Evaluation of Women’s Knowledge about Risk Factors and Early Detection of Breast Cancer among Women Working in Governmental Sector in Gaza Strip, Palestine

Evaluation of Women’s Knowledge about Risk Factors and Early Detection of Breast Cancer among Women Working in Governmental Sector in Gaza Strip, Palestine | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Evaluation of Women’s Knowledge about Risk Factors and Early Detection of Breast Cancer among Women Working in Governmental Sector in Gaza Strip, Palestine Eman suliman hassouna This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5711635/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose: The purpose of the study was to evaluate women's knowledge about signs and symptoms, risk factors and early detection of breast cancer at governmental sector in Gaza Strip. Materials &Methods: The study utilized a cross-sectional design. The sample included 253 women employed in the ministries in Gaza Strip. Data were collected through a pre-tested self-administered questionnaire. Results: The results showed no significant association between knowledge about BC and age, marital status, and level of education. Participated women were able to recognize signs and symptoms of BC. They were knowledgeable about risk factors, screening and early detection, the factors that increase the possibility of BC, and measures to prevent development of BC. Conclusion: The researcher expects that this study may help in increasing the attention about screening and early detection of BC in order to improve the outcome. Health Economics & Outcomes Research Women’s knowledge Risk factors Screening and early detection Breast cancer Gaza Strip Introduction Breast cancer (BC) is the most common prevailing type of women cancer and is the second cause of cancer-related mortality in women (Alotaibi et al., 2018 ). According to the World Health Organization (WHO) reports, in 2020, there were 2.3 million women diagnosed with BC and 685 000 deaths globally. As of the end of 2020, there were 7.8 million women alive who were diagnosed with BC in the past 5 years, making it the world’s most prevalent cancer. BC occurs in every country of the world in women at any age after puberty but with increasing rates in later life (WHO, 2023). BC patients account for as much as 36% of oncological patients (Nardin et al., 2020 ). The incidence of BC is increasing all over the world, but the highest incidence occurs in industrialized countries as almost half of the cases on a global scale are in developed countries (Global Cancer Observatory, 2020). The ongoing increase in the incidence of BC is mainly attributed to the modern lifestyle, associated with a poor diet, nicotine smoking, excessive stress and poor physical activity (Bellanger et al., 2018 ). In the United States, the crude rate of BC was 85/105, in United Kingdom 94/105, in Germany 85.4/105, and the average incidence in Europe was 84/105 (Global Cancer Observatory, 2020). In the Middle East, BC is the most prevalent cancer among females; In Qatar, BC is the most commonly diagnosed cancer among women. According to the estimation of the Global Cancer Observatory, BC ranks highest, accounting for 37.5% of new cancer cases in females recorded in Qatar (Global Cancer Observatory, 2021). The incidence of BC in Algeria is 49.3, in Jordan 39.7, in Kuwait 40.8, in Lebanon 16.9, and in Morocco 35.6 (Al-Shamsi et al., 2022 ). In Palestine, BC is ranked the highest in women accounting for 35.6% (Salem, 2023 ). Several demographic, social and biomedical risk factors are associated with BC. Age of the women, early age at menarche, delayed first birth and menopause, nulliparity, short duration lactation, use of birth control pills, obesity, excess consumption of fats, hormone replacements and more importantly women having family history are considered as significant risk factors of BC by various epidemiological and clinical studies (Vishwakarma et al., 2019 ; Mathew et al., 2008 ; Mohite et al., 2015 ). Early detection of BC is of great importance in improving the prognosis and increase survival rate. This can be attained by breast-self exam (BSE), periodic mammography, awareness of signs and symptoms, and adequate knowledge about risk factors contributing to the possibility of developing BC (Almeshari et al., 2023 ). Due to the seriousness of BC, it is essential to make sure that women are aware of its threatening effect on life and the importance of early detection through knowing signs and symptoms. Therefore, the purpose of this study is to evaluate the knowledge about risk factors of BC, signs and symptoms and methods of screening among women working in governmental sector in Gaza Strip. Materials and Methods Design and sample A cross-sectional study was conducted on 253 women working in governmental sector in Gaza Strip including Ministry of Health, Ministry of Education, ministry of Labor ….. The targeted women were contacted online, using google forms to fill the questionnaires. Instrument of the study The researcher used a pre-tested self-administered questionnaire. The questionnaire was designed to measure total knowledge about breast cancer (Alabbody et al., 2017 ). The questionnaire consisted of the following parts: personal information (age, marital status, and level of education). Knowledge about signs and symptoms of BC, screening methods and early detection of BC, risk factors, controlling and prevention of BC. Data collection Data were collated and subject to quality measures. The data were reviewed and cleaned before statistical analysis. Data analysis Data analysis was performed using the SPSS (version 25). Descriptive statistics such as frequencies and percentages were computed for categorical variables; whereas, means and standard deviations were for continuous variables. Analyses also included t-tests and one-way ANOVA to assess the association between independent and dependent variables. Chi square was also carried out to find out the correlations between two continuous variables. The significance level (p-value) was set at 0.05. Ethical consideration The researcher obtained agreement from MoH to carry out the study. Before starting data collection, participants were informed about the objectives, methodology and the approximate time to complete the questionnaire. Informed consent was obtained from each participant. In addition, participants were also assured that all information related to them will be kept confidential. Results Table (1): Distribution of study participants by sociodemographic factors Variable Group n Percent (%) Age 21–30 years 30 11.9 31–40 years 120 47.4 41–50 years 79 31.2 51–60 years 24 9.5 Total 253 100.0 Marital status Married 205 81.0 Single 31 12.3 Divorced 13 5.1 Widow 4 1.6 Total 253 100.0 Level of education Secondary school and less 25 9.9 Intermediate diploma 19 7.5 Bachelor degree 139 54.9 Postgraduate 70 27.7 Total 253 100.0 Table (1) showed that age of the women ranged between 21–60 years, the age group 31–40 years old was the most prevalent (47.4%) followed by the age group 41–50 years old (31.2%). The majority of them were married (81%), and most of them have bachelor degree (54.9%). Table (2): Knowledge about the importance of early detection of breast cancer Variable Level of knowledge x² P value Low n(%) Moderate n(%) Good n(%) Age 21–30 years 1(0.4) 