18051 - Factors Associated with Breast Self Examination...

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Factors Associated with  Breast Self Examination (BSE)  Practice Among Female Patients  in an Out Patient Clinic   in the Philippines MARIA FIDELIS C. MANALO, MD, MSc  Epidemiology  CFM III-C Research Group FEU-NRMF Medical Center 
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BREAST CANCER Philippines Second to lung cancer in  prevalence 5 year survival is 40% Ngelangel and Wang, 2002 Women at risk : Those in rural areas, with low  educational attainment, history of  benign disease, infertility, and age  beyond 35 Protected women : Those with dysmenorrhea, number  of live births and breast feeding
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BREAST SELF EXAM Devised in 1950s, before mammography Inexpensive, available and simple Mixed opinions on its usefulness: Beneficial:  Reduced mortality and morbidity Non-beneficial : (Thomas, 1997; Semiglazov, 1993) No significant differences in mortality and  morbidity Adherence to its use: (Maxwell, 2002) Psychosocial- embarrassment, shyness Economical- costs, timeliness Educational- knowledge, misconceptions
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BACKGROUND Perceived Benefits Cost-effective: Diagnostic modality of choice in the Philippines Saves 3 million PhP annually (Ngelangel, 2002) Early detection resulting to small tumor sizes  (Harvey, 1997) Improved survival rates (Huguley, 1988) Contradictions to Perceived Benefits: Mortality rates show no significant difference for  those educated of BSE and those who were not  (Thomas, 1997; Semiglazov, 1993)
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BACKGROUND Perceived Barriers Small proportion adhere to BSE  guidelines (Houts, 1991; Kash, 1992) Factors: Skill, training and technique                (Phillip, 1986) Anxiety (Lerman, 1993) Culture (Graham, 2002) Fatalistic view of Filipinos               (Ngelangel, 1989) Religion, forgetfulness, psychology,  resources, education (Maxwell, 2000)
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BACKGROUND Perceived Susceptibility 50% of cases of breast cancer are  detected by women themselves Ngelangel in 2002 lists factors increasing  susceptibility to breast cancer: Lower than high school education (OR=1.87) History of benign breast disease (OR=2.51) Infertility (OR=5.83) >35 years of age (OR=18.2)
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BACKGROUND Perceived Seriousness Early detection results in greater chance  of long term survival Randomized trials of mammographic  screening showed reduced mortality  by 30% (Kerlikowske, 1995)
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18051 - Factors Associated with Breast Self Examination...

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