The Investigation of Risk Factors and Awareness of Breast Cancer Among Syrian Immigrant Women

Öz

Objective: The study aims to determine the risk factors and awareness of breast cancer among Syrian migrant women, who are a disadvantaged group. Methods: This descriptive study was completed with 400 women selected using the random sampling method. The data were collected with the Personal Information Form, the Breast Cancer Awareness Measure-Arabic, and the Breast Cancer Risk Assessment Form. Percentage, mean, and median analyses, the Kruskal Wallis Test, and the Mann-Whitney U Test were used to analyze the data. Results: The mean age of the women participating in the study was found to be 41.85±8.67. 45.8% of the participants in the study had a high body mass index. It was determined that 95% of the Syrian migrant women did not have a mammogram, 92.8% did not perform a breast self-examination, and 68.5% did not know the early diagnosis methods of breast cancer. The total breast cancer risk of the women participating in the study was found to be 162.35 (50-675). This means that the risk of developing breast cancer in Syrian migrant women over the age of 18 is moderately high. The awareness level of the women participating in the study regarding breast cancer was found to be 8.1 (0-27). It was determined that the breast cancer screening awareness levels of Syrian immigrant women aged 41-50 were higher than those of women aged 30-40. It was also found that the higher the level of education of the participants, the higher their awareness levels regarding breast cancer symptoms. Conclusions: It was found that the awareness of breast cancer among the participants was low. In this context, training programs should be implemented for Syrian migrant women so that they can learn about breast cancer risks and their awareness can be increased.

Anahtar Kelimeler

• Early diagnosis
• awareness
• breast cancer
• migration

Suriyeli Göçmen Kadınların Meme Kanserine Yönelik Risk Faktörleri ve Farkındalıklarının İncelenmesi

Öz

AAmaç: Bu çalışmanın amacı Suriyeli göçmen kadınların meme kanserine yönelik risk faktörlerini ve farkındalıklarını belirlemektir. Yöntem: Tanımlayıcı türde olan araştırma, 2021 yılı Eylül-Ekim ayları arasında yapılmıştır. Rastgele örnekleme yöntemiyle araştırma kapsamında yapılan güç analizine göre araştırma 400 kadın ile tamamlanmıştır. Veri toplama aracı olarak araştırmacılar tarafından literatür doğrultusunda hazırlanan kişisel bilgi formu, 'Meme Kanseri Farkındalık Ölçeği-Arapça formu' ve 'Meme Kanseri Risk Değerlendirme Formu' kullanılmıştır. Verilerin değerlendirilmesinde yüzde, ortalama, medyan, Kruskal Wallis Testi ve Mann-Whitney U analizleri kullanıldı. Bulgular: Araştırmaya katılan kadınların yaş ortalaması 41.85±8.67 olarak bulundu. Çalışmaya katılan katılımcıların %45.8'inin vücut kitle indeksi yüksek bulundu. Suriyeli göçmen kadınların %95'inin mamografi çektirmediği, %92.8'inin kendi kendine meme muayenesi yapmadığı ve %68.5'inin meme kanseri erken tanı yöntemlerini bilmediği belirlendi. Araştırmaya katılan kadınların toplam meme kanseri riski 162.35 (50-675) olarak bulundu. Bu da 18 yaş üstü Suriyeli göçmen kadınların meme kanserine yakalanma riskinin orta derecede yüksek olduğu anlamına gelmektedir. Araştırmaya katılan kadınların meme kanserine yönelik farkındalık düzeyleri 8.1(0-27) olarak bulunmuştur. 41-50 yaş arası Suriyeli göçmen kadınların meme kanseri tarama farkındalık düzeylerinin 30-40 yaş grubundaki kadınlara göre daha yüksek olduğu belirlendi. Ayrıca katılımcıların eğitim düzeyi ne kadar yüksekse meme kanseri belirtilerine ilişkin farkındalık düzeylerinin de o kadar yüksek olduğu bulunmuştur. Sonuç: Araştırma sonuçlarına göre elde edilen bulgular dikkate alındığında: Kadınların meme kanserine ilişkin farkındalıklarının düşük olduğu bulunmuştur. Araştırmaya katılan kadınların eğitim düzeyi ile meme kanseri farkındalıklarının ters orantılı olduğu bulundu. Ayrıca kadınların çoğunun meme kanseri erken tanı uygulamalarını bildiği, ancak uygulamadığı belirlendi. Bu kapsamda dezavantajlı bir grup olan Suriyeli göçmen kadınların meme kanseri risklerini öğrenmeleri ve farkındalıklarını artırmaları için eğitim programları uygulanmalıdır.

