<p>Risk Assessment for Breast Cancer Development and Its Clinical Impact on Screening Performance in Iranian Women</p>

Abstract

IntroductionThe aim of this study is to estimate the objective and subjective risk and to examine their associations with three forms of breast cancer screening.MethodsThis cross-sectional study was conducted with a sample of 800 women aged 35–85 years from the community setting and outpatient clinic in Babol, the north of Iran. The demographic, socio-economic characteristics and the risk factor profiles were collected through in-person interview. The health belief model (HBM) and visual analog scales were used to assess the women’s perceived risk of breast cancer. The practice of women regarding breast self-examination (BSE), breast clinical examination (BCE), and mammography were measured. We used the Gail model in estimating 5-year and lifetime risk. The logistic regression model was applied to determine the relationship of calculated and perceived risk on screening behaviors.ResultsThe mean of estimated 5-year and lifetime risk were 0.89 ±0.89 and 8.87 ±3.84 percent respectively while the perceived personal risk on visual scale perception was much greater than the calculated risk. The high 5-year calculated risk was a predictor of mammography practice but not BSE and BCE; however, after adjusting the subscales of HBM and socio-demographic characteristics, its effect remained significant (adjusted OR=1.97(95% CI: 1.02–3.08)). The perceived risk from HBM in particular self-efficacy (p=0.001) remained positively significant on all forms of screening practice.ConclusionWhile the perceived risk from HBM scale was meaningful in screening performance, the calculated risk from the Gail model had a clinical impact on mammography behaviors independent of HBM scales.

Breast Cancer Screening Strategies and Indicators in Iran, A Systematic Review

“…Results of three studies showed 52.9%, 30.9%, and 60% of females, did not know how to perform BSE or didn't have the necessary skills to do it (9)(10)(11). The mean of 5-year and lifetime BC risk perception was calculated 0.89 ±0.89 and 8.87 ±3.84, respectively (18). It was demonstrated that a higher 5-year risk perception had more predictive power for performing Mammo, while it did not predict achieving BSE or CBE.…”

Accuracy of Self-Perceived Risk Perception of Breast Cancer Development in Iranian Women

“…This model was automated with an interactive online program based on clinical and reproductive data of individuals' risk pro les that computes the actual 5-year and lifetime risk and also the average risk with similar age of individuals in the population of women. The details of this risk calculation were explained elsewhere 12 .…”

“…The increasing incidence in developing counties is mainly attributed to changes in lifestyles and reproductive behaviors [6][7][8][9][10] . Because of the low performances of Iranian women in screening, the majority of patients are diagnosed at a higher stage of the disease that is corresponded with a high mortality rate [11][12][13] . To establish a preventive strategy for early detection, the risk assessment is primarily interested in BC from a public health perspective.…”

Accuracy of self-perceived risk perception of breast cancer development in Iranian women

“…A cluster sampling technique was used to recruit individuals in the study in the randomly selected community-based clusters and also the outpatient clinic. The details of sampling methods were described elsewhere 12 . In brief, 20 randomly selected community-based clusters and 3 outpatient clinics in the major educational hospitals were used to select samples.…”

“…The increasing incidence in developing counties mainly attributed to changes in lifestyles and reproductive behaviors [6][7][8][9][10] . The majority of women with BC are diagnosed at a higher stage of the disease that is corresponded with a high mortality rate [11][12][13] . To establish a preventive strategy for early detection, the risk assessment is primarily interested in BC from a public health perspective.…”