07.03.2017 eesa

HEALTH LITERACY OF FEMALE POPULATION ON BREAST CANCER PREVENTION IN KRASNODAR CITY

Authors / Autors / Автора:

V.V. Zavyalova
Teaching Assistant at the Department of Public Health,
Healthcare and History of Medicine,
Federal State-Funded Educational Institution of Higher Education
“Kuban State Medical University”,
K.P. Levonyan
Oncologist of the first category,
State Budgetary Healthcare Institution “Regional Oncologic Dispensary #1”,
T.V. Chitanava
Fifth-year student at Therapeutic Department,
Federal State-Funded Educational Institution of Higher Education
“Kuban State Medical University”,
A.A. Kiseleva
Fifth-year student of Therapeutic Department,
Federal State-Funded Educational Institution of Higher Education
“Kuban State Medical University”,
S.A. Markova
Fifth-year student of Therapeutic Department,
Federal State-Funded Educational Institution of Higher Education
“Kuban State Medical University”,
S.A. Kardanova
Fifth-year student of Therapeutic Department,
Federal State-Funded Educational Institution of Higher Education
“Kuban State Medical University”,

There are 12 million new cases of cancer detected each year, with 10.9 per cent being the breast cancer. [1,8] World medical society expresses a great concern about an increase in breast cancer incidence rate. Breast cancer is the most common form of cancer among women, with about 1.4 million of new cases being diagnosed every year. [8] Breast cancer causes about 20% of deaths from malignant tumors in Europe. Over the last 20 years the mortality rate from this pathology has considerably declined in many developed countries, which is due to the appearance of new medical products (chemotherapeutic and biotherapeutic drugs) on the one hand, and the improvement of screening techniques and early detection of cancer, on the other. Fifty-four thousand women in Russia are diagnosed with breast cancer every year. In 2011 breast cancer was the leading cause in death rate from malignant tumors (17.3%) in the country. [7] According to the research data of Krasnodar Region, provided by Dr. M.V. Kazantseva (Chief Physician of the State Budgetary Healthcare Institution “Clinical Oncologic Dispensary #1” of Ministry of Health Care of Krasnodar Region, chief consulting oncology specialist of Ministry of Health Care of Krasnodar Region) breast cancer constituted 10.1 per cent in the incidence pattern, being on the second place after skin cancer (17.7%). [5]

Since 2011, a Governor-supported cancer prevention project “Oncopatrol” has been carried out in Krasnodar Region. It is aimed at early detection of precancerous and cancerous tumors. 127,771 women were examined over the period of three years (2011-2014). The results of follow-up examinations (ultrasound examination, mammography) showed 1.9 per cent of premalignant conditions (2,450) and 1.0 per cent (1,331) of suspected breast cancer cases.

The most noted outcomes of the prevention program “Oncopatrol” are the following: the accessibility of early cancer detection among the population for the identification of oncologic pathologies; the increase in the number of new malignant tumor cases diagnosed at early stages; intensification of preventive examinations.

During 2014-2015 there were visits to 14 territories of Krasnodar region, and 27 preventive examinations were carried out in Krasnodar city. About nine thousand women were examined, half of them being the citizens of Krasnodar city. There were detected 499 precancerous conditions, 49 per cent of them in Krasnodar (245); 71 cases of suspected breast cancer, with 47.9 per cent being detected in the city (34). It highlights once again the importance of prevention procedures, in order to raise awareness among the population about the causes of cancer, its early signs, and the ability to conduct self-examinations, in particular.

The aim of the research is to study the awareness of cancer prevention among female population in Krasnodar city.

Materials and methods

Over the period from September 1 through December 1, 2015 was conducted a survey in Obstetrics and Gynecology Teaching Clinic in Krasnodar city. 255 clinic patients aged from 18 to 63 years and over became the participants of the research. The questionnaire consisted of 4 sections: passport information, the awareness among women on the prevention of the breast cancer, bad habits, patient’s status, 35 questions and a series of 97 multiple choice answers with a gradation chart. Data processing was carried out in Microsoft Excel 2010 program.

