Document Type : Original Article

Authors

1 Forensic Medicine and Toxicology, Zabol University of Medical Science, Zabol, Iran

2 Department of Social Medicine, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran

3 Department of Internal Medicine, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran

Abstract

Based on the lack of acceptance of screening programs, including breast cancer screening, and cultural-social and economic differences in different regions of our country, the purpose of this research is to determine the attitudinal barriers to breast cancer mammographic screening among women of Zabol city. The study method is cross-sectional and descriptive-analytical. The statistical population includes 200 women aged over 40 years in Zabol city in 2020 who have not had mammography and were selected by census. The standard questionnaire of professional ethics criteria was used to collect research data. The study data were analyzed using SPSS software. In this study, 200 women were questioned. 5% of women were single and 85.5% were married. 56% of the surveyed women were housewives and 82% employed. 13.5% of women were illiterate and 44.5% university education. The most frequent attitudinal barriers among women were related to the barrier "not having breast cancer symptoms" and "mammography performed by male staff and physicians" so that these two factors were agreed by 75.5% and 49.5% of women, respectively. On the other hand, the lowest frequency of the above factors is related to the three factors "The lack of diagnostic significance of mammography in early cancer diagnosis" with 6% agree and completely agree, and "Not trusting mammography" and "Not trusting national policies and guidelines” with 9% agree and completely agree. Our study revealed the most important factors of reducing motivation among women in the Sistan region regarding mammography. Also, this study showed that women's employment, education and economic status can be effective in their attitude towards mammography.

Graphical Abstract

Investigating attitudinal barriers to breast cancer mammography screening among women in Zabol city

Keywords

Main Subjects

ِ
Dr. Soleyman Saravani
Zabol University of Medical sciences

Google Scholar

Open Access

This article is licensed under a CC BY License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit: http://creativecommons.org/licenses/by/4.0/

 

Publisher’s Note

CMBR journal remains neutral with regard to jurisdictional claims in published maps and institutional afflictions.

 

Letters to Editor

Given that CMBR Journal's policy in accepting articles will be strict and will do its best to ensure that in addition to having the highest quality published articles, the published articles should have the least similarity (maximum 15%). Also, all the figures and tables in the article must be original and the copyright permission of images must be prepared by authors. However, some articles may have flaws and have passed the journal filter, which dear authors may find fault with. Therefore, the editor of the journal asks the authors, if they see an error in the published articles of the journal, to email the article information along with the documents to the journal office.

CMBR Journal welcomes letters to the editor ([email protected], [email protected]) for the post-publication discussions and corrections which allows debate post publication on its site, through the Letters to Editor. Critical letters can be sent to the journal editor as soon as the article is online. Following points are to be considering before sending the letters (comments) to the editor.

[1] Letters that include statements of statistics, facts, research, or theories should include appropriate references, although more than three are discouraged.

[2] Letters that are personal attacks on an author rather than thoughtful criticism of the author’s ideas will not be considered for publication.

[3] There is no limit to the number of words in a letter.

[4] Letter writers should include a statement at the beginning of the letter stating that it is being submitted either for publication or not.

[5] Anonymous letters will not be considered.

[6] Letter writers must include Name, Email Address, Affiliation, mobile phone number, and Comments.

[7] Letters will be answered as soon as possible.

