examination (CBE) in a crosssectional sample of 700 Malaysian secondary school teachers.

Methodology: A two-stage sampling frame was used; a simple random sample of 10 out of 24 schools was selected and all teachers within those schools were invited to participate. The following data were collected using a self-administered questionnaire (i) sociodemographic data, (ii) five knowledge categories: general knowledge of breast cancer, signs and symptoms, risk factors, mammography, recommended frequency of BSE and CBE, and (iii) practiceof BSE and

Results: The response rate was 74% (518/700). Level of exercise was associated with BSE (p=0.02) and CBE (p=0.01), with exercise twice a week showing the strongest association compared to never exercising, OR=2.71 (95% CI=1.38-5.33, p=0.004) for BSE, OR=2.40 (95% CI=1.27-4.55, p=0.007) for CBE. Self-report of having an annual medical check up was associated with BSE, OR=2.13, (95% CI=1.29- 3.52, p<001) and CBE, OR=2.41, (95% CI=1.57-3.70, p<001). Likelihood of practicing BSE improved with increasing total knowledge 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- 3.91, p=0.02) compared to the lowest quartile Q1 when adjusted forexercise
and annual checkup. Knowledge of symptoms and signs was associated with BSE practice, OR =1.25 (95% CI 1.06-1.48, p=0.009) and CBE, OR =1.3 (95% CI 1.08-1.57, p=0.005) having adjusted for exercise and annual checkup (BSE and CBE) and age and marital status (CBE). General knowledge was also positively associated with BSE, OR=1.39 (95% CI 1.07-1.81, p=0.01) after adjustment though not with 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 breast cancer is the most important factor associated with BSE and CBE in Malaysian women after adjustment for other positive health behaviors. Knowledge of risk factors, mammography and recommended frequency of BSE and CBE were not associated with practice of BSE and CBE.