Knowledge, attitude and practice towards breast cancer and screening among women in northwestern China: a cross-sectional study

Background: Breast cancer constitutes the most common cancer among women and has been a major, life-threatening, public health concern. The knowledge, attitude and practice towards breast cancer and screening among women should be assessed in order to guide current breast cancer interventions, espec...

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Main Authors: Jinlin Liu, Xizhu Qian, Xiaohan Huang, Zhuqing Duan
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:The Lancet Regional Health. Western Pacific
Online Access:http://www.sciencedirect.com/science/article/pii/S2666606524002888
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author Jinlin Liu
Xizhu Qian
Xiaohan Huang
Zhuqing Duan
author_facet Jinlin Liu
Xizhu Qian
Xiaohan Huang
Zhuqing Duan
author_sort Jinlin Liu
collection DOAJ
description Background: Breast cancer constitutes the most common cancer among women and has been a major, life-threatening, public health concern. The knowledge, attitude and practice towards breast cancer and screening among women should be assessed in order to guide current breast cancer interventions, especially under the background that many cities in China are carrying out free breast cancer screening programs for urban and rural women. Methods: A cross-sectional survey was conducted from July 2023 to September 2024, in nearly 100 medical institutions in Xi’an, the largest city in northwestern China. All women asking for medical services related to breast diseases were invited to participate in the survey. Descriptive statistics, multiple linear regressions, and binary logistic regressions were performed. Findings: Of 26,586 women aged 20-60 years, the average knowledge scores on risk factors, signs and symptoms, and prevention methods of breast cancer were 6.20 (S.D. 3.98, range 0-10), 4.65 (S.D. 2.89, range 0-7), and 6.58 (S.D. 3.40, range 0-9), respectively. The average score on the overall knowledge of breast cancer was 17.44 (S.D. 9.63, range 0-26). However, 17.1% (4,553)-21.8% (5,801) of women still had no knowledge of risk factors, signs and symptoms, and prevention methods of breast cancer. The average score of attitudes towards breast cancer screening was 4.11 (S.D. 1.13, range 1-5). 56.2% of women had received breast cancer screening services. After adjusting for potential confounding factors, having a higher knowledge score of breast cancer was significantly associated with a more positive attitude towards breast cancer screening among women (b 0.01, t 8.72), and women who had a higher knowledge score of breast cancer (OR 1.01, 95% CI 1.00-1.01) and had a more positive attitude towards breast cancer screening (OR 1.19, 95% CI 1.16-1.21) were more likely to receive breast cancer screening services. Meanwhile, women’s attitudes towards breast cancer screening played a partial mediating role in the association between their knowledge of breast cancer and having received breast cancer screening services. Besides, education and occupation are two significant influencing factors associated with the knowledge, attitude and practice towards breast cancer and screening among women. Interpretation: The study revealed a lack of awareness and comprehensive knowledge about breast, as well as low self-risk perception and low uptake of breast cancer screening services among women in Xi’an. The scaling-up of breast cancer information and dissemination should be prioritized by the government, hence improving the uptake of breast cancer screening services. Funding: National Natural Science Foundation of China (72204199); Research Project of Humanities and Social Sciences of the Ministry of Education of China (22XJC630001).
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spelling doaj-art-08e0aab295304f939b28aec658f079eb2025-08-20T03:11:48ZengElsevierThe Lancet Regional Health. Western Pacific2666-60652025-02-015510129410.1016/j.lanwpc.2024.101294Knowledge, attitude and practice towards breast cancer and screening among women in northwestern China: a cross-sectional studyJinlin Liu0Xizhu Qian1Xiaohan Huang2Zhuqing Duan3Northwestern Polytechnical University, ChinaNorthwestern Polytechnical University, ChinaNorthwestern Polytechnical University, ChinaXi'an Jiaotong University, ChinaBackground: Breast cancer constitutes the most common cancer among women and has been a major, life-threatening, public health concern. The knowledge, attitude and practice towards breast cancer and screening among women should be assessed in order to guide current breast cancer interventions, especially under the background that many cities in China are carrying out free breast cancer screening programs for urban and rural women. Methods: A cross-sectional survey was conducted from July 2023 to September 2024, in nearly 100 medical institutions in Xi’an, the largest city in northwestern China. All women asking for medical services related to breast diseases were invited to participate in the survey. Descriptive statistics, multiple linear regressions, and binary logistic regressions were performed. Findings: Of 26,586 women aged 20-60 years, the average knowledge scores on risk factors, signs and symptoms, and prevention methods of breast cancer were 6.20 (S.D. 3.98, range 0-10), 4.65 (S.D. 2.89, range 0-7), and 6.58 (S.D. 3.40, range 0-9), respectively. The average score on the overall knowledge of breast cancer was 17.44 (S.D. 9.63, range 0-26). However, 17.1% (4,553)-21.8% (5,801) of women still had no knowledge of risk factors, signs and symptoms, and prevention methods of breast cancer. The average score of attitudes towards breast cancer screening was 4.11 (S.D. 1.13, range 1-5). 56.2% of women had received breast cancer screening services. After adjusting for potential confounding factors, having a higher knowledge score of breast cancer was significantly associated with a more positive attitude towards breast cancer screening among women (b 0.01, t 8.72), and women who had a higher knowledge score of breast cancer (OR 1.01, 95% CI 1.00-1.01) and had a more positive attitude towards breast cancer screening (OR 1.19, 95% CI 1.16-1.21) were more likely to receive breast cancer screening services. Meanwhile, women’s attitudes towards breast cancer screening played a partial mediating role in the association between their knowledge of breast cancer and having received breast cancer screening services. Besides, education and occupation are two significant influencing factors associated with the knowledge, attitude and practice towards breast cancer and screening among women. Interpretation: The study revealed a lack of awareness and comprehensive knowledge about breast, as well as low self-risk perception and low uptake of breast cancer screening services among women in Xi’an. The scaling-up of breast cancer information and dissemination should be prioritized by the government, hence improving the uptake of breast cancer screening services. Funding: National Natural Science Foundation of China (72204199); Research Project of Humanities and Social Sciences of the Ministry of Education of China (22XJC630001).http://www.sciencedirect.com/science/article/pii/S2666606524002888
spellingShingle Jinlin Liu
Xizhu Qian
Xiaohan Huang
Zhuqing Duan
Knowledge, attitude and practice towards breast cancer and screening among women in northwestern China: a cross-sectional study
The Lancet Regional Health. Western Pacific
title Knowledge, attitude and practice towards breast cancer and screening among women in northwestern China: a cross-sectional study
title_full Knowledge, attitude and practice towards breast cancer and screening among women in northwestern China: a cross-sectional study
title_fullStr Knowledge, attitude and practice towards breast cancer and screening among women in northwestern China: a cross-sectional study
title_full_unstemmed Knowledge, attitude and practice towards breast cancer and screening among women in northwestern China: a cross-sectional study
title_short Knowledge, attitude and practice towards breast cancer and screening among women in northwestern China: a cross-sectional study
title_sort knowledge attitude and practice towards breast cancer and screening among women in northwestern china a cross sectional study
url http://www.sciencedirect.com/science/article/pii/S2666606524002888
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