Anahtar Kelimeler

• Erken tanı
• Farkındalık
• meme kanseri
• göç

Kaynakça

1. Akram, M., Iqbal, M., Daniyal, M., & Khan, A.U. (2017). Awareness and current knowledge of breast cancer. Biol Res, 50, 33. https://doi.org/10.1186/s40659-017-0140-9
2. Al-Khasawneh, E., Leocadio, M., Seshan, V., Siddiqui, S., Khan, A., & Al-Manaseer, M. (2016). Transcultural adaptation of the Breast Cancer Awareness Measure. International Nursing Review, 63(3), 445–454. https://doi.org/10.1111/inr.12265
3. Alatrash, M. (2020). Prevalence, perceived benefits, and perceived barriers regarding breast cancer screening among three Arab American women subgroups. Journal of Transcultural Nursing: Official Journal of the Transcultural Nursing Society, 31(3), 242–249. https://doi.org/10.1177%2F1043659619859058
4. Alawa, J., Hamade, O., Alayleh, A., Fayad L., & Khoshnood, K. (2020). Cancer Awareness and Barriers to Medical Treatment Among Syrian Refugees and Lebanese Citizens in Lebanon. J Canc Educ, 35, 709–717. https://doi.org/10.1007/s13187-019-01516-3
5. Alhomsi, K. (2020). Breast Cancer Screening Campaign of 2018 and 2019 at Al-Mouwasat University Hospital in Damascus. Syria Chemistry Research Journal, 5(6), 6-12. Available from: https://aspu.edu.sy/site/english/index.php?node=55190&cat=77596&First=11&Last=176&CurrentPage=11&wid=1136&refBack=
6. Alsaraireh, A., & Darawad, M.W. (2017). Breast cancer awareness, attitude and practices among female university students: A descriptive study from Jordan. Health Care for Women International, 1-13. https://doi.org/10.1080/07399332.2017.1368516
7. American Cancer Society. (2014). Breast Cancer Prevention and Early Detection. Available from: URL:http://www.cancer.org/cancer/breastcancer/moreinformation/ breastcancerearlydetection/index.
8. American Cancer Society. (2021). Breast Cancer. Available from: https://www.cancer.org/cancer/breast-cancer/risk-and-prevention/breast-cancer-risk-factors-you-cannot-change.html.