14(5.5) 15(5.9) 3.069 0.800 31–40 years 2(0.8) 45(17.8) 73(28.9) 41–50 years 2(0.8) 31(12.3) 46(18.2) 51–60 years 0 7(2.8) 17(6.7) Total 5(2.0) 97(38.3) 151(59.7) Marital status Married 3(1.2) 74(29.2) 128(50.6) 7.952 0.221 Single 1(0.4) 16(6.3) 14(5.5) Divorced 1(0.4) 5(2.0) 7(2.8) Widow 0 2(0.8) 2(0.8) Total 5(2.0) 97(38.3) 151(59.7) Level of education Secondary school and less 1(0.4) 11(4.3) 13(5.1) 3.511 0.742 Bachelor 4(1.6) 53(20.9) 82(32.4) Intermediate diploma 0 7(2.8) 12(4.7) Postgraduate 0 26(10.3) 44(17.4) Total 5(2.0) 97(38.3) 151(59.7) Table (2) presented the correlation between level of knowledge and age, marital status, and level of education. The results showed that 2% of women have low knowledge, 38.3% have moderate knowledge, and 59.7% have good knowledge about the importance of early detection of BC. 28.9% of women from the age group 31–40 years and 18.2% of women from the age group 41–50 years have good knowledge without statistical significant differences (p = 0.800). Also, 50.6% of married women have good knowledge and 29.2% have moderate knowledge, without statistical significant differences (p = 0.221). The results also showed that 32.4% of women who hold bachelor degree have good knowledge and 20.9% have moderate knowledge, without statistical significant differences (p = 0.742). These results indicated no statistical significant differences in level of knowledge about the importance of early detection of BS related to personal characteristics of women. Table (3): Knowledge about signs and symptoms of breast cancer Answers about symptoms of BC n % Change in breast shape & size, painless breast mass, armpit node 3 1.2 Change in breast shape & size, painless breast mass, armpit node, abnormal secretions from the nipple 3 1.2 Change in breast shape & size, painless breast mass, armpit node, abnormal secretions from the nipple, thickness of breast tissue 69 27.3 Change in breast shape & size, painless breast mass, armpit node, abnormal secretions from the nipple, thickness of breast tissue, itching, ulceration of nipple 26 10.3 Change in breast shape & size, painless breast mass, armpit node, visible blood vessels on skin of breast 1 0.4 Change in breast shape & size, painless breast mass, armpit node, thickness of breast 2 0.8 Change in breast shape & size, thickness of breast tissue 42 16.6 Change in breast shape & size, white milk-like secretion from the nipple 2 0.8 Painless breast mass, armpit node 44 17.4 Painless breast mass, armpit node, abnormal secretions from the nipple 2 0.8 Painless breast mass, armpit node, abnormal secretions from the nipple, inverted nipple 1 0.4 Painless breast mass, armpit node, abnormal secretions from the nipple, visible blood vessels on skin of breast 1 0.4 Painless breast mass, armpit node, abnormal secretions from the nipple, visible blood vessels on skin of breast, thickness of breast tissue 6 2.4 Painless breast mass, armpit node, abnormal secretions from the nipple, itching, ulceration of nipple 1 0.4 Painless breast mass, armpit node, thickness of breast tissue 6 2.4 Painless breast mass, white milk-like secretion from the nipple, visible blood vessels on skin of breast, itching, ulceration of nipple 4 1.6 All the symptoms 40 15.8 Total 253 100.0 Table (3) illustrated the knowledge about signs and symptoms of BC. The results showed that 27.3% of study participants know that change in breast shape & size, painless breast mass, armpit node, abnormal secretions from the nipple, and thickness of breast were among symptoms of BC, 17.4% know that symptoms of BC included painless breast mass, and axillary node. Also, 15.8% know all the symptoms of BC. These results indicated that women knew most of the signs and symptoms of BC. Table (4): Knowledge about risk factors of breast cancer Factor Response n Percent (%) Effect of aging on the possibility of developing BC Decrease 4 1.6 Increase 180 71.2 No effect 33 13.0 I do not know 36 14.2 Effect of not becoming pregnant on the possibility of developing BC Decrease 15 5.9 Increase 150 59.3 No effect 54 21.3 I do not know 34 13.4 Effect of removal of ovaries on the possibility of developing BC Decrease 22 8.7 Increase 106 41.9 No effect 105 41.5 I do not know 20 7.9 Effect of obesity after menopause on the possibility of developing BC Decrease 6 2.4 Increase 145 57.3 No effect 66 26.1 I do not know 36 14.2 Main reason of increasing the possibility of developing BC in obese women after menopause Elevated estrogen level 42 16.6 Elevated estrogen level, elevated level of antioxidants in the blood 124 49.0 elevated level of antioxidants in the blood 30 11.9 Inadequate physical activity 57 22.5 Table (4) showed that 71.2% of women stated that increasing of age will increase the possibility of developing BC, 59.3% reported that absence of pregnancy and childbirth increase the possibility of developing BC, 41.9% said that removal of ovaries increase the chance of having BC, 57.3% stated that obesity after menopause increase the possibility of BC. Also, 49% of women stated that elevated estrogen level, and elevated level of antioxidants in the blood increase the possibility of developing BC after menopause. Table (5): Knowledge about methods of screening, early detection and prevention of breast cancer Knowledge about: n Percent (%) Methods of screening and early detection of BC Breast self-exam (BSE) 38 15.0 BSE, radio-active imaging 13 5.1 BSE, radio-active imaging, fine needle aspiration 6 2.4 BSE, radio-active imaging, ultra-sonography 7 2.8 BSE, clinical exam 33 13.0 BSE, clinical exam, radio-active imaging 40 15.8 BSE, clinical exam, ultra-sonography 10 4.0 BSE, ultra-sonography 18 7.1 Clinical exam, radio-active imaging 8 3.2 All the methods 80 31.6 Total 253 100.0 Preferable time to perform BSE Every week 6 2.4 Every month, before menstruation 6 2.4 Every month, after menstruation 189 74.7 Every year 52 20.6 International strategies to control & reduce incidence of BC Early detection 68 26.9 Prevention 10 4.0 Prevention & early detection 172 68.0 Treatment at early stage 3 1.2 Total 253 100.0 Table (5) presented screening methods of BC. The results showed that 15% of study participants knew that BSE was a method of screening for BC, 15.8% reported BSE, clinical exam, and radio-active imaging as methods of screening for BC, 13% knew that BSE and clinical exam were screening method for BC. It is noticed that BSE was the most prevalent method as stated by the studied women. Also, 74.7% of women stated that the preferable time for performing B was every month after the menses, and 68% reported that prevention and early detection are the best strategies to control and prevent the development of BC. Table (6): Factors of controlling and prevention of breast cancer Knowledge about: n Percent (%) Factors that help in decreasing the incidence BC Regular periodic breast exam 51 20.2 Early pregnancy, visit the doctor when detecting breast lump, regular periodic breast exam 8 3.2 Early pregnancy, physical activity / sporting 9 3.6 Regular periodic breast exam, visit the doctor when detecting breast lump 80 31.6 Regular periodic breast exam, visit the doctor when detecting breast lump, physical activity / sporting 42 16.6 Physical activity / sporting, decrease fat consumption, regular periodic breast exam 21 8.3 All the mentioned factors 42 16.6 Total 253 100.0 Methods of