Breast cancer knowledge and screening practices: a survey of 1,000 Asian women

Sim HL, Seah M, Tan SM
Correspondence: Dr Tan Su-Ming, su_ming_tan@cgh.com.sg

ABSTRACT
Introduction The incidence of breast cancer in Asia is rapidly rising. Knowledge and perception often influence attendance at screening programmes. However, there has not been any survey to assess the level of knowledge of breast cancer in an Asian population. Singapore has a multiracial population and is the only Asian country with a national screening programme. We conducted a survey on 1,000 women to assess their level of knowledge and screening practices.
Methods A self-administered questionnaire was used, where one point was given for a correct answer and zero for an incorrect / “not sure” response. The maximum knowledge score was 19. The women were also surveyed for their screening practices. Points were not assigned to questions on practice.
Results The response rate was 100 percent. The mean score was 11.4 and the median was 12 (range 0–19). The scores were high for general knowledge and disease progression, but poor for risk factors, screening, symptoms and treatment. Several myths and misconceptions were prevalent. Only 53 percent did regular breast self-examination (BSE), while 57 percent of women aged 40 years and above had gone for a screening mammogram. Increasing age, Malay race, lower educational level, lower socioeconomic class and not knowing anyone with breast cancer were significant independent predictors of poor knowledge. Higher educational level and knowledge scores were significant independent predictors of BSE practice and screening mammogram attendance.
Conclusion Knowledge affects practice. Public education is required to correct misconceptions and focus on women with poor knowledge. This would help to improve screening attendance rates.

Keywords: breast cancer knowledge, breast self examination, public education, screening mammogram
Singapore Med J 2009; 50(2): 132-138