Barriers to Timely Seeking of Breast Cancer Care Among Palestinian Women: A Cross-Sectional Study

Author:

Elshami Mohamedraed12ORCID,Qawasmi Malak Ayman3,Ghithan Roba Jamal4,Al-Slaibi Ibrahim5,Alser Mohammed6,Shurrab Nouran Ramzi4,Ismail Islam Osama7,Mahfouz Ibtisam Ismail8,AbdulQader Fannon Aseel8,Hawa Mona Radi9,Giacaman Narmeen4,Ahmaro Manar4,Okshiya Heba Mahmoud10,Zaatreh Rula Khader11,AbuKhalil Wafa Aqel4,Usrof Faten Darwish12,Melhim Noor Khairi13,Madbouh Ruba Jamal4,Abu Hziema Hala Jamal8,Abed-Allateef Lahlooh Raghad4,Ubaiat Sara Nawaf4,Jaffal Nour Ali4,Alawna Reem Khaled4,Abed Salsabeel Naeem8,Abuzahra Bessan Nimer4,Abu Kwaik Aya Jawad14,Dodin Mays Hafez4,Taha Raghad Othman4,Alashqar Dina Mohammed8,Mobarak Roaa Abd-alfattah4,Smerat Tasneem15,Albarqi Shurouq I.16,Abu-El-Noor Nasser17,Bottcher Bettina8

Affiliation:

1. Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH

2. Ministry of Health, Gaza, Palestine

3. Department of Medical Laboratory Sciences, Hebron University, Hebron, Palestine

4. Faculty of Medicine, Al-Quds University, Jerusalem, Palestine

5. Almakassed Hospital, Jerusalem, Palestine

6. The United Nations Relief and Works Agency for Palestine Refugees in the Near East, Gaza, Palestine

7. Faculty of Medicine, Al Azhar University-Gaza, Gaza, Palestine

8. Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine

9. Tulkarem Governmental Hospital, Tulkarem, Palestine

10. Al-Shifa Hospital, Gaza, Palestine

11. Caritas Baby Hospital, Bethlehem, Palestine

12. Faculty of Health Sciences Master of Medical Laboratory Sciences, Islamic University of Gaza, Gaza, Palestine

13. Department of Pharmacy, An-Najah National University, Nablus, Palestine

14. Faculty of Dentistry, Al-Quds University, Jerusalem, Palestine

15. Faculty of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine

16. Faculty of Pharmacy, Al-Azhar University of Gaza, Gaza, Palestine

17. Faculty of Nursing, Islamic University of Gaza, Gaza, Palestine

Abstract

PURPOSE Examining the association of breast cancer (BC) symptom awareness with time to help seeking and exploring barriers to timely presentation may enhance the effectiveness of BC awareness campaigns and early detection efforts. This study aimed to assess the anticipated time for seeking medical advice when experiencing a potential BC symptom among women in Palestine and to identify their barriers to early presentation. MATERIALS AND METHODS A convenience sampling method was used to recruit adult women from hospitals, primary health care facilities, and public areas across 11 governorates in Palestine. A translated-into-Arabic version of the validated BC Awareness Measure was used. The questionnaire consisted of three sections: sociodemographic information, recognition of 13 BC symptoms and reporting time for seeking medical advice, and barriers to early presentation. RESULTS A total of 5,257 questionnaires were included. The proportion of participants who would seek medical advice immediately varied on the basis of the nature of BC symptoms. For symptoms related to the breast, the proportion ranged from 25.7% for redness of the breast skin to 53.5% for a lump or thickening in the breast. For symptoms related to the nipple, the proportion ranged from 30.7% for nipple rash to 48.0% for discharge or bleeding from the nipple. Exhibiting good BC symptom awareness was associated with a higher likelihood of seeking medical advice within a week for all BC symptoms. Emotional barriers were the most frequently reported barriers. There was no association between increasing levels of BC awareness and reporting fewer or more barriers. CONCLUSION The nature of BC symptoms had an impact on help-seeking behaviors. Participants with good BC symptom awareness were more likely to seek medical advice earlier.

Publisher

American Society of Clinical Oncology (ASCO)

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