Assess the awareness regarding Early Identification, Prevention and Management of Breast Cancer among Early Adult Women

 

Ms. Lakshmi K. M.¹, Jaseela K. T.², Ms. Anjana P², Ayisha Sithara² M. T. Dhrishya²

¹Asso Professor, MES College of Nursing, Palachode (P.O), Kolathur Via, Perinthalmanna, Kerala- 679338

²Third Year B.Sc Nursing Student, MES College of Nursing, Palachode P.O, Kolathur, Perinthalmanna, Kerala-679338

 

ABSTRACT:

Breast cancer is the most common female cancer worldwide representing nearly a quarter (23%) of all cancers in women. Breast cancer is a complex disease and even now the primary cause is unknown.  Diagnosis of breast cancer at early stage contributes to increases the survival rate of women. This study aim was to assess the awareness regarding breast cancer among early adult women in selected community areas of Perinthalmanna and also distributing pamphlet regarding causes, diagnosis and early identification and treatment of breast cancer. Methods and materials: This study was conducted using quantitative research approach-non experimental descriptive research design was used. Purposive sampling technique was used to select the samples of 60 early adult women. The tools used for the data collection were Performa to collect socio-demographic variables, semi structured self administered questionnaire were used to assess the awareness of women regarding breast cancer. The collected data were analysed using descriptive and inferential statistics. Results: Regarding the level of awareness of breast cancer among early adult women, 7% had adequate awareness, 60% had moderate awareness, and 33% had inadequate awareness. There is a significant association with the health information and family monthly income (p<0.05) but no association with age, education, occupation, type of family, dietary pattern, residence, religion, marital status, family history.

 

INTRODUCTION:

Breast cancer is the most common female cancer worldwide representing nearly a quarter (23%) of all cancers in women.¹ The global burden of breast cancer expected to cross 2million by the year 2030, with the growing proportions from developing countries.²

 

One woman dies of cervical cancer every 8 minutes in India, for every 2 women newly diagnosed with breast cancer, one woman dies of it in India.³

 

Breast cancer incidence rates within India display a 3-4 fold variations across the country, with the highest rate observed in the northeast and in major metropolitan cities such as Mumbai and New Delhi. Reason for this variation include difference in demographics (e.g. Education), reproductive (e.g. Age at first child and number of children), anthropometric (e.g. Adiposity) and lifestyle factor (e.g. Tobacco smoking & alcohol use).⁴

 

There is no single, specific cause of breast cancer; rather, a combination of hormonal, genetic, and possibly environmental events may contribute to its development.⁵

 

Breast cancer is the most common malignancy in American women except for skin cancer. It is second only to lung cancer as the leading cause of death from cancer in women. Over 211,000 new cases of breast cancer are diagnosed in women in the United States each year. Each year in the United States, approximately 40,870 deaths (40,410 women and 460 men) occur related to breast cancer. The incidence rate of breast cancer is slowly increasing, with a slight decline in the number of deaths related to breast cancer. The largest decreases have been noted in younger women, including both African American and white women.⁶

 

High Risk Factors for Breast Cancer includes early menarche before age 12, late menopause after age 55, obesity, late age of first birth >35 years, nulliparity, never breastfed, atypical lobular hyperplasia, nipple discharge other than milk, high dose breast or chest irradiation, combined oral contraceptives intake, oestrogen replacement therapy. Gene mutations (BRCA-1 or BRCA-2) play a role in 5%-10% of breast cancer.⁷

 

Breast cancer mortality could be reduced by 30% through early detection using routine mammography alone or together with an annual clinical breast examination by a primary health care provider beginning between 40 and 50 years of age and annual clinical examination also recommends women to perform monthly breast self examination (BSE) beginning at 20 years of age.⁸

 

A community based, cross-sectional study carried out in a resettlement colony in South Delhi to assess the awareness of breast cancer in women using Semi-structured interview schedule to collect information regarding breast cancer. Modified Kuppuswamy scale was used for assessing the socio-economic status. A total of 333 women were included. The mean age was 36 years+/-15.1 and 46% were illiterate. Only 185 (56%) women were aware of breast cancer; among them, 51% knew about at least one of the signs /symptoms, 53% were aware that breast cancer can be detected early, and only 35% mentioned about risk factors. Thus, awareness about breast cancer is low amongst women in this community. There is a need for awareness generation programs to educate women about breast cancer, propagation of correct messages and promote early detection of breast cancer^.9

 

Breast cancer unlike other type of cancer is an easily screen able cancer, effects an easily visible organ and have an effective treatment¹⁰. The 5-year survival rate is 85% with early detection whereas later detection decreases the survival rate to 56%.¹¹

 

According to WHO breast cancer in women worldwide, with nearly 1.7 million new cases diagnosed in 2012 (second most common cancer overall). This represents about 12% of all new cancer cases and 25% of all cancers in women.  More than half million die from this disease.  The main reason for this escalating mortality is lack of awareness and late diagnosis of disease.¹²

 

STATEMENT OF THE PROBLEM:

A study to assess the awareness regarding early identification, prevention and management of breast cancer among early adult women in selected community areas of perinthalmanna.

