DOI QR코드

DOI QR Code

Differences in Breast and Cervical Cancer Screening Rates in Jordan among Women from Different Socioeconomic Strata: Analysis of the 2012 Population-Based Household Survey

  • Al Rifai, Rami (Department of International Health and Medicine, Division of Public Health, Tokyo Medical and Dental University) ;
  • Nakamura, Keiko (Department of International Health and Medicine, Division of Public Health, Tokyo Medical and Dental University)
  • Published : 2015.10.06

Abstract

Background: The burden of breast and cervical cancer is changing over time in developing countries. Regular screening is very important for early detection and treatment. In this study, we assessed inequalities in breast and cervical cancer screening rates in women according to household wealth status, and analyzed the potential predictors associated with a low cancer screening rate in Jordan. Materials and Methods: A nationwide populationbased cross-sectional survey collected information on different variables at the national level. All ever-married women (the phrase is used throughout the text to refer to women who had ever married) aged 15-49 years were included in the survey. Analysis of breast self-examination (BSE) and clinical breast examination (CBE) at least once in the previous year was carried out in 11,068 women, while lifetime Pap-smear testing was carried out in 8,333 women, aged 20-49 years. Results: Over 39% and 19% of ever-married Jordanian women reported having undergone a breast examination during the previous year and Pap smear examination at least once in their lifetime, respectively. The rate of BSE in the previous year was 31.5%, that of CBE in the previous year was 19.3%, and that of Pap smear examination at least once in life was 25.5%. The adjusted OR was higher for performing BSE (aOR 1.22, 95% CI 1.04-1.43), undergoing CBE (aOR 1.31, 95% CI 1.08-1.60) and undergoing Pap smear examination (aOR 2.38, 95% CI 1.92-2.93) among women in the highest wealth-index quintile as compared to those in the lowest quintile. The concentration index was 0.11 for BSE, 0.01 for CBE, and 0.27 for Pap smear examination. Women in their twenties, living in rural or the southern region of Jordan, with an elementary school education or less, who listened to the radio or read the newspaper not more than a few times a year, and nulliparous women were less likely to undergo breast and cervical cancer screening. Conclusions: The rates of breast and cervical cancer screening are low in Jordan. Reducing the sociodemographic and economic inequalities in breast and cervical cancer screenings requires concerted outreach activities for women living under socially deprived conditions.