preventing breast cancer Good nutrition 14 5.5 Good nutrition, avoid hormones consumption 25 9.9 Good nutrition, weight control 29 11.5 Good nutrition, increase physical activity 9 3.6 Good nutrition, increase physical activity, weight control, avoid hormones consumption 16 6.3 Weight control, avoid hormones 6 2.4 Increase physical activity, weight control, avoid hormones 12 4.7 Avoid alcohol consumption, good nutrition 27 10.7 All the above mentioned are correct 73 28.9 All the above mentioned are not correct 42 16.6 Total 253 100.0 Table (6) illustrated that regular periodic breast exam, and visiting the doctor when detecting breast lump are factors that help in decreasing the incidence of BC, and 20% considered periodic breast exam as a factor for decreasing the incidence of BC. The results also showed that 11.5% of studied women stated that good nutrition, and weight control are essential methods to prevent the development of BC and 28.9% know all the methods of prevention of BC. Discussion The results showed that more than half of the women have good knowledge about the importance of early detection of BC, and they were aware and knew most of the signs and symptoms of BC. The results of Almeshari et al. ( 2023 ) showed that the overall knowledge level about BC was 46.36%. Similarly, the results of Hamed et al. ( 2022 ) showed that women could recognize the symptoms of BC such as lump or thickening under the armpit (54%), lump in the breast or thickening of the breast tissue (50.9%), while other signs and symptoms were not recognized by more than half of the women, while the results of Sarker et al. ( 2022 ) indicated that the overall mean score of total knowledge items about BC was 34.3%; knowledge about signs and symptoms of BC was 36.8%, and the most common symptoms that were recognized correctly were color change of breast (48.3%), new lump in the breast or armpit (42.8%), and change in breast shape and size including inverted nipple (40.3%). The studied women expressed good knowledge about risk factors of BC including older age, abundant from pregnancy and childbirth, resection of ovaries, and obesity after menopause. The results of Sarker et al. ( 2022 ) showed that the mean score of knowledge about BC risk was 33.5%. Moreover, the studied women expressed knowledge about screening methods including BSE, radio-active imaging, ultrasonography, clinical exam, and fine needle aspiration. Most of the women knew that the preferred time to perform BSE was every month after menses, and prevention and early detection were the highest strategies to control and prevent BC. The results of Hamed et al. ( 2022 ) indicated that among those who perform BSE, a fifth only check at least once every 6 months (19.95%), checking at least once a month (18.43%), and checking at least once a week (8.3%). In addition, the results of Sarker et al. ( 2022 ) indicated that the mean score of knowledge about BC screening was 36.4%. Factors that help in decreasing the incidence of BC included periodic breast exam on regular bases, physical activity and engagement in sports activities. The results of Almeshari et al. ( 2023 ) showed that respondents had average knowledge about risk factors as well as signs and symptoms (57.62% and 52%, respectively), whereas awareness and practice of BSE and screening methods were 36.37% and 38.9% respectively. The studied women showed good knowledge about methods of preventing BC including good nutrition, avoiding hormones consumption, weight control, and physical activity. The results of Sarker et al. ( 2022 ) indicated that the mean score of knowledge about BC prevention was 36.2%. Conclusion The present study concluded that women who are working in governmental sector have relatively overall good knowledge about signs and symptoms of BC, screening methods, risk factors, and preventive measures of BC. Special training programs about BSE and screening should be held to reach a large number of women. Also, women should be encouraged to talk about BSE to their friends and relatives at home in order to improve awareness about BSE and encourage them to get professional medical exam periodically in order to decrease the ongoing steady increase in BC in Gaza Strip. The researcher expects that this study may help in increasing the attention about screening for early detection of BC in order to provide early treatment, which will result in improving the outcome, improving the quality of life of survivors, and decreasing the mortality rate of BC. Declarations My study was approved by the Ethics Committee (IRB) of (Gaza ministry of Health), and the approval number is (210005486) References Alabbody H, Alelwan N, Atoof W, Badn B. Evaluation of women' s knowledge about risk factors and early detection of breast cancer at Ibn Rushd College of Education in Baghdad University. Iraqi National Journal of Nursing Specialties, 2017; 30(1); 117-123. Almeshari M, Alzamil Y, Alyahyawi A, Abanomy A, Althmali O, Al-Enezi M. S, et al. Awareness level, knowledge and attitude towards breast cancer among staff and students of Hail University, Saudi Arabia. Plos one, 2023; 18 (3), e0282916.‏ Alotaibi RM, Rezk HR, Juliana CI, Guure C. Breast cancer mortality in Saudi Arabia: Modelling observed and unobserved factors. PLoS One. 2018; 13(10):1–16. https://doi.org/10.1371/journal.pone. 0206148 PMID: 30347002. Al-Shamsi, H. O., Abu-Gheida, I. H., Iqbal, F., & Al-Awadhi, A.. Cancer in the Arab world. 2022 476. Springer Nature.‏ Anton-Culver H, Chang J, Bray F, Znaor, A, Stevens L, Eser S, et al. Cancer burden in four countries of the Middle East Cancer Consortium (Cyprus; Jordan; Israel; Izmir (Turkey)) with comparison to the United States surveillance; epidemiology and end results program. Cancer Epidemiol. 2016; 44: 195–202. Bellanger M., Zeinomar N., Tehranifar P., Terry M.B. Are Global Breast Cancer Incidence and Mortality Patterns Related to Country-Specific Economic Development and Prevention Strategies? J. Glob. Oncol . 2018;4:1–16. doi: 10.1200/JGO.17.00207 Global Cancer Observatory.International Agency for Research on Cancer. Global Cancer Observatory. Cancer Today. 2020. https://gco.iarc.fr/today. Accessed 10.9.2023. Hamed E, Alemrayat B, Syed M, Daher-Nashif S, Abu Rashed H, Kane T. Breast cancer knowledge, attitude, and practice among women in Qatar. International Journal of Environmental Research and Public Health, 2022; 19, 3995. https://doi.org/10.3390/ijerph19073995. Mathew A, Gajalakshmi V, Rajan B, Kanimozhi V, Brennan P, Mathew BS, et al. Anthropometric factors and breast cancer risk among urban and rural women in South India: a multicentre case-control study. Br J Cancer. 2008; 99(1):207–13. Mohite VR, Pratinidhi AK, Mohite RV. Reproductive risk factors and breast cancer: a case control study from rural India. Bangladesh J Med Sci. 2015; 14(3):258–64. Nardin S., Mora E., Varughese F.M., D’Avanzo F., Vachanaram A.R., Rossi V., Saggia C., Rubinelli S., Gennari A. Breast Cancer Survivorship, Quality of Life, and Late Toxicities. Front. Oncol . 2020;16:864. doi: 10.3389/fonc.2020.00864. Salem H. S. Cancer status in the Occupied Palestinian Territories: types; incidence; mortality; sex, age, and geography distribution; and possible causes. Journal of Cancer Research and Clinical Oncology, 2023; 149 (8): 5139-5163.