  1. Fazeli-Nasab B, Sayyed RZ, Sobhanizadeh A (2021) In Silico Molecular Docking Analysis of α-Pinene: An Antioxidant and Anticancer Drug Obtained from Myrtus communis. Int J Cancer Manag 14 (2): e89116. doi: https://doi.org/10.5812/ijcm.89116
  2. Cronin KA, Lake AJ, Scott S, Sherman RL, Noone AM, Howlader N, Henley SJ, Anderson RN, Firth AU, Ma J, Kohler BA, Jemal A (2018) Annual Report to the Nation on the Status of Cancer, part I: National cancer statistics. Cancer 124 (13): 2785-2800. doi: https://doi.org/10.1002/cncr.31551
  3. DeSantis CE, Ma J, Goding Sauer A, Newman LA, Jemal A (2017) Breast cancer statistics, 2017, racial disparity in mortality by state. CA Cancer J Clin 67 (6): 439-448. doi: https://doi.org/10.3322/caac.21412
  4. Dyba T, Randi G, Bray F, Martos C, Giusti F, Nicholson N, Gavin A, Flego M, Neamtiu L, Dimitrova N, Negrao Carvalho R, Ferlay J, Bettio M (2021) The European cancer burden in 2020: Incidence and mortality estimates for 40 countries and 25 major cancers. European journal of cancer (Oxford, England : 1990) 157: 308-347. doi: https://doi.org/10.1016/j.ejca.2021.07.039
  5. Prabhu VS, Bansal N, Liu Z, Finalle R, Senecal M, Kothari S, Trowers K, Myers E (2021) HPV vaccination uptake and administration from 2006 to 2016 in a commercially insured population of the United States. BMC Public Health 21 (1): 1629. doi: https://doi.org/10.1186/s12889-021-11664-1
  6. Charkazi A, Ghourchaei A, RazzaqNejad A (2013) Knowledge, practice and perceived threat toward breast cancer in the women living in Gorgan, Iran. Journal of Research Development in Nursing and Midwifery 10 (1): 25-32. doi:
  7. Ghasemi S, Mahaki B, Dreassi E, Aghamohammadi S (2020) Spatial Variation in Lung Cancer Mortality and Related Men-Women Disparities in Iran from 2011 to 2014. Cancer Manag Res 12: 4615-4624. doi: https://doi.org/10.2147/cmar.s247178
  8. Mousavi SM, Gouya MM, Ramazani R, Davanlou M, Hajsadeghi N, Seddighi Z (2009) Cancer incidence and mortality in Iran. Annals of Oncology 20 (3): 556-563. doi: https://doi.org/10.1093/annonc/mdn642
  9. Cao W, Chen HD, Yu YW, Li N, Chen WQ (2021) Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020. Chin Med J (Engl) 134 (7): 783-791. doi: https://doi.org/10.1097/cm9.0000000000001474
  10. Lei S, Zheng R, Zhang S, Chen R, Wang S, Sun K, Zeng H, Wei W, He J (2021) Breast cancer incidence and mortality in women in China: temporal trends and projections to 2030. Cancer biology & medicine 18 (3): 900-909. doi: https://doi.org/10.20892/j.issn.2095-3941.2020.0523
  11. Harirchi I, Kolahdoozan S, Karbakhsh M, Chegini N, Mohseni SM, Montazeri A, Momtahen AJ, Kashefi A, Ebrahimi M (2011) Twenty years of breast cancer in Iran: downstaging without a formal screening program. Annals of Oncology 22 (1): 93-97. doi: https://doi.org/10.1093/annonc/mdq303
  12. Ginsburg O, Yip CH, Brooks A, Cabanes A, Caleffi M, Dunstan Yataco JA, Gyawali B, McCormack V, McLaughlin de Anderson M, Mehrotra R, Mohar A, Murillo R, Pace LE, Paskett ED, Romanoff A, Rositch AF, Scheel JR, Schneidman M, Unger-Saldana K, Vanderpuye V, Wu TY, Yuma S, Dvaladze A, Duggan C, Anderson BO (2020) Breast cancer early detection: A phased approach to implementation. Cancer 126 Suppl 10 (Suppl 10): 2379-2393. doi: https://doi.org/10.1002/cncr.32887
  13. Bretthauer M, Kalager M (2013) Principles, effectiveness and caveats in screening for cancer. Journal of British Surgery 100 (1): 55-65. doi: https://doi.org/10.1002/bjs.8995