 

OBJECTIVES:

1.     Assess the level of awareness regarding early identification, prevention and management of breast cancer among early adult women.

2.     Find out the association between the awareness regarding early identification, prevention and management of breast cancer and their demographic variables.

 

ASSUMPTION:

The investigator assumes that the adult women have inadequate awareness on early identification, prevention and management of breast cancer.

 

MATERIAL AND METHODS:

Research approach: quantitative approach

Research design: Non experimental descriptive research design.

Setting of study: selected community areas in perinthalmanna.

Population: target population is early adult women  residing in selected community areas in perinthalmanna..

Sample: early adult women.

Sample Size:  60 early adult women.

Sampling techniques: Non probability purposive sampling techniques were used.

 

CRITERIA FOR SAMPLE SELECTION:

Inclusive Criteria:

1.     Women who are in age between 20- 40 years.

2.     Women who are willing to participate in the study.

3.     Women who are available at the time of data collection.

 

Exclusive Criteria:

1.     Women who have aged below 20 years and above 40 years.

2.     Women who are under treatment of breast cancer.

3.     Women who are have any other type of cancer.

4.     Mothers who were not willing to participate in the study.

 

DESCRIPTION OF THE TOOL:

The tool 1 consist of

Section -A:

Demographic variables such as age in years, educational status, occupation, family income, dietary pattern, religion, residence, type of family, marital status, family history of breast cancer, source of information.

Section-B:

Self structured knowledge questionnaire to assess the awareness regarding early identification, prevention and management of breast cancer among early adult women.

 

RELIABILITY AND VALIDITY:

The tool was prepared with the guidance by the experts on the basis of objectives, which were assessed and evaluated, accepted by research committee. Content validity of this instrument was obtained from nursing experts. Reliability and practicability of tool was tested through the pilot study and used for main study.

 

DATA COLLECTION PROCEDURE:

The data were collected from early adult women who were residing at selected community area of perinthalmanna with the help of demographic variables and self structured questionnaire regarding breast cancer.

 

PLAN FOR DATA ANALYSIS:

Data analysis was done based on the objectives of the study using descriptive and inferential statistics. The collected data for each variable was analyzed, categorized and interpreted in the form of tables. Demographic data was analysed in terms of frequency and percentage. Frequency and percentage distribution of sample according to awareness of early adult women. To find out association between the awareness of early adult women and selected socio demographic variables was analysed by using chi-square.

 

 

 

Section- A

Table - 1 Frequency and percentage distribution of early adult women according to their demographic variables                       N= 60

S. No.	Demographic Data	No.	Percentage %
1.	Age in years a)   20-25years b)   26-30 years c)   31- 35 years d)  36 – 40 years	10 15 16 19	16.7 25.0 26.7 31.6
2.	Educational Status a)    Illiterate b)    primary education c)    secondary education d)    graduate e)    others	0 26 14 19 1	0 43.0 23.0 32.0 2.0
3.	Occupation a)    Home maker b)    government employ c)    private employ d)    others	53 0 4 3	88.0 0.0 7.0 5.0
4.	Family income per month a)    Rs  less than 5000 b)    Rs.5001- 10000 c)    Rs10001 – 15000 d)    Rs above 15001	34 17 3 6	57.0 28.0 5.0 10.0
5.	Dietary pattern a)  Vegetarian b)  Non vegetarian	7 53	12.0 88.0
6.	Religion a)  Hindu b)  Muslim c)  Christian d)  Others	17 39 4 0	28.0 65.0 7.0 0
7.	Residence a)  rural b)  urban c)  semi urban	48 2 10	80.0 3.0 17.0
8.	Type of family a)  Nuclear b)  Joint c)  Extended	28 32 0	47.0 53.0 0
9.	Marital status a)  Married b)  Single c)  Widow d)  Separated	42 9 3 6	70.0 15.0 5.0 10.0
10	Family history of breast cancer a)  Yes b)  No	5 55	8.0 92.0
11	Source of health information a)  Mass media b)  Health personnel c)  Neighbours and friend d)  Others	43 11 3 3	72.0 18.0 5.0 5.0

 

 

Section A:

Table – 1 revealed that among 60 samples, 19 (31.6%) were belongs to the age group of 36-40 years, 26 (43.0%) were primary education, 53 (88.0%) were home maker, 34 (57.0%) were belongs to monthly income of less than Rs.5000, 53 (88%) were non vegetarian, 39 (65%) were Muslim, 48 (80.0%) were residing in rural, 32 ( 53.0%) were  joint family , family history of breast cancer 55( 92%) were No, 43( 72.0%) were obtained information through mass media.