‏ Sarker R, Islam M.S, Moonajilin M.S, Rahman M, Gesesew HA, Ward PR. Knowledge of breast cancer and breast self-examination practices and its barriers among university female students in Bangladesh: Findings from a cross-sectional study. PLoS ONE, 2022; 17(6): e0270417. https://doi.org/10.1371/journal. pone.0270417. The Global Cancer Observatory. International Agency for Research on Cancer, March 2021. https://gco.iarc.fr/ today/data/factsheets/populations/634-qatar-fact-sheets.pdf. Vishwakarma G, Ndetan H, Das DN, Gupta G, Suryavanshi M, Mehta A, et al. Reproductive factors and breast cancer risk: a meta-analysis of case-control studies in Indian women. South Asian J Cancer. 2019;8(2):80-84. WHO. Breast cancer. Key facts, July 2023. https://www.who.int/news-room/fact-sheets/detail/breast-cancer. Additional Declarations The authors declare no competing interests. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5711635","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":394336029,"identity":"54272852-6793-46a9-8bcb-a2181ebd9978","order_by":0,"name":"Eman suliman hassouna","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4ElEQVRIiWNgGAWjYHACNoYPBhI8bOw9YB4PHzFaGGdUWMjw8ZxhYDgA1MJGjBZmnjMVNnISOWAtDAS18IsdfvaAtw3oMMm3Bx9/zLGTYWNgfvjoBh4tkrPTzA0kQVqk85INDm5LBjqMzdg4B48Wg9sJZhKGYC05ZhIHtzEDtYDYeLTY307/JpEIdtgZkJZ6wloMQIYfOAPUIsED0nKYsBaJ2zllkg0VQC08OcYGZ7cd52FjJuAX/tnp26T/GNTZy7efMXxQua3anp+9+eFjfFqwAGbSlI+CUTAKRsEowAIAw98994DDKFMAAAAASUVORK5CYII=","orcid":"","institution":"","correspondingAuthor":true,"prefix":"","firstName":"Eman","middleName":"suliman","lastName":"hassouna","suffix":""}],"badges":[],"createdAt":"2024-12-25 14:14:47","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-5711635/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5711635/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":74209704,"identity":"4058c299-1edb-48e9-8863-86c30964e261","added_by":"auto","created_at":"2025-01-20 04:50:48","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":933672,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5711635/v1/0aaa6b70-b826-4196-b908-6cd095d6793a.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eEvaluation of Women’s Knowledge about Risk Factors and Early Detection of Breast Cancer among Women Working in Governmental Sector in Gaza Strip, Palestine\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eBreast cancer (BC) is the most common prevailing type of women cancer and is the second cause of cancer-related mortality in women (Alotaibi et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). According to the World Health Organization (WHO) reports, in 2020, there were 2.3\u0026nbsp;million women diagnosed with BC and 685 000 deaths globally. As of the end of 2020, there were 7.8\u0026nbsp;million women alive who were diagnosed with BC in the past 5 years, making it the world\u0026rsquo;s most prevalent cancer. BC occurs in every country of the world in women at any age after puberty but with increasing rates in later life (WHO, 2023).\u003c/p\u003e \u003cp\u003eBC patients account for as much as 36% of oncological patients (Nardin et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). The incidence of BC is increasing all over the world, but the highest incidence occurs in industrialized countries as almost half of the cases on a global scale are in developed countries (Global Cancer Observatory, 2020).\u003c/p\u003e \u003cp\u003eThe ongoing increase in the incidence of BC is mainly attributed to the modern lifestyle, associated with a poor diet, nicotine smoking, excessive stress and poor physical activity (Bellanger et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). In the United States, the crude rate of BC was 85/105, in United Kingdom 94/105, in Germany 85.4/105, and the average incidence in Europe was 84/105 (Global Cancer Observatory, 2020).\u003c/p\u003e \u003cp\u003eIn the Middle East, BC is the most prevalent cancer among females; In Qatar, BC is the most commonly diagnosed cancer among women. According to the estimation of the Global Cancer Observatory, BC ranks highest, accounting for 37.5% of new cancer cases in females recorded in Qatar (Global Cancer Observatory, 2021). The incidence of BC in Algeria is 49.3, in Jordan 39.7, in Kuwait 40.8, in Lebanon 16.9, and in Morocco 35.6 (Al-Shamsi et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). In Palestine, BC is ranked the highest in women accounting for 35.6% (Salem, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSeveral demographic, social and biomedical risk factors are associated with BC. Age of the women, early age at menarche, delayed first birth and menopause, nulliparity, short duration lactation, use of birth control pills, obesity, excess consumption of fats, hormone replacements and more importantly women having family history are considered as significant risk factors of BC by various epidemiological and clinical studies (Vishwakarma et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Mathew et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2008\u003c/span\u003e; Mohite et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2015\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eEarly detection of BC is of great importance in improving the prognosis and increase survival rate. This can be attained by breast-self exam (BSE), periodic mammography, awareness of signs and symptoms, and adequate knowledge about risk factors contributing to the possibility of developing BC (Almeshari et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDue to the seriousness of BC, it is essential to make sure that women are aware of its threatening effect on life and the importance of early detection through knowing signs and symptoms. Therefore, the purpose of this study is to evaluate the knowledge about risk factors of BC, signs and symptoms and methods of screening among women working in governmental sector in Gaza Strip.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eDesign and sample\u003c/p\u003e \u003cp\u003eA cross-sectional study was conducted on 253 women working in governmental sector in Gaza Strip including Ministry of Health, Ministry of Education, ministry of Labor \u0026hellip;.. The targeted women were contacted online, using google forms to fill the questionnaires.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eInstrument of the study\u003c/h2\u003e \u003cp\u003eThe researcher used a pre-tested self-administered questionnaire. The questionnaire was designed to measure total knowledge about breast cancer (Alabbody et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). The questionnaire consisted of the following parts: personal information (age, marital status, and level of education). Knowledge about signs and symptoms of BC, screening methods and early detection of BC, risk factors, controlling and prevention of BC.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData collection\u003c/h3\u003e\n\u003cp\u003eData were collated and subject to quality measures. The data were reviewed and cleaned before statistical analysis.\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eData analysis was performed using the SPSS (version 25). Descriptive statistics such as frequencies and percentages were computed for categorical variables; whereas, means and standard deviations were for continuous variables. Analyses also included t-tests and one-way ANOVA to assess the association between independent and dependent variables. Chi square was also carried out to find out the correlations between two continuous variables. The significance level (p-value) was set at 0.05.