Breast Cancer Screening Behaviors and its Association with Health Literacy and Breast Cancer Perception in Women Refereed to Health Centers of Tabriz City, 1401

Abstract

Abstract: Background and Objective: Early detection of breast cancer and subsequent timely treatment are crucial control and preventive measures that can significantly reduce breast cancer-related mortality, especially among high-risk groups. Screening is a key component of breast cancer early detection programs. Early detection of breast cancer is a critical step in reducing mortality from this disease. This study aimed to determine breast cancer screening behaviors and associated factors among women over 40 years of age attending health centers in Tabriz in 2022. Methods: This cross-sectional descriptive correlational study included 372 women over 40 years of age attending health centers in Tabriz, selected using random cluster sampling. Demographic questionnaires, breast cancer perception, breast cancer screening behavior checklists, and health literacy assessments were completed through interviews. Data analysis was performed using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (Pearson correlation test, independent t-test, one-way ANOVA, and multiple logistic regression analysis using the backward strategy) using SPSS software version 16. Results: In this study, 372 women over 40 years of age attending health centers in Tabriz participated. The majority of participants were homemakers (54.6%), married (79.6%), had sufficient income (60.7%), had university education (41.2%), and had no underlying diseases (56.7%). Thirty-nine participants (10.5%) had a history of benign breast mass, and 74 (19.9%) had it in their relatives. Regarding screening behaviors, the findings showed that 68.3% of women over 40 years of age underwent breast examination (9.9% regularly and monthly), 60.2% underwent breast examination by a physician or midwife (8.9% regularly every six months), 51.3% underwent mammography (12.3% regularly annually), and 36.2% underwent sonography (3.8% regularly every six months). The overall mean breast cancer perception score was 65.04 with a standard deviation of 8.06, indicating a moderate level, and the overall mean health literacy score was 68.97 with a standard deviation of 23.04. Using multiple variable regression modeling with the backward strategy: LR, the results showed a significant relationship between the presence of benign mass in relatives (a OR=2.47, P=0.008), breast cancer perception (a OR=2.20, P=0.009) with breast self-examination, and individual's age variable (a OR=2.40, P=0.003), and the presence of benign masses in individuals (a OR=8.49, P=<0.001) with mammography, age(a OR=2.33, p=0.005) and the presence of benign masses in individuals (a OR=8.84, P<0.001), and the presence of benign masses in individuals (a OR=18.84, P<0.001) with sonography. Discussion and Conclusion: Considering the low rate of recommended screening behaviors, it is necessary for health educators to pay more attention to health guardians and emphasize the importance of screening at recommended intervals in their training. Furthermore, the use of reminder systems in the national health system to remind women, especially those over 40 years of age, of the appropriate time for screening is recommended. Improving knowledge and attitudes toward breast cancer in health centers, which are the first point of contact for women with the health system, seems essential. Iranian women's awareness of breast cancer is relatively low, which can be one of the reasons for the increased mortality rate from this disease. Fear has the lowest perceived average among various dimensions. The perceived fear level can affect women's protective behavior.