Results of the research and discussion

During the survey the respondents were divided into 5 age groups: 18-28 years – 36.5% (93); 29-40 years – 26.7% (68); 41-51 years – 16.5% (42); 52-62 years – 10.9% (28); 63 years and over – 9.4% (24).

Our research has shown that 71.4 per cent of respondents aged 52-62 years and 50,0 per cent aged over 63 years had an abortion more than once, which according to the scientific research increases the risk of breast cancer by 40.0 per cent. [9] The proportion of women who have bad habits (smoking, using a solarium) has decreased with age by a factor of two. This means that, despite all risks, young women can’t quit bad habits. The use of hormonal contraceptives among women aged 41-54 years constituted 26.2 per cent, which may have a negative impact on postmenopausal period and cause malignant tumor development. Only 58.8 per cent of women who had a child were breastfeeding. At the same time, every second woman breastfed less than a year, which is one of the main risk factors of breast cancer as the reduction of breastfeeding period maintains high rate of estrogen and prolactin in blood, increasing the likelihood of tumor formation. The percentage of patients who suffered fibrocystic mastopathy in the age group of 63 years and older is 41.7 per cent, which is 38 times higher than in the age group of 18-28 year olds (1.1%). It signals a high risk factor among women aged over 63 years.

When answering the question “Do you know that mastopathy belongs to the group of cancerous diseases?” 53.8 per cent of patients aged 18-28 years answered negatively. Then, the respondents were asked to choose an answer to the question “Are you aware of breast self-examination techniques? If yes, what was the source of information?” In age groups of 29-40 years – 26.8 per cent (25) learned about self-examination techniques after visiting the physician in the policlinic, 30.9 per cent – from the internet. Women from the age group of 41-51 and 52-62 42.9 per cent (18) and 7.2 per cent (2) respectively got to know about the self-examination from the internet; 33.4% (14) and 57.1% (16) – after visiting the policlinic. Most of the survey participants aged 63 years and over were mostly informed about these techniques by policlinic physicians. It should be noted that in the age group of 18- 28-year-olds every third woman knew nothing about self-examination. A large concern causes the fact that, considering a rather large proportion of women who know about the self-examination techniques, only 12.9 per cent of all respondents use them. And only 35.5 per cent of patients aged 18-28 years know about the necessity to have the ultrasound examination of mammary glands on 4th-14th day of the menstrual cycle. The need of mammography at the age of 40 once a year is known only to 44.7 per cent (114) of respondents from all age groups. Attention should be paid to the fact that the number of visits to a gynecologist has dropped. The percentage of gynecologist appointments in the age group of 18- 28-year-olds was only 45.2 per cent; among patients aged 29-40 years – about 40 per cent, a little bit over 30 per cent of those aged 41-51 years.

Conclusion

A data analysis of the survey, which was conducted among 255 patients of Obstetrics and Gynecology Teaching Clinic aged from 18 to 63 years and over, showed that every sixth woman aged 18-28 years has bad habits, and this signifies the necessity of additional measures to raise awareness about breast cancer among this category of patients. Moreover, a decreasing number of visits to gynecologist among women of the childbearing age should also be noted. Only half of the respondents from all age groups knew about the need of regular preventive examinations (ultrasound examination of mammary glands, mammography). In addition to that, more than a half of women who have a child breastfed, and every second woman breastfed less than a year, which is one of the risk factors for breast cancer development. The use of hormonal contraceptives among women aged 41-51 years constituted 26.2 per cent. This fact may negatively influence the postmenopausal period. There is also a high percentage of patients who had fibrocystic mastopathy in the age group of 63 years and over (41.7%), thus showing high risk factors for this age group. To conclude, female population of Krasnodar city needs further training in health literacy in order to lead a healthy lifestyle, fill the gaps in the knowledge about breast cancer and examination techniques. The results of this social survey may be used for the managerial decision-making.

Bibliography / Referencje / Список литературы:

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