Keywords

References

  1. Akinyemiju TF (2012). Socio-economic and health access determinants of breast and cervical cancer screening in low-income countries: analysis of the world health survey. PLoS One, 7, 48834. https://doi.org/10.1371/journal.pone.0048834
  2. Al Nsour M, Brown DW, Tarawneh M, et al (2012). Breast and cervical cancer screening among women in Jordan: Findings from the behavioral risk factor surveillance system-2007. Open Breast Cancer J, 4, 1-7. https://doi.org/10.2174/1876817201204010001
  3. Al Sairafi M, Mohamed FA (2009). Knowledge, attitudes, and practice related to cervical cancer screening among Kuwaiti women. Med Princ Pract, 18, 35-42. https://doi.org/10.1159/000163044
  4. Al-Meer FM, Aseel MT, Al-Khalaf J, et al (2011). Knowledge, attitude and practices regarding cervical cancer and screening among women visiting primary health care in Qatar. EMHJ, 17, 855-61.
  5. Althuis MD, Dozier JM, Anderson WF, et al (2005). Global trends in breast cancer incidence and mortality 1973-1997. Int J Epidemiol, 34, 405-12 https://doi.org/10.1093/ije/dyh414
  6. Amarin ZO, Badria LF, Obeidat BR (2008). Attitudes and beliefs about cervical smear testing in ever-married Jordanian women. East Mediterr Health J, 14, 389-97.
  7. Breen N, Wagener DK, Brown ML, et al (2001). Progress in cancer screening over a decade: Results of cancer screening from the 1987, 1992, and 1998 national health interview surveys. J Natl Cancer Inst, 93, 1704-13. https://doi.org/10.1093/jnci/93.22.1704
  8. Dahlui M, Ng C, Al-Sadat, et al (2011). Is breast self examination (BSE) still relevant? A study on BSE performance among female staff of university of Malaya. Asian Pac J Cancer Prev, 12, 369-72.
  9. Elovainio L, Nieminen P, Miller AB (1997). Impact of cancer screening on women's health. Int J Gynaecol Obstet, 58, 137-47. https://doi.org/10.1016/S0020-7292(97)02859-2
  10. Gakidou E, Nordhagen S, Obermeyer Z (2008). Coverage of cervical cancer screening in 57 countries: Low average levels and large inequalities. PLoS Medicine, 5, 132. https://doi.org/10.1371/journal.pmed.0050132
  11. GLOBOCAN (2012) Estimated cancer incidence, mortality, and prevalence worldwide in 2012. Facts sheets, jordan. cancer incidence and mortality worldwide: IARC Cancer Base No.10, Lyon, France: International Agency for Research on Cancer; 2012. Available at: http://globocan.iarc.fr/Pages/fact_sheets_population.aspx
  12. ICO Information Centre on HPV and Cancer, Human Papillomavirus and Related Cancers, Fact Sheet 2013. Available at: http://www.hpvcentre.net/statistics/reports/JOR_FS.pdf.
  13. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90 https://doi.org/10.3322/caac.20107
  14. Jemal A, Center MM, DeSantis C, et al (2010). Global patterns of cancer incidence and mortality rates and trends. Cancer Epidemiology, Biomarkers & Prevention, 19, 1893-907.
  15. Jordan breast cancer program, Early Detection Plan. Available at: http://www.jbcp.jo
  16. Jordan Economy Profile (2014). Available at: http://www.indexmundi.com/jordan/economy_profile.html
  17. Jordan Population and Family Health Survey 2007. Department of Statistics [Jordan] and ICF International. 2008. Calverton, Maryland, USA: Department of Statistics and ICF International.
  18. Jordan Population and Family Health Survey 2012. Department of Statistics [Jordan] and ICF International. 2013. Calverton, Maryland, USA: Department of Statistics and ICF International.
  19. Jordan profile 2015, World Health Organization, Global Health Observatory Data Repository. http://apps.who.int/gho/data/node.country.country-JOR
  20. Library of Congress [US], Federal Research Division. Country profile: Jordan. Washington (DC): Library of Congress; 2006. Available at: http://lcweb2.loc.gov/frd/cs/profiles/Jordan.pdf.
  21. Maaita M, Barakat M (2002). Jordanian women's attitudes towards cervical screening and cervical cancer. J Obstet Gynaecol, 22, 421-2. https://doi.org/10.1080/01443610220141416
  22. Maqsood B, Zeeshan MM, Rehman F, et al (2009). Breast cancer screening practices and awareness in women admitted to a tertiary care hospital of Lahore, Pakistan. J Pak Med Assoc, 59, 418-21
