br The participants overall knowledge of BC risk factors
The participants’ overall knowledge of BC risk factors and warning signs was calculated as described in the methodology of this 434-13-9 study. Figure 2 shows significant differences in responses related to limited level of knowledge between knowledge of risk factors and knowledge of warning signs (P ¼ < .001). Higher percentages of adequate level of responses were found for knowledge of risk factors, followed by knowledge of the warning signs of BC (limited level of knowledge 93.1%, and 57.4%, respectively).
Factors Associated with Knowledge of Risk Factors and Warning Symptoms of Breast Cancer
Table 3 shows the association between knowledge of BC risk factors and warning symptoms, overall knowledge, and character-istics of the study group. Around one third (30.3%) of women had performed BSE, 21.9% had performed CBE, and only 1.6% used the mammogram. A chi-square test identified that women partici-pants with an overall limited knowledge of BC were significantly
Women Attending PHCC in Ghail Bawazir District, Yemen
Table 5 Univariate and Multivariate Logistic Regression Model of Factors Associated With the Limited Performance of CBE
Level of education
Abbreviations: AOR ¼ adjusted odds ratio; BSE ¼ breast self-examination; CBE ¼ clinical breast examination; CI ¼ confidence intervals; OR ¼ odds ratio.
more likely married, with an education level below secondary, unemployed, and who never had BSE (P < .01). Additionally, women with an education level below secondary, unemployed, and who never had BSE were found significantly likely to have limited knowledge of risk factors (P < .01). Similarly, a significant limited level of knowledge of warning signs were found more likely among women who were older, married, with an education level below secondary, and who never had BSE (P < .01).
Tables 4, 5, and 6 show the univariate and multivariate analysis for analyzing the association of factors with the limited performance and use of BSE, CBE, and mammogram as screening tools for BC. For BSE factors such as working status, those with limited knowledge of warning signs and BSE were likely associated with limited perfor-mance of BSE when tested with the univariate analysis, and all factors together with the level of education below secondary were also asso-ciated with the performance of BSE among the study population.
A similar analysis was applied to test the performance of factors associated with the use of CBE. Age was found to be a determinant in both nonadjusted and adjusted ORs also among those women with limited knowledge of BSE or CBE methods. No likely
associations were found when testing the use of mammogram as a screening method by either the analysis of univariate modality or the multivariate one.
Knowledge and Barriers of Breast Cancer Screening Methods
As demonstrated in Table 7, participants were recognized as less knowledgeable in all the three known types of screening methods. The most likely knowledge of the screening methods were for CBE (47.0%), less knowledge for BSE (58.0%), and the least amount of knowledge for mammogram and ultrasound (89.3%).
Some participants reported barriers that will not allow them to practice different BC screening methods, namely, BSE, CBE, and mammogram. The responses of the participants were summarized in four main areas, which were considered as a barrier for not performing one or more of the screening methods. Most of the participants indicated that zone of elongation had no health problems that required practicing any screening method. These findings were more apparent for the use of CBE (57.9%), mammogram (44.2%), and also BSE (38.9%). Another reported barrier was the lack of information about the
Amen Bawazir et al
Table 6 Univariate and Multivariate Logistic Regression Model of Factors Associated With the Limited Use of Mammogram
Level of education
Abbreviations: AOR ¼ Adjusted odds ratio; BSE ¼ Breast self-examination; CBE ¼ Clinical breast examination; CI ¼ Confidence intervals; OR ¼ Odds ratio.
different screening methods such as BSE, CBE, and mammogram (42.1%, 25.2%, and 39.0%, respectively). Some women expressed their feelings of fear from knowing the results of screening tests for BC and the possibility of finding cancer, while others expressed negative interest in practicing any type of BC screening method.