  14. Yeh JM, Lowry KP, Schechter CB, Diller LR, Alagoz O, Armstrong GT, Hampton JM, Leisenring W, Liu Q, Mandelblatt JS, Miglioretti DL, Moskowitz CS, Oeffinger KC, Trentham-Dietz A, Stout NK (2020) Clinical Benefits, Harms, and Cost-Effectiveness of Breast Cancer Screening for Survivors of Childhood Cancer Treated With Chest Radiation : A Comparative Modeling Study. Ann Intern Med 173 (5): 331-341. doi: https://doi.org/10.7326/m19-3481
  15. Al-Mousa DS, Alakhras M, Spuur KM, Alewaidat H, Abdelrahman M, Rawashdeh M, Brennan PC (2020) The implications of increased mammographic breast density for breast screening in Jordan. Journal of medical radiation sciences 67 (4): 277-283. doi: https://doi.org/10.1002/jmrs.414
  16. Bolejko A, Hagell P, Wann-Hansson C, Zackrisson S (2015) Prevalence, Long-term Development, and Predictors of Psychosocial Consequences of False-Positive Mammography among Women Attending Population-Based Screening. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 24 (9): 1388-1397. doi: https://doi.org/10.1158/1055-9965.epi-15-0060
  17. Ho PJ, Wong FY, Chay WY, Lim EH, Lim ZL, Chia KS, Hartman M, Li J (2021) Breast cancer risk stratification for mammographic screening: A nation-wide screening cohort of 24,431 women in Singapore. Cancer Med 10 (22): 8182-8191. doi: https://doi.org/10.1002/cam4.4297
  18. Kopans DB (2021) A history of DMIST and its implications - Limited resources should be better spent. Clin Imaging 78: 301-303. doi: https://doi.org/10.1016/j.clinimag.2021.06.005
  19. Mascara M, Constantinou C (2021) Global Perceptions of Women on Breast Cancer and Barriers to Screening. Current oncology reports 23 (7): 74. doi: https://doi.org/10.1007/s11912-021-01069-z
  20. Yaya S, Zegeye B, Ahinkorah BO, Seidu AA, Ameyaw EK, Adjei NK, Shibre G (2021) Predictors of skilled birth attendance among married women in Cameroon: further analysis of 2018 Cameroon Demographic and Health Survey. Reprod Health 18 (1): 70. doi: https://doi.org/10.1186/s12978-021-01124-9
  21. Trigoni M, Griffiths F, Tsiftsis D, Koumantakis E, Green E, Lionis C (2008) Mammography screening: views from women and primary care physicians in Crete. BMC Women's Health 8: 1-12. doi: https://doi.org/10.1186/1472-6874-8-20
  22. Donato F, Bollani A, Spiazzi R, Soldo M, Pasquale L, Monarca S, Lucini L, Nardi G (1991) Factors associated with non-participation of women in a breast cancer screening programme in a town in northern Italy. Journal of Epidemiology & Community Health 45 (1): 59-64. doi: http://dx.doi.org/10.1136/jech.45.1.59
  23. Rezaee Ghazdehi M, Amini L, Parvizi S, Hoseyni AF (2013) Attitudinal Barriers to Mammography Screening among Women in Tehran. Journal of Mazandaran University of Medical Sciences 23 (99): 69-75. doi:
  24. Carles M, Martinez-Alonso M, Pons A, Perez-Lacasta MJ, Perestelo-Perez L, Sala M, Vidal C, Garcia M, Toledo-Chavarri A, Codern N, Feijoo-Cid M, Romero A, Pla R, Soler-Gonzalez J, Castells X, Rue M (2017) The effect of information about the benefits and harms of mammography on women's decision-making: study protocol for a randomized controlled trial. Trials 18 (1): 426. doi: https://doi.org/10.1186/s13063-017-2161-7
  25. Nazzal Z, Sholi H, Sholi SB, Sholi MB, Lahaseh R (2018) Motivators and barriers to mammography screening uptake by female health-care workers in primary health-care centres: a cross-sectional study. Lancet 391 Suppl 2: S51. doi: https://doi.org/10.1016/s0140-6736(18)30417-3
  26. Solbjor M (2018) The Storting debates about mammography screening in 1998. Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke 138 (10). doi: https://doi.org/10.4045/tidsskr.17.1049