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eEthical consideration\u003c/h3\u003e\n\u003cp\u003eThe researcher obtained agreement from MoH to carry out the study. Before starting data collection, participants were informed about the objectives, methodology and the approximate time to complete the questionnaire. Informed consent was obtained from each participant. In addition, participants were also assured that all information related to them will be kept confidential.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e \u003cb\u003eTable\u0026nbsp;(1): Distribution of study participants by sociodemographic factors\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21\u0026ndash;30 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31\u0026ndash;40 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e47.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e41\u0026ndash;50 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51\u0026ndash;60 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e205\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e81.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eLevel of education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary school and less\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntermediate diploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBachelor degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e54.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePostgraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;(1) showed that age of the women ranged between 21\u0026ndash;60 years, the age group 31\u0026ndash;40 years old was the most prevalent (47.4%) followed by the age group 41\u0026ndash;50 years old (31.2%). The majority of them were married (81%), and most of them have bachelor degree (54.9%).\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(2): Knowledge about the importance of early detection of breast cancer\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eLevel of knowledge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ex\u0026sup2;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLow n(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eModerate n(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood n(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e21\u0026ndash;30 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14(5.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15(5.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e3.069\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.800\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e31\u0026ndash;40 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2(0.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45(17.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73(28.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e41\u0026ndash;50 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2(0.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31(12.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46(18.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e51\u0026ndash;60 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7(2.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17(6.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5(2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e97(38.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e151(59.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3(1.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74(29.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e128(50.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e7.952\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.221\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16(6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14(5.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5(2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7(2.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWidow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(0.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(0.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5(2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e97(38.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e151(59.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLevel of education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary school and less\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11(4.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13(5.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e3.511\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.742\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBachelor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(1.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53(20.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e82(32.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntermediate diploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7(2.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12(4.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePostgraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26(10.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44(17.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5(2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e97(38.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e151(59.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;(2) presented the correlation between level of knowledge and age, marital status, and level of education. The results showed that 2% of women have low knowledge, 38.3% have moderate knowledge, and 59.7% have good knowledge about the importance of early detection of BC. 28.9% of women from the age group 31\u0026ndash;40 years and 18.2% of women from the age group 41\u0026ndash;50 years have good knowledge without statistical significant differences (p\u0026thinsp;=\u0026thinsp;0.800). Also, 50.6% of married women have good knowledge and 29.2% have moderate knowledge, without statistical significant differences (p\u0026thinsp;=\u0026thinsp;0.221). The results also showed that 32.4% of women who hold bachelor degree have good knowledge and 20.9% have moderate knowledge, without statistical significant differences (p\u0026thinsp;=\u0026thinsp;0.742). These results indicated no statistical significant differences in level of knowledge about the importance of early detection of BS related to personal characteristics of women.