performance The use of mammography by this group
performance. The use of mammography by this group is lower than that reported in global and regional reports in literature.1,27 It is recommended that future studies should assess the factors related to the scarcity of this practice in particular and include a larger sample of older women who are most likely to be recommended to receive mammography. The highest reported barrier to performance of all screening methods was “not having health problems,” which is a misconception that needs to be corrected among this group of women through an influential BC campaign. In addition to lack of information, being afraid of the results is another reported barrier to practicing screening among this sample of women. Primary healthcare clinics have a pivotal role in strengthening awareness of breast health and prevention behaviors among the women popula-tion. Hence, an investigation of women’s perception about BC and its screening practices and factors enabling and inhibiting these practices in Yemen is essential to promote this preventive behavior.
Avoiding BC assessment has been linked to cancer-related worry and anxiety in several studies.28,29 These studies also suggested that the primary healthcare setting provides more health education and strategies to relieve worries and anxiety for better screening opportunities.
The data collected in this study are self-reported and most likely prone to measurement errors associated with recall of information and social desirability. Additionally, the sample size is limited, and it Melatonin has been collected from a single region, thus restricting the gener-alizability of the results to all the Yemeni women. Future studies should include diverse populations from different regions to assess the association of factors with knowledge of BC and its screening among Yemeni women and make recommendations at the national level that will affect the entire country.
Although most of the surveyed women reported receiving in-formation of BC screening from relatives and friends, it is deemed essential that this information be incorporated in health education delivered, and practicing CBE in the primary healthcare setting is strongly recommended. This could engage a large number of Yemeni women in BC prevention and screening practices by themselves with an active role in promoting this behavior among their families and friends.
Clinical Practice Points
BC among females has one of the highest incidence rates in Yemen.
The poor knowledge and wrong beliefs about BC prevention among women are responsