Awareness of Palestinian Women About Breast Cancer Risk Factors: A National Cross-Sectional Study
Mohamedraed Elshami, Faten Darwish Usrof, Mohammed Alser, Ibrahim Al‐Slaibi, Heba Mahmoud Okshiya, Roba Jamal Ghithan, Nouran Ramzi Shaban Shurrab, Islam Osama Ismail, Ibtisam Ismail Mahfouz, Aseel AbdulQader Fannon, Malak Ayman Mousa Qawasmi, Mona Radi Mohammad Hawa, Narmeen Giacaman, Manar Ahmaro, Rula Khader Zaatreh, Wafa Aqel, Noor Khairi Melhim, Ruba Jamal Madbouh, Hala Jamal Abu Hziema, Raghad Abed-Allateef Lahlooh, Sara Nawaf Ubaiat, Nour Ali Jaffal, Reem Khaled Alawna, Salsabeel Naeem Abed, Bessan Nimer Ali Abuzahra, Aya Jawad Abu Kwaik, Mays Hafez Dodin, Raghad Othman Taha, Dina Mohammed Alashqar, Roaa Abd-al-Fattah Mobarak, Tasneem Smerat, Nasser Abu-El-Noor, Bettina Böttcher
Abstract
PURPOSE This study aimed to assess awareness of Palestinian women about breast cancer (BC) age-related and lifetime risks and its risk factors and to identify factors associated with good awareness. MATERIALS AND METHODS Adult women were recruited from government hospitals, primary health care centers, and public spaces in 11 governorates in Palestine. Recognition of 14 BC risk factors was assessed using a translated-into-Arabic version of the validated BC awareness measure. The level of BC risk factor awareness was determined on the basis of the number of risk factors recognized: poor (0-4), fair (5-9), and good (10-14). RESULTS Of 6,269 potential participants approached, 5,434 agreed and completed the questionnaire (response rate = 86.7%). A total of 5,257 questionnaires were included: 2,706 from the West Bank and Jerusalem and 2,551 from the Gaza Strip. Only 173 participants (3.3%) recognized the age-related risk of BC. More than one quarter (n = 1,465; 27.9%) recognized the lifetime risk of BC. The most recognized modifiable risk factor was not breastfeeding (n = 4,937; 93.9%), whereas the least recognized was having children later on in life or not at all (n = 1,755; 33.4%). The most recognized nonmodifiable risk factor was radiation exposure (n = 4,579; 87.1%), whereas the least recognized was starting the periods at an early age (n = 1,030; 19.6%). In total, 2,024 participants (38.4%) demonstrated good BC risk factor awareness. Participants from the Gaza Strip had a higher likelihood than participants from the West Bank and Jerusalem to have good awareness (42.0% v 35.2%). Age ≥ 40 years, postsecondary education, and visiting hospitals and primary health care centers were all associated with an increase in the likelihood of having good BC risk factor awareness. CONCLUSION The awareness of BC risk factors was suboptimal. These findings highlight the need for implementing health education programs combined with consistent use of ad hoc opportunities to raise awareness by health care providers.