Breast Cancer Awareness and Associated Factors among Students of Allied Health Sciences in Indonesia and Pakistan: A cross-sectional study
Authors: Tayyeb Muhammad , Khuzaiyah Siti , Owais Muhammad , Hussain Israr , Ullah Sana , Lodhi Muhammad Arif , Adnani Qorinah Estiningtyas Sakilah , Geraghty Sadie 
Published: June 2023

Background
Breast-cancer-related morbidity and mortality has been shown to be decreased by the implementation of worldwide-accepted screening guidelines, and by appropriate education and training of health professionals on risk identification and screening. This study aims to determine the significance of educational sessions in improving health professionals’ knowledge about breast cancer, particularly screening modalities that can optimalise patient outcomes.
Methods
A cross-sectional survey was conducted using a non-probability convenience sampling technique. A total of 1067 students in Allied Health programmes in Indonesia and Pakistan participated in the study. Data were collected through the validated questionnaire “Breast Cancer Awareness Measure” developed by Cancer Research UK, King’s College London in English and Bahasa Indonesia. Data were analyzed through the Statistical Package for Social Sciences software (SPSS) version 26.0. Descriptive and linear regression analysis were conducted.
Results
Age, education, residence and marital status were significantly related to the mean score of knowledge about breast cancer signs and risk factors. Participants aged 50 years and older had a higher mean knowledge score (13.25 ± 1.12), and postgraduate students had a higher mean score of breast cancer knowledge than undergraduate students, with mean scores of 11.45 ± 4.023 and 11.29 ± 4.001, respectively. Students living in urban areas had a higher mean score than those living in rural areas, with the mean score of breast cancer knowledge being 11.57 ± 3.957 and 11.05 ± 4.047, respectively. Married students were more knowledgeable than single or never married. The mean score for married/ living with a partner was 11.65 ± 4.133, while for single/never married was 11.27 ± 3.995. There was a significant correlation between age, education, residence and marital status to the mean score of knowledge about signs and risk factors of breast cancer, with each p-value being 0.000. Students in the age group 18–35 years, and 36–50 years had lower knowledge score, B (SE) = 1.946 (.676), 5.986 (.633), and 3.082 (.647) as compared to students aged 50 years and above. Undergraduate students had lower knowledge scores (B: 2.562, SE: .119) than postgraduate students. Students living in rural areas had lower knowledge scores (B: − .002, SE: .061) than those living in Urban areas. Furthermore, single/never married had lower knowledge scores than married/living with a partner (BE: 2.180, SE .101). On adjustment for the potential confounders, age, education, and marital status, they remained positively associated with a higher level of knowledge, with p values .004, .000, and .000, respectively.
Conclusion
The level of awareness of breast cancer among participants of women of reproductive age was low. Age, education, residency, and marital status were linked to awareness levels and found as factors limiting women's understanding of breast cancer. Individually and community tailored knowledge and attitude by health care professionals may be required to provide support in better understanding and awareness of breast cancer. The study outcomes recommend that policymakers, clinicians, and public health practitioners should consider the factors identified in the results of this study when designing and developing intervention programs to improve the awareness of breast cancer among students enrolled in allied health sciences programs.