  27. Tejeda S, Thompson B, Coronado GD, Martin DP (2009) Barriers and facilitators related to mammography use among lower educated Mexican women in the USA. Social Science & Medicine 68 (5): 832-839. doi: https://doi.org/10.1016/j.socscimed.2008.12.023
  28. Zapka JG, Stoddard AM, Costanza ME, Greene HL (1989) Breast cancer screening by mammography: utilization and associated factors. American Journal of Public Health 79 (11): 1499-1502. doi: https://doi.org/10.2105/AJPH.79.11.1499
  29. McDonald ES, McCarthy AM, Akhtar AL, Synnestvedt MB, Schnall M, Conant EF (2015) Baseline Screening Mammography: Performance of Full-Field Digital Mammography Versus Digital Breast Tomosynthesis. AJR Am J Roentgenol 205 (5): 1143-1148. doi: https://doi.org/10.2214/ajr.15.14406
  30. Canelo-Aybar C, Ferreira DS, Ballesteros M, Posso M, Montero N, Sola I, Saz-Parkinson Z, Lerda D, Rossi PG, Duffy SW, Follmann M, Grawingholt A, Alonso-Coello P (2021) Benefits and harms of breast cancer mammography screening for women at average risk of breast cancer: A systematic review for the European Commission Initiative on Breast Cancer. J Med Screen 28 (4): 389-404. doi: https://doi.org/10.1177/0969141321993866
  31. Moodi M, Rezaeian M, Mostafavi F, Sharifirad G-R (2012) Determinants of mammography screening behavior in Iranian women: A population-based study. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences 17 (8): 750-759. doi: https://pubmed.ncbi.nlm.nih.gov/23798942
  32. Alexandraki I, Mooradian AD (2010) Barriers Related to Mammography Use for Breast Cancer Screening Among Minority Women. Journal of the National Medical Association 102 (3): 206-218. doi: https://doi.org/10.1016/S0027-9684(15)30527-7
  33. Lopez EDS, Khoury AJ, Dailey AB, Hall AG, Chisholm LR (2009) Screening Mammography: A Cross-Sectional Study to Compare Characteristics of Women Aged 40 and Older From the Deep South Who Are Current, Overdue, and Never Screeners. Women's Health Issues 19 (6): 434-445. doi: https://doi.org/10.1016/j.whi.2009.07.008
  34. Murabito JM, Evans JC, Larson MG, Kreger BE, Splansky GL, Freund KM, Moskowitz MA, Wilson PW (2001) Family breast cancer history and mammography: Framingham Offspring Study. American journal of epidemiology 154 (10): 916-923. doi: https://doi.org/10.1093/aje/154.10.916
  35. Vogel VG, Graves DS, Vernon SW, Lord JA, Winn RJ, Peters GN (1990) Mammographic screening of women with increased risk of breast cancer. Cancer 66 (7): 1613-1620. doi: https://doi.org/10.1002/1097-0142(19901001)66:7%3C1613::AID-CNCR2820660728%3E3.0.CO;2-E
  36. Kaplan KM, Weinberg GB, Small A, Herndon JL (1991) Breast cancer screening among relatives of women with breast cancer. American Journal of Public Health 81 (9): 1174-1179. doi: https://doi.org/10.2105/AJPH.81.9.1174
  37. Chiarelli AM, Blackmore KM, Mirea L, Done SJ, Majpruz V, Weerasinghe A, Rabeneck L, Muradali D (2020) Annual vs Biennial Screening: Diagnostic Accuracy Among Concurrent Cohorts Within the Ontario Breast Screening Program. J Natl Cancer Inst 112 (4): 400-409. doi: https://doi.org/10.1093/jnci/djz131
  38. Kassabian M, Olowolaju S, Akinlotan MA, Lichorad A, Pope R, Williamson B, Horel S, Bolin JN (2021) The association between rurality, sociodemographic characteristics, and mammogram screening outcomes among a sample of low-income uninsured women. Preventive medicine reports 24: 101645. doi: https://doi.org/10.1016/j.pmedr.2021.101645