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(3): Knowledge about signs and symptoms of breast cancer\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabc\" border=\"1\"\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnswers about symptoms of BC\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChange in breast shape \u0026amp; size, painless breast mass, armpit node\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChange in breast shape \u0026amp; size, painless breast mass, armpit node, abnormal secretions from the nipple\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChange in breast shape \u0026amp; size, painless breast mass, armpit node, abnormal secretions from the nipple, thickness of breast tissue\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChange in breast shape \u0026amp; size, painless breast mass, armpit node, abnormal secretions from the nipple, thickness of breast tissue, itching, ulceration of nipple\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChange in breast shape \u0026amp; size, painless breast mass, armpit node, visible blood vessels on skin of breast\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChange in breast shape \u0026amp; size, painless breast mass, armpit node, thickness of breast\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChange in breast shape \u0026amp; size, thickness of breast tissue\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChange in breast shape \u0026amp; size, white milk-like secretion from the nipple\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePainless breast mass, armpit node\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePainless breast mass, armpit node, abnormal secretions from the nipple\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePainless breast mass, armpit node, abnormal secretions from the nipple, inverted nipple\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePainless breast mass, armpit node, abnormal secretions from the nipple, visible blood vessels on skin of breast\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePainless breast mass, armpit node, abnormal secretions from the nipple, visible blood vessels on skin of breast, thickness of breast tissue\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePainless breast mass, armpit node, abnormal secretions from the nipple, itching, ulceration of nipple\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePainless breast mass, armpit node, thickness of breast tissue\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePainless breast mass, white milk-like secretion from the nipple, visible blood vessels on skin of breast, itching, ulceration of nipple\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll the symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;(3) illustrated the knowledge about signs and symptoms of BC. The results showed that 27.3% of study participants know that change in breast shape \u0026amp; size, painless breast mass, armpit node, abnormal secretions from the nipple, and thickness of breast were among symptoms of BC, 17.4% know that symptoms of BC included painless breast mass, and axillary node. Also, 15.8% know all the symptoms of BC. These results indicated that women knew most of the signs and symptoms of BC.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(4): Knowledge about risk factors of breast cancer\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabd\" border=\"1\"\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFactor\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResponse\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eEffect of aging on the possibility of developing BC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDecrease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIncrease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e180\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e71.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo effect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI do not know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eEffect of not becoming pregnant on the possibility of developing BC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDecrease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIncrease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e59.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo effect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI do not know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eEffect of removal of ovaries on the possibility of developing BC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDecrease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIncrease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo effect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI do not know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eEffect of obesity after menopause on the possibility of developing BC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDecrease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIncrease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e57.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo effect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI do not know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMain reason of increasing the possibility of developing BC in obese women after menopause\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eElevated estrogen level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eElevated estrogen level, elevated level of antioxidants in the blood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e49.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eelevated level of antioxidants in the blood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInadequate physical activity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;(4) showed that 71.2% of women stated that increasing of age will increase the possibility of developing BC, 59.3% reported that absence of pregnancy and childbirth increase the possibility of developing BC, 41.9% said that removal of ovaries increase the chance of having BC, 57.3% stated that obesity after menopause increase the possibility of BC. Also, 49% of women stated that elevated estrogen level, and elevated level of antioxidants in the blood increase the possibility of developing BC after menopause.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(5): Knowledge about methods of screening, early detection and prevention of breast cancer\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabe\" border=\"1\"\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnowledge about:\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eMethods of screening and early detection of BC\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBreast self-exam (BSE)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBSE, radio-active imaging\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBSE, radio-active imaging, fine needle aspiration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBSE, radio-active imaging, ultra-sonography\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBSE, clinical exam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBSE, clinical exam, radio-active imaging\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBSE, clinical exam, ultra-sonography\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBSE, ultra-sonography\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinical exam, radio-active imaging\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll the methods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePreferable time to perform BSE\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvery week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvery month, before menstruation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvery month, after menstruation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e189\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvery