Breast Cancer Screening in Low- and Middle-Income Countries: A Perspective From Malawi

Gutnik, Lily; Matanje-Mwagomba, Beatrice; Msosa, Vanessa; Mzumara, Suzgo; Khondowe, Blandina; Moses, Agnes; Kohler, Racquel E.; Carey, Lisa A.; Lee, Clara N.; Gopal, Satish

doi:10.1200/jgo.2015.000430

Cited by 40 publications

(32 citation statements)

References 23 publications

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“…Even though the majority of the participants were aware of the BSE, only a few of them knew the techniques of BSE. Most women, as reported in earlier studies [16,22], are often aware of cancer screening methods yet do not practice [23]. e possible explanation of the minimal rate of the regular monthly practice of BSE is the fewer rate of the previous history of exposure to breast disease among our study participants which is 5.4%.…”

Section: Discussionmentioning

confidence: 58%

Practice and Barriers toward Breast Self-Examination among Palestinian Women in Gaza City, Palestine

Baloushah

Salisu

Elsous

et al. 2020

The Scientific World Journal

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Breast self-examination (BSE) is one of many first-line screening practices aimed at early detection and prevention of fatal outcomes of breast cancer. The present study aimed to identify Palestinian women’s practices, awareness, and barriers to BSE. Using descriptive-analytical methods, a previously validated questionnaire was administered to a conveniently selected sample of women. The study was conducted among women who visited primary health clinics (PHCs) in Gaza City. A total of 390 participants who met the selection criteria answered the self-administered questionnaires. We used SPSS version 24.0 to analyze the data. The findings suggest that the practice of BSE among women in Gaza is low, with only 40% of the study participants reporting that they never practiced BSE before, even though 76.7% reported that they were aware of BSE. In general, the main barriers to BSE practices were that participants had wrong perceptions and lacked knowledge about BSE. Others also reported fear of detecting breast cancer as a barrier. The practice of BSE among Palestinian women in the Gaza Strip is low and marred with trivial issues as barriers that could be eliminated with dedicated and extensive educational campaigns in the area.

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Section: Discussionmentioning

confidence: 58%

Practice and Barriers toward Breast Self-Examination among Palestinian Women in Gaza City, Palestine

Baloushah

Salisu

Elsous

et al. 2020

The Scientific World Journal

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“…19 Studies in Malawi and other African settings have suggested that lay health workers may be a promising option for breast cancer education and conducting CBEs. 43 , 44 …”

Section: Discussionmentioning

confidence: 99%

Breast Cancer Knowledge, Behaviors, and Preferences in Malawi: Implications for Early Detection Interventions From a Discrete Choice Experiment

Kohler

Gopal

Lee

et al. 2017

JGO

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PurposeBreast cancer is the most common female cancer in Africa and leading cause of death resulting from cancer; however, many countries lack early detection services. In Malawi, women are frequently diagnosed with large tumors after long symptomatic periods. Little is known about local cancer knowledge.MethodsWe administered a cross-sectional survey with a discrete choice experiment to a random sample in urban and rural areas of Lilongwe district. Bivariable and multivariable analyses determined factors associated with knowledge. Preference utilities for early detection interventions were estimated using a hierarchical Bayesian model in Sawtooth software.ResultsOf 213 women recruited, fewer than half were aware of breast cancer. In multivariable analysis, electricity at home and knowing someone with cancer increased the odds of awareness. Women were more knowledgeable about symptoms than treatment or risk factors; more than 60% erroneously believed local misconceptions. Seventeen percent were aware of breast self-examination, and 20% were aware of clinical breast examination (CBE); few reported either behavior. Common barriers included not knowing where to access CBE and transportation difficulties. Discrete choice experiment results indicated the detection strategy (breast health awareness, CBE, or both) was the most important attribute of an intervention, followed by the encounter setting and travel time.ConclusionAddressing misconceptions in health messages and engaging survivors to promote early detection may help improve breast cancer knowledge in Malawi. Program designs accounting for women’s preferences should provide breast health education and CBEs in convenient settings to address transportation barriers, particularly for women with low socioeconomic position.

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“…Because CBE may be pragmatic and cost-effective for low-resource settings like Malawi [3, 7], we conducted a pilot study evaluating feasibility and acceptability of CBE screening performed by laywomen [8]. We found that laywomen could be successfully trained to provide breast cancer education and competently perform CBE [9].…”

Section: Introductionmentioning

confidence: 99%

Experiences and perceptions regarding clinical breast exam screening by trained laywomen in Malawi

Kohler

Miller

Gutnik

et al. 2017

Cancer Causes Control

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Purpose Despite the increasing burden, breast cancer control in sub-Saharan Africa is insufficient. Late diagnosis and lack of early detection and screening services contribute to high mortality. Clinical breast exam (CBE) screening can be valuable in low-income countries, including use of community health workers and non-health professionals to conduct exams. We assessed experiences of women who underwent CBE screening by trained laywomen in Lilongwe, Malawi, as part of a pilot program. Methods The pilot study invited women attending urban health clinics to a breast cancer educational talk followed by CBE screening by trained laywomen. We purposively sampled participants from the pilot study and interviewed them about the screening experience and future cancer education programs and services. Results Overall participants had positive experiences and were willing to undergo CBE screening by trained laywomen. Participants were motivated by the educational talk, shared newly acquired cancer knowledge with their social networks, and encouraged others to seek screening. Screened women suggested strategies for future interventions including combining breast and cervical cancer screening, using female providers, partnering with community leaders to increase uptake, and expanding services into the community. Conclusions Asymptomatic Malawian women accepted CBE screening by trained laywomen and considered breast cancer an important health issue. Women appreciated combined education and screening services and proposed further linkage of breast and cervical cancer screening. Based on our results, training laywomen to educate the public on breast cancer and conduct CBE is a feasible breast cancer control strategy in sub-Saharan Africa.

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Breast Cancer Screening in Low- and Middle-Income Countries: A Perspective From Malawi

Cited by 40 publications

References 23 publications

Practice and Barriers toward Breast Self-Examination among Palestinian Women in Gaza City, Palestine

Practice and Barriers toward Breast Self-Examination among Palestinian Women in Gaza City, Palestine

Breast Cancer Knowledge, Behaviors, and Preferences in Malawi: Implications for Early Detection Interventions From a Discrete Choice Experiment

Experiences and perceptions regarding clinical breast exam screening by trained laywomen in Malawi

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