9. Aslan, F.E., & Gürkan, A. (2007). The Risk Of Breast Cancer At The Women. The Journal Of Breasth Health, 3 (2), 63-68. Available from: https://cms.galenos.com.tr/Uploads/Article_42688/ejbh-3-63-En.pdf
10. Babaoğlu, A.B., Büyüközmen, E., & Can, F.E. (2021). Awareness of Cancer Screening Tests in the Community in Izmir and Factors Affecting the Participation of Individuals in Cancer Screening Tests. Med J West Black Sea, 5(2), 173-181. https://doi.org/10.29058/mjwbs.853692
11. Bekteshi, V., & Schootman, M. (2024). Bridging gaps in breast cancer screening: a comparative study of mexican women in u.s. rural and urban areas. Journal of Primary Care & Community Health, 15. https://doi.org/10.1177/21501319241295916
12. Boulos, D. N., & Ghali, R.R. (2014). Awareness of breast cancer among female students at Ain Shams University, Egypt. Glob J Health Sci, 6, 154. https://doi.org/10.5539/gjhs.v6n1p154
13. Canadian Cancer Society. (2021). Early detection and screening for breast cancer. Available from: https://www.cancer.ca/en/region-selector-page/?url=%2fen%2fabout-us%2fpage-not-found%2f.
14. Canadian Cancer Society. (2021). Causes of Breast Cancer. Available from: http://www.cancer.ca/.
15. Cancer Research. (2021). The Cancer Awareness Measures. Available from: https://www.cancerresearchuk.org/health-professional/awareness-and-prevention/the-cancer-awareness-measures-cam.
16. Eroğlu, C., Eryılmaz, M.A., Cıvcık, S., & Gürbiz, Z. (2010). Breast Cancer Risk Assessment: 5000 Cases. International Journal of Hematology-Oncology, 20(1), 27-33. Available from: https://www.uhod.org/pdf/PDF_389.pdf
17. Esen, E.S., Taş, B.G., Öztürk, G.Z., & Toprak, D. (2020). Determination of breast cancer risk level in women 18 years of age or older. Turkish Journal of Family Practice, 24(1), 32-40. https://doi.org/10.15511/tahd.20.00132
18. General Directorate of Migration Management. (2021). Strategic Plan 2017-2021. Available from: https://www.goc.gov.tr/kurumlar/goc.gov.tr/evraklar/Stratejik-Yonetim/Stratejik-Planlar/yeni/Stratejik-Plan-2017_2021.pdf
19. Guruge, S., Hunter, J., Barker, K., McNally, M., & Magalhães, L. (2010). Immigrant women’s experiences of receiving care in a mobile health clinic. Journal of Advanced Nursing, 66(2), 350-359. https://doi.org/10.1111/j.1365-2648.2009.05182.x
20. Güzel, N., & Bayraktar, N. (2019). Determining Women's Awareness and Practices for Early Diagnosis of Breast Cancer. HUHEMFAD, 6(2), 101-110. Available from: https://dergipark.org.tr/en/download/article-file/773957
21. Hazra, A., Ullrich, A., & Nimri, O. (2023). Disparities in breast cancer characteristics among Syrian migrants and jordanian women in the jordan cancer registry from 2010 to 2016. Jama Network Open, 6(7), e2325197. https://doi.org/10.1001/jamanetworkopen.2023.25197
22. Htay, M.N., Donnelly, M., Schliemann, D., Loh, S.Y., Dahlui, M., Tamin, N.S.B., Somasundaram, S., & Su, T.T. (2020). Translation and Validation of the Breast Cancer Awareness Measurement Tool in Malaysia. Asian Pac J Cancer Prev, 21(1), 217–223. https://doi.org/10.31557/APJCP.2020.21.1.217
23. Husna, P.H., Marni Nurtanti, S., Handayani, S., Ratnasari, N.Y., Ambarwati, R., & Susanto, T. (2019). Breast self-examination education for skill and behavior. Educ Health (Abingdon), 32, 101–2. https://doi.org/10.4103/efh.EfH_226_18
24. IBM Corporation. (2011). IBM SPSS Statistics for Windows, Version 20.0. IBM Corporation.
25. Islam, N., Patel, S., Brooks-Griffin, Q., Kemp, P., Raveis, V., Riley, L., Gummi, S., Queano Nur, P., Ravenell, J., Cole, H., & Kwon, S. (2017). Understanding barriers and facilitators to breast and cervical cancer screening among Muslim women in New York City: Perspectives from key ınformants. S.M. Journal of Community Medicine, 3 (1): 1–11. https://pubmed.ncbi.nlm.nih.gov/29629435/
26. Jahan, S., Al-Saigul, A.M., & Abdelgadir, M.H. (2006). Breast cancer. Knowledge, attitudes and practices of breast self examination among women in Qassim region of Saudi Arabia. Saudi Med J, 27, 1737-41. https://pubmed.ncbi.nlm.nih.gov/17106553/
27. Khan, T.M., Leong, J.P., Ming, L.C., & Khan, A.H. (2015). Association of knowledge and cultural perceptions of Malaysian women with delay in diagnosis and treatment of breast cancer: a systematic review. Asian Pac J Cancer Prev, 16, 5349–57. https://doi.org/10.7314/apjcp.2015.16.13.5349
28. Linsell, L., Burgess, C.C., & Ramirez, A.J. (2008). Breast cancer awareness among older women. Brit J Cancer, 99, 1221-1225. https://doi.org/10.1038/sj.bjc.6604668
29. Madhukumar, S., Thambiran, U.R., Basavaraju, B., & Bedadala, M.R. (2017). A study on awareness about breast carcinoma and practice of breast self-examination among basic sciences’ college students, Bengaluru. J Family Med Prim Care, 6 (3), 487–490. https://doi.org/10.4103/2249-4863.222026