 

 

 

 

 

section B:

Table – 2 Assessment of awareness regarding breast cancer among early adult women N =60

S. No	Level of awareness	Number of samples	Percentage
		N	%
1.	> 76% - adequate awareness	4	7.0%
2.	51- 75% - moderate awareness	36	60%
3.	<50% - inadequate awareness	20	33.0%

 

Section B:

Table - 2 - Shows the awareness score regarding breast cancer among early adult women, 4 (7.0%) had adequate awareness, 36 (60.0%) had moderate awareness and 20 (33.0%) had inadequate awareness.

 

 

Section C:

Table --3 Association of knowledge score with demographic variables                                                                                         N= 60

S. no	Demographic variables	>76% Adequate awareness		51-75% Moderate awareness		<50% Inadequate awareness		Chi-squire value (x2)	d (f)	P value
		N	%	N	%	N	%
1.	Age in years a) 20-25years  b) 26-30 years c) c), 31- 35 years d) d)  36 – 40 years	0 3 0 1	0 5 0 2	6 8 9 13	10 13 15 22	4 4 7 5	7 7 12 8	7.226	6	12.59
2.	Educational Status a) Illiterate b) primary education c) secondary education d) graduate e) others	0 0 1 2 0	0 0 2 3 0	0 14 9 14 1	0 23 15 23 2	0 12 4 3 0	0 20 7 5 0	7.35	8	15.51
3.	Occupation a) Home maker b) government employ c) private employ d) others	2 0 1 1	3 0 2 2	32 0 2 2	53 0 3 3	19 0 1 0	3- 0 2 0	7.23	6	12.59
4.	Family income per month a) Rs  less than 5000 b) Rs.5001- 10000  c) Rs10001 – 15000 d) Rs above 15001	0 1 0 3	0 2 0 5	17 13 3 3	28 22 5 5	17 3 0 0	28 5 0 0	28.7	6	12.59.
5.	Dietary pattern a) Vegetarian b) Non vegetarian	4 33	7 55	2 13	3 22	1 7	2 12	0.067	2	5.99
6.	Religion a) Hindu b) Muslim c) Christian d) Others	1 2 1 0	2 3 2 0	10 24 2 0	17 40 3 0	6 13 1 0	10 22 2 0	2.44	6	12.59
7.	Residence a) rural b) urban c) semi urban	4 0 0	7 0 0	27 2 7	45 3 12	17 0 3	28 0 5	2.53	4	9.49
8.	Type of family a) Nuclear b) Joint c) Extended	1 3 0	2 5 0	18 18 0	30 30 0	9 11 0	15 18 0	0.93	4	9.49
9.	Marital status a) Married b) Single c) Widow d) Separated	32 4 2 3	53 7 3 5	5 2 1 2	8 3 2 3	5 3 0 1	8 5 0 2	6.359	6	12.59
10	Family history of breast cancer a) Yes b) No	0 4	0 7	4 32	7 53	1 19	2 32	1.002	2	5.99
11	Source of health information a) Mass media b) Health personnel c) Neighbours and friend d) Others	2 0 1 1	3 0 2 2	25 8 1 2	42 13 2 3	16 3 1 0	27 5 2 0	15.08	6	12.59.

 

Section C:

Table -3 shows the awareness has a significant association with the health information and family monthly income (p<0.05) significant There is no association between age, education, occupation, type of family, dietary pattern, residence, religion, marital status, family history.

 

MAJOR FINDINGS:

Study findings revealed that among 60 samples, 19 (31.6%) were belongs to the age group of 36-40 years, 26 (43.0%) were primary education, 53 (88.0%) were home maker, 34 (57.0%) were belongs to monthly income of less than Rs.5000, 53 (88%) were non vegetarian, 39 (65%) were Muslim, 48 (80.0%) were residing in rural, 32 ( 53.0%) were  joint family , family history of breast cancer 55( 92%) were No, 43( 72.0%) were obtained information through mass media.

 

In this study revealed that awareness score regarding breast cancer among early adult women, 4 (7.0%) had adequate awareness, 36 (60.0%) had moderate awareness and 20 (33.0%) had inadequate awareness.

 

Present study shows the awareness has a significant association with the health information and family monthly income (p< 0.05). There is no association between age, education, occupation, type of family, dietary pattern, residence, religion, marital status, family history.

 

CONCLUSION:

Breast cancer is the leading cause of death among women. Early identification through monthly breast self examination, high risk women should undergo mammography. The result of the present study revealed 20 (33.0%) samples have inadequate awareness regarding breast cancer. These findings emphasis on raising awareness about breast cancer is effective way to overcome a challenging problem of breast cancer.

 

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Received on 19.06.2018         Modified on 20.07.2018

Accepted on 02.08.2018      ©A&V Publications All right reserved