Breast Cancer Screening in Semi-Rural Malaysia: Utilisation and Barriers

Mohan, Devi, Su, Tin T., Donnelly, Michael, Hoe, Wilfred M. K., Schliemann, Désirée, Tan, Min M., Reidpath, Daniel, Taib, Nur A. and Allotey, Pascale, (2021). Breast Cancer Screening in Semi-Rural Malaysia: Utilisation and Barriers. International Journal of Environmental Research and Public Health, 18(23), 1-14

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  • Sub-type Journal article
    Author Mohan, Devi
    Su, Tin T.
    Donnelly, Michael
    Hoe, Wilfred M. K.
    Schliemann, Désirée
    Tan, Min M.
    Reidpath, Daniel
    Taib, Nur A.
    Allotey, Pascale
    Title Breast Cancer Screening in Semi-Rural Malaysia: Utilisation and Barriers
    Appearing in International Journal of Environmental Research and Public Health
    Volume 18
    Issue No. 23
    Publication Date 2021-11-23
    Place of Publication Basel
    Publisher Multidisciplinary Digital Publishing Institute
    Start page 1
    End page 14
    Language eng
    Abstract Breast cancer (BC) is the commonest cancer in Malaysia. Delayed diagnosis is a significant cause of BC mortality in the country. Early diagnosis and screening are vital strategies in mortality reduction. This study assessed the level of utilisation and barriers for breast self-examination (BSE), clinical breast examination (CBE) and mammogram in a semi-rural population in Malaysia and compared these across the different ethnic groups. This cross-sectional study was conducted among women aged 40 years and above, embedded within a health and demographic surveillance site (HDSS) in Segamat, Malaysia. Trained data collectors collected data on screening and barriers during home visits. Study participants (n = 250) were aged 59.4 ± 10.9 years and represented Malaysia’s three major ethnic groups. Practice of regular BSE, CBE uptake (ever) and mammogram (ever) was 23.2%, 36% and 22.4%, respectively. Regular BSE practice was highest in the Malay ethnic group and least among the Chinese. Regular CBE was very low in all ethnic groups (<5%). Mammogram uptake was highest among Chinese (34.4%), followed by Indians (30.4%) and Malays (16.6%). After adjusting for other socio-demographic variables, Malay ethnicity was positively associated with regular BSE (adjusted OR = 5.26, 95% CI 2.05, 13.50) and negatively associated with having had a mammogram (adjusted OR = 0.3, 95% CI 0.15, 0.57). Lower education was negatively associated (adjusted OR = 0.36, 95% CI 0.17, 0.74) with mammogram attendance (ever). Emotional and financial barriers were the most reported types of barriers, specifically, fear of diagnosis (74.8%), cost of diagnosis (69.6%) and fear of losing a breast (66.4%). Malay women more commonly reported most barriers compared to other ethnic groups. Screening uptake was low among semi-rural women in Malaysia. Implementing culturally appropriate interventions that consider ethnic differences is crucial to empowering women to engage in BC screening initiatives in these communities.
    Keyword Breast cancer
    Copyright Holder Multidisciplinary Digital Publishing Institute
    Copyright Year 2021
    Copyright type Creative commons
    DOI 10.3390/ijerph182312293
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    Created: Wed, 24 Nov 2021, 16:36:13 JST by Radhika Das on behalf of UNU IIGH