year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInternational strategies to control \u0026amp; reduce incidence of BC\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEarly detection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrevention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrevention \u0026amp; early detection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e172\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTreatment at early stage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;(5) presented screening methods of BC. The results showed that 15% of study participants knew that BSE was a method of screening for BC, 15.8% reported BSE, clinical exam, and radio-active imaging as methods of screening for BC, 13% knew that BSE and clinical exam were screening method for BC. It is noticed that BSE was the most prevalent method as stated by the studied women. Also, 74.7% of women stated that the preferable time for performing B was every month after the menses, and 68% reported that prevention and early detection are the best strategies to control and prevent the development of BC.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(6): Factors of controlling and prevention of breast cancer\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabf\" border=\"1\"\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnowledge about:\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eFactors that help in decreasing the incidence BC\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRegular periodic breast exam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEarly pregnancy, visit the doctor when detecting breast lump, regular periodic breast exam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEarly pregnancy, physical activity / sporting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRegular periodic breast exam, visit the doctor when detecting breast lump\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRegular periodic breast exam, visit the doctor when detecting breast lump, physical activity / sporting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical activity / sporting, decrease fat consumption, regular periodic breast exam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll the mentioned factors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMethods of preventing breast cancer\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGood nutrition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGood nutrition, avoid hormones consumption\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGood nutrition, weight control\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGood nutrition, increase physical activity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGood nutrition, increase physical activity, weight control, avoid hormones consumption\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight control, avoid hormones\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIncrease physical activity, weight control, avoid hormones\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAvoid alcohol consumption, good nutrition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll the above mentioned are correct\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll the above mentioned are not correct\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;(6) illustrated that regular periodic breast exam, and visiting the doctor when detecting breast lump are factors that help in decreasing the incidence of BC, and 20% considered periodic breast exam as a factor for decreasing the incidence of BC. The results also showed that 11.5% of studied women stated that good nutrition, and weight control are essential methods to prevent the development of BC and 28.9% know all the methods of prevention of BC.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe results showed that more than half of the women have good knowledge about the importance of early detection of BC, and they were aware and knew most of the signs and symptoms of BC. The results of Almeshari et al. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) showed that the overall knowledge level about BC was 46.36%. Similarly, the results of Hamed et al. (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) showed that women could recognize the symptoms of BC such as lump or thickening under the armpit (54%), lump in the breast or thickening of the breast tissue (50.9%), while other signs and symptoms were not recognized by more than half of the women, while the results of Sarker et al. (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) indicated that the overall mean score of total knowledge items about BC was 34.3%; knowledge about signs and symptoms of BC was 36.8%, and the most common symptoms that were recognized correctly were color change of breast (48.3%), new lump in the breast or armpit (42.8%), and change in breast shape and size including inverted nipple (40.3%).\u003c/p\u003e \u003cp\u003eThe studied women expressed good knowledge about risk factors of BC including older age, abundant from pregnancy and childbirth, resection of ovaries, and obesity after menopause. The results of Sarker et al. (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) showed that the mean score of knowledge about BC risk was 33.5%.\u003c/p\u003e \u003cp\u003eMoreover, the studied women expressed knowledge about screening methods including BSE, radio-active imaging, ultrasonography, clinical exam, and fine needle aspiration. Most of the women knew that the preferred time to perform BSE was every month after menses, and prevention and early detection were the highest strategies to control and prevent BC. The results of Hamed et al. (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) indicated that among those who perform BSE, a fifth only check at least once every 6 months (19.95%), checking at least once a month (18.43%), and checking at least once a week (8.3%). In addition, the results of Sarker et al. (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) indicated that the mean score of knowledge about BC screening was 36.4%. Factors that help in decreasing the incidence of BC included periodic breast exam on regular bases, physical activity and engagement in sports activities. The results of Almeshari et al. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) showed that respondents had average knowledge about risk factors as well as signs and symptoms (57.62% and 52%, respectively), whereas awareness and practice of BSE and screening methods were 36.37% and 38.9% respectively. The studied women showed good knowledge about methods of preventing BC including good nutrition, avoiding hormones consumption, weight control, and physical activity. The results of Sarker et al. (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) indicated that the mean score of knowledge about BC prevention was 36.2%.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe present study concluded that women who are working in governmental sector have relatively overall good knowledge about signs and symptoms of BC, screening methods, risk factors, and preventive measures of BC.