Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Feb 24, 2019; 10(2): 98-109
Published online Feb 24, 2019. doi: 10.5306/wjco.v10.i2.98
Hong Kong female’s breast cancer awareness measure: Cross-sectional survey
May Pui Shan Yeung, Emily Ying Yang Chan, Samuel Yeung Shan Wong, Benjamin Hon Kei Yip, Polly Suk-Yee Cheung
May Pui Shan Yeung, Emily Ying Yang Chan, Division of Global Health and Humanitarian Medicine, the Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
Samuel Yeung Shan Wong, Benjamin Hon Kei Yip, Division of Family Medicine and Primary Healthcare, the Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
Polly Suk-Yee Cheung, Hong Kong Breast Cancer Foundation, Hong Kong, China
Author contributions: All authors contributed to study conception and design; Yeung MPS, Chan EYY and Wong SYS performed the research and wrote the paper; Yip BHK analysed and interpreted the data; all authors contributed to editing, reviewing and final approval of the paper.
Institutional review board statement: The study was reviewed and approved by the Survey and Behavioural Research Ethics Committee (SBREC) of the Chinese University of Hong Kong.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study (survey) enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the Strobe Statement – checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Emily Ying Yang Chan, Professor, MBBS, MD, Division of Global Health and Humanitarian Medicine, the Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Prince of Wales Hospital, Ngan Shing Street, Hong Kong, China. emily.chan@cuhk.edu.hk
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Received: September 4, 2018
Peer-review started: September 4, 2018
First decision: October 15, 2018
Revised: November 5, 2018
Accepted: January 9, 2019
Article in press: January 9, 2019
Published online: February 24, 2019
Processing time: 171 Days and 19.2 Hours
ARTICLE HIGHLIGHTS
Research background

Breast cancer is the most common cancer in women worldwide. In Hong Kong, breast cancer accounted for 26.6% of all new cancers in females diagnosed in 2015. The median age of breast cancer patients was 51.0 in Hong Kong, which is younger, when compared with 62 in the United States and 61 in Australia.

Research motivation

The emphasis of previous research conducted in Hong Kong focused mainly on knowledge, perception and behavior on screening tests, rather than disease awareness. In reviewing the literature we found no other study using a validated measure to assess cancer awareness in a population based sample in Hong Kong. In addition to screening practices, this survey aims to examine women’s awareness and knowledge about breast cancer. Online search of validated questionnaires on awareness of breast cancer yielded three validated tools. The Cancer Awareness Measure (CAM) of the Cancer Research United Kingdom was chosen.

Research objectives

The aim of this study is to examine Hong Kong women’s awareness, perception, knowledge, and screening practice of breast cancer. Early cancer detection and diagnosis saves lives, because treatments are most likely to be effective in people who are diagnosed at an earlier stage. It is of interest to know how women of different age vary in awareness of the risks of breast cancer, so that public health promotion intervention would be customized to distinct subpopulations.

Research methods

We carried out a population-based cross-sectional survey using random telephone interviews to women aged 18 or above. The original United Kingdom CAM was modified according to the local context as there is no national breast cancer screening in Hong Kong. The data was analysed using proportions, chi-square test and adjusted odds ratios (ORs).

Research results

A total of 1000 participants completed the CAM questionnaire from 1731 responses (response rate = 57.8%) from September to October 2017. Respondents received higher education (secondary school or above) had better breast cancer awareness, more frequent screening and more had tried prevention practices when compared to those with lower education. Those in age groups 31-45 and 46-60 had higher percentages in performing breast self-exam and mammography when compared to the 18 - 30 and 61 or above age groups.

Research conclusions

The survey results indicated a government-led public health initiatives should raise awareness on prevention and early detection of breast cancer in women, with targeted promotion strategy for those with low education level and advance in age.

Research perspectives

Further study can be performed to examine breast cancer awareness and disease risk perception in association with socioeconomic status. Besides, other studies to explore whether there are differences in cancer awareness in places with and without national screening programme would provide insights to the impact of territory-wide initiatives.