  23. Marmot M, Friel S, Bell R, et al (2008). Closing the gap in a generation: health equity through action on the social determinants of health. commission on social determinants of health. Lancet, 372, 1661-9. https://doi.org/10.1016/S0140-6736(08)61690-6
  24. McKinnon B, Harper S, Moore S (2011). Decomposing incomerelated inequality in cervical screening in 67 countries. Int J Public Health, 56, 139-52. https://doi.org/10.1007/s00038-010-0224-6
  25. Montazeri A, Vahdaninia M, Harirchi I, et al (2008). Breast cancer in Iran: need for greater women awareness of warning signs and effective screening methods. Asia Pac Fam Med, 7, 6. https://doi.org/10.1186/1447-056X-7-6
  26. O'Donnell O, Van Doorslaer E, Wagstaff A, et al (2008). Analyzing health equity using household survey data: a guide to techniques and their implementation. Washington, DC: The World Bank. Available at: http://siteresources.worldbank.org/INTPAH/Resources/Publications/459843-1195594469249/HealthEquityFINAL.pdf
  27. Parkin DM, Nambooze S, Wabwire-Mangen F, et al (2010). Changing cancer incidence in kampala, uganda, 1991-2006. Int J Cancer, 126, 1187-95. https://doi.org/10.1002/ijc.24838
  28. Parkin DM, Sitas F, Chirenje M, et al (2008). Part I: Cancer in indigenous africans-burden, distribution, and trends. Lancet Oncol, 9, 683-92. https://doi.org/10.1016/S1470-2045(08)70175-X
  29. Porter P (2008). "Westernizing" women's risks? breast cancer in lower-income countries. N Engl J Med, 358, 213-6. https://doi.org/10.1056/NEJMp0708307
  30. Porter PL (2009). Global trends in breast cancer incidence and mortality. Salud Publica Mex, 51, 141-6. https://doi.org/10.1590/S0036-36342009000800003
  31. Rutstein S, Johnson K. The DHS wealth index. In DHS Comparative Reports No. 6. 2004, Calverton, Maryland: ORC Macro.
  32. Sankaranarayanan R, Boffetta P (2010). Research on cancer prevention, detection and management in low- and mediumincome countries. Ann Oncol, 21, 1935-43 https://doi.org/10.1093/annonc/mdq049
  33. Sim HL, Seah M, Tan SM (2009). Breast cancer knowledge and screening practices: a survey of 1,000 Asian women. Singapore Med J, 50, 132-38.
  34. Tfayli A, Temraz S, Abou Mrad R, et al (2010). Breast cancer in low- and middle-income countries: an emerging and challenging epidemic. J Oncol, 2010, 490631.
  35. Thun MJ, DeLancey JO, Center MM, et al (2010). The global burden of cancer: Priorities for prevention. Carcinogenesis, 31, 100-110. https://doi.org/10.1093/carcin/bgp263
  36. Underwood C, Kamhawi S, Nofal A (2013). Religious leaders gain ground in the Jordanian family-planning movement. Int J Gynaecol Obstet, 123, 33-7. https://doi.org/10.1016/j.ijgo.2013.05.005
  37. Wagstaff A (2011). The concentration index of a binary outcome revisited. J Health Econ, 20, 1155-60. https://doi.org/10.1002/hec.1752
  38. Wilson CM, Tobin S, Young RC (2004). The exploding worldwide cancer burden: The impact of cancer on women. Int J Gynecol Cancer, 14, 1-11.
  39. World Cancer Report, 2014. Available at: http://www.who.int/mediacentre/factsheets/fs297/en/
  40. Yoo BN, Choi KS, Jung KW, et al (2012). Awareness and practice of breast self-examination among Korean women: results from a nationwide survey. Asian Pac J Cancer Prev, 13, 123-5. https://doi.org/10.7314/APJCP.2012.13.1.123
  41. Zur Hausen H (2009). Papillomaviruses in the causation of human cancers-a brief historical account. Virology, 384, 260-5. https://doi.org/10.1016/j.virol.2008.11.046

Cited by

  1. Influence of Genotype and Haplotype of MDR1 (C3435T, G2677A/T, C1236T) on the Incidence of Breast Cancer - a Case-Control Study in Jordan vol.17, pp.1, 2016, https://doi.org/10.7314/APJCP.2016.17.1.261
  2. Knowledge, attitudes and barriers towards breast cancer health education among community pharmacists vol.7, pp.3, 2016, https://doi.org/10.1111/jphs.12140
  3. Individual-level and community-level determinants of cervical cancer screening among Kenyan women: a multilevel analysis of a Nationwide survey vol.17, pp.1, 2017, https://doi.org/10.1186/s12905-017-0469-9
  4. Avaliação da não realização do exame Papanicolaou por meio do Sistema de Vigilância por inquérito telefônico vol.52, pp.0, 2018, https://doi.org/10.1590/s1980-220x2017029503390