\u003c/p\u003e \u003cp\u003eSpecial training programs about BSE and screening should be held to reach a large number of women. Also, women should be encouraged to talk about BSE to their friends and relatives at home in order to improve awareness about BSE and encourage them to get professional medical exam periodically in order to decrease the ongoing steady increase in BC in Gaza Strip.\u003c/p\u003e \u003cp\u003eThe researcher expects that this study may help in increasing the attention about screening for early detection of BC in order to provide early treatment, which will result in improving the outcome, improving the quality of life of survivors, and decreasing the mortality rate of BC.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eMy study was approved by the Ethics Committee (IRB) of (Gaza ministry of Health), and the approval number is (210005486)\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eAlabbody H, Alelwan N, Atoof W, Badn B. Evaluation of women\u0026apos; s knowledge about risk factors and early detection of breast cancer at Ibn Rushd College of Education in Baghdad University. Iraqi National Journal of Nursing Specialties, 2017; 30(1); 117-123.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eAlmeshari M, Alzamil Y, Alyahyawi A, Abanomy A, Althmali O, Al-Enezi M. S, et al. Awareness level, knowledge and attitude towards breast cancer among staff and students of Hail University, Saudi Arabia.\u0026nbsp;Plos one,\u0026nbsp;2023;\u003cem\u003e18\u003c/em\u003e(3), e0282916.\u0026rlm;\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eAlotaibi RM, Rezk HR, Juliana CI, Guure C. Breast cancer mortality in Saudi Arabia: Modelling observed and unobserved factors. PLoS One. 2018; 13(10):1\u0026ndash;16. https://doi.org/10.1371/journal.pone. 0206148 PMID: 30347002.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eAl-Shamsi, H. O., Abu-Gheida, I. H., Iqbal, F., \u0026amp; Al-Awadhi, A..\u0026nbsp;Cancer in the Arab world. 2022 476. Springer Nature.\u0026rlm;\u003c/li\u003e\n \u003cli\u003eAnton-Culver H, Chang J, Bray F, Znaor, A, Stevens L, Eser S, et al. Cancer burden in four countries of the Middle East Cancer Consortium (Cyprus; Jordan; Israel; Izmir (Turkey)) with comparison to the United States surveillance; epidemiology and end results program. Cancer Epidemiol. 2016; 44: 195\u0026ndash;202.\u003c/li\u003e\n \u003cli\u003eBellanger M., Zeinomar N., Tehranifar P., Terry M.B. Are Global Breast Cancer Incidence and Mortality Patterns Related to Country-Specific Economic Development and Prevention Strategies? J. Glob. Oncol\u003cem\u003e.\u0026nbsp;\u003c/em\u003e2018;4:1\u0026ndash;16. doi:\u0026nbsp;10.1200/JGO.17.00207\u003c/li\u003e\n \u003cli\u003eGlobal Cancer Observatory.International Agency for Research on Cancer. Global Cancer Observatory. Cancer Today. 2020. https://gco.iarc.fr/today. Accessed 10.9.2023.\u003c/li\u003e\n \u003cli\u003eHamed E, Alemrayat B, Syed M, Daher-Nashif S, Abu Rashed H, Kane T. Breast cancer knowledge, attitude, and practice among women in Qatar. International Journal of Environmental Research and Public Health, 2022;\u0026nbsp;19, 3995. https://doi.org/10.3390/ijerph19073995.\u003c/li\u003e\n \u003cli\u003eMathew A, Gajalakshmi V, Rajan B, Kanimozhi V, Brennan P, Mathew BS, et al. Anthropometric factors and breast cancer risk among urban and rural women in South India: a multicentre case-control study. Br J Cancer. 2008; 99(1):207\u0026ndash;13.\u003c/li\u003e\n \u003cli\u003eMohite VR, Pratinidhi AK, Mohite RV. Reproductive risk factors and breast cancer: a case control study from rural India. Bangladesh J Med Sci. 2015; 14(3):258\u0026ndash;64.\u003c/li\u003e\n \u003cli\u003eNardin S., Mora E., Varughese F.M., D\u0026rsquo;Avanzo F., Vachanaram A.R., Rossi V., Saggia C., Rubinelli S., Gennari A. Breast Cancer Survivorship, Quality of Life, and Late Toxicities. Front. Oncol\u003cem\u003e.\u0026nbsp;\u003c/em\u003e2020;16:864. doi:\u0026nbsp;10.3389/fonc.2020.00864.\u003c/li\u003e\n \u003cli\u003eSalem H. S. Cancer status in the Occupied Palestinian Territories: types; incidence; mortality; sex, age, and geography distribution; and possible causes.\u0026nbsp;Journal of Cancer Research and Clinical Oncology,\u0026nbsp;2023;\u003cem\u003e149\u003c/em\u003e(8): 5139-5163.\u0026rlm;\u003c/li\u003e\n \u003cli\u003eSarker R, Islam M.S, Moonajilin M.S, Rahman M, Gesesew HA, Ward PR. Knowledge of breast cancer and breast self-examination practices and its barriers among university female students in Bangladesh: Findings from a cross-sectional study. PLoS ONE, 2022; 17(6): e0270417. https://doi.org/10.1371/journal. pone.0270417.\u003c/li\u003e\n \u003cli\u003eThe Global Cancer Observatory. International Agency for Research on Cancer, March 2021. https://gco.iarc.fr/ today/data/factsheets/populations/634-qatar-fact-sheets.pdf.\u003c/li\u003e\n \u003cli\u003eVishwakarma G, Ndetan H, Das DN, Gupta G, Suryavanshi M, Mehta A, et al. Reproductive factors and breast cancer risk: a meta-analysis of case-control studies in Indian women. South Asian J Cancer. 2019;8(2):80-84.\u003c/li\u003e\n \u003cli\u003eWHO. Breast cancer. Key facts, July 2023. https://www.who.int/news-room/fact-sheets/detail/breast-cancer.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Women’s knowledge, Risk factors, Screening and early detection, Breast cancer, Gaza Strip","lastPublishedDoi":"10.21203/rs.3.rs-5711635/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5711635/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose:\u003c/strong\u003e The purpose of the study was to evaluate women's knowledge about signs and symptoms, risk factors and early detection of breast cancer at governmental sector in Gaza Strip.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMaterials \u0026amp;Methods:\u003c/strong\u003eThe study utilized a cross-sectional design. The sample included 253 women employed in the ministries in Gaza Strip. Data were collected through a pre-tested self-administered questionnaire.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The results showed no significant association between knowledge about BC and age, marital status, and level of education. Participated women were able to recognize signs and symptoms of BC. They were knowledgeable about risk factors, screening and early detection, the factors that increase the possibility of BC, and measures to prevent development of BC.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e The researcher expects that this study may help in increasing the attention about screening and early detection of BC in order to improve the outcome.\u003c/p\u003e","manuscriptTitle":"Evaluation of Women’s Knowledge about Risk Factors and Early Detection of Breast Cancer among Women Working in Governmental Sector in Gaza Strip, Palestine","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-01-20 04:42:39","doi":"10.21203/rs.3.rs-5711635/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"443b04f9-8aae-4916-b76d-41cfe99a68bf","owner":[],"postedDate":"January 20th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":42030440,"name":"Health Economics \u0026 Outcomes Research"}],"tags":[],"updatedAt":"2025-01-20T04:42:39+00:00","versionOfRecord":[],"versionCreatedAt":"2025-01-20 04:42:39","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5711635","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5711635","identity":"rs-5711635","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}