30. Morey, B., Gee, G., Ehrenstein, O., Shariff‐Marco, S., Canchola, A., Yang, J., … & Gomez, S. (2019). Higher breast cancer risk among immigrant asian american women than among us-born asian american women. Preventing Chronic Disease, 16. https://doi.org/10.5888/pcd16.180221
31. Omar, A., Bakr, A., & Ibrahim, N. (2020). Female medical students' awareness, attitudes, and knowledge about early detection of breast cancer in Syrian Private University, Syria. Heliyon, 6(4), e03819. https://doi.org/10.1016/j.heliyon.2020.e03819
32. Poehls, U., Hack, C.C., Wunderle, M., Renner, S.P., Lux, M.P., Beckmann, M.W., Fasching, P.A., & Nabieva, N. (2019). Awareness of breast cancer incidence and risk factors among healthy women in Germany: an update after 10 years. European Journal of Cancer Prevention, 28(6), 515-521 https://doi.org/10.1097/CEJ.0000000000000500
33. Racine, L., Andsoy, I., Maposa, S., Vatanparast, H., & Fowler-Kerry, S. (2021). Examination of Breast Cancer Screening Knowledge, Attitudes, and Beliefs among Syrian Refugee Women in a Western Canadian Province. Canadian Journal of Nursing Research, 54 (2), 177-189. https://doi.org/10.1177/08445621211013200
34. Radi, S.M. (2013). Breast Cancer Awareness among Saudi Females in Jeddah. Asian Pacific Journal of Cancer Prevention, 14(7), 4307–4312. https://doi.org/10.7314/apjcp.2013.14.7.4307
35. Rahman, S.A., Al–Marzouki, A., Otim, M., Khayat, N.E.H., Yousef, R., & Rahman, P. (2019). Awareness about Breast Cancer and Breast Self-Examination among Female Students at the University of Sharjah: A Cross-Sectional Study. Asian Pac J Cancer Prev, 20(6), 1901–1908. https://doi.org/10.31557/APJCP.2019.20.6.1901
36. Qadire, M.A., Aljezawi, M., & Al-Shdayfat, N. (2017). Cancer awareness and barriers to seeking medical help among Syrian refugees in Jordan: a baseline study. J Cancer Educ, 34, 19-25. https://doi.org/10.1007/s13187-017-1260-1
37. Saçıkara, Z., & Koçoğlu-Tanyer, D. (2021). Participation and Knowledge of Rural Women in Cervical and Breast Cancer Screening. Journal of Continuing Medical Education, 30 (1), 43-52. https://doi.org/10.17942/sted.652657
38. Sama, C.B., Dzekem, B., Kehbila, J., Ekabe, C.J, Vofo, B., Abua, N.L., & Angwafo, F.A. (2017). Awareness of breast cancer and breast self-examination among female undergraduate students in a higher teachers training college in Cameroon. Pan African Medical Journal, 28. https://doi.org/10.11604/pamj.2017.28.91.10986
39. Schliemann, D., Donnelly, M., Dahlui, M., Loh, S.Y., Ibrahim, N.S., Somasundaram, S., Donnelly, C., & Su, T.T. (2018). The ‘Be Cancer Alert Campaign’: protocol to evaluate a mass media campaign to raise awareness about breast and colorectal cancer in Malaysia. BMC Cancer, 18, 881. https://doi.org/10.1186/s12885-018-4769-8
40. Siegel, R.L., Miller, K.D., & Jemal, A. (2017). Cancer statistics. Cancer J Clin, 67, 7-30. https://doi.org/10.3322/caac.21387
41. Silbermann, M., Daher, M., Kebudi, R., Nimri, O., Al-Jadiry, M., & Baider, L. (2016). Middle eastern conflicts: implications for refugee health in the European Union and middle eastern host countries. J Glob Oncol, 2(6), 422–430. https://doi.org/10.1200/JGO.2016.005173
42. Stewart, B.W., & Wild, C.P. (2014). World Cancer Report 2014. Cenevre, İsviçre: WHO Press. https://doi.org/10.3945/an.116.012211
43. Sun, Y.S., Zhao, Z., Yang, Z.N., Xu, F., Lu, H.J., Zhu, Z.Y., Shi, W., Jiang, J., Yao, P.P., & Zhu, H.P. (2017). Risk Factors and Preventions of Breast Cancer. Int J Biol Sci, 13(11), 1387-1397. https://doi.org/10.7150/ijbs.21635
44. Example of Sultanbeyli. (2018). Syrians in Turkey in their 6th Year. Available from: https://www.raporlar.org/wp-content/uploads/2018/04/6-yilinda-Turkiyedeki-suriyeliler-sultanbeyli-ornegi.pdf 11-14.
45. T.C. Ministry of Health, General Directorate of Public Health, Department of Cancer. (2020). Breast Cancer Screening Program National Standards. Available from: https://hsgm.saglik.gov.tr/tr/kanser-tarama-standartlari/listesi/meme-kanseri-tarama-program%C4%B1-ulusal-standartlar%C4%B1.html.
46. Zorogastua, K., Sriphanlop, P., Reich, A., Aly, S. Cisse, A., & Jandorf, L. (2017). Breast and cervical cancer screening among U.S. and non-U.S. born African American Muslim women in New York City. AIMS Public Health, 4(1), 78–93. https://doi.org/10.3934/publichealth.2017.1.78
47. Yeung, M.P.S., Chan, E.Y.Y., Wong, S.Y.S., Yip, B.H.K., & Cheung, P.S.Y. (2019). Hong Kong female’s breast cancer awareness measure: Cross-sectional survey. World J Clin Oncol, 10(2), 98-109. https://doi.org/10.5306/wjco.v10.i2.98
48. Waks, A.G., & Winer, E.P. (2019). Breast Cancer Treatment: A Review. JAMA, 321(3), 288–300. https://doi.org/10.1001/jama.2018.19323.
49. World Health Organisation. (2018). 10 Facts About Cancer. Available from: http://www.who.int/features/factfiles/cancer/en/.
50. World Health Organization. (2019). Breast cancer: Early diagnosis and screening. https://www.who.int/cancer/prevention/diagnosis-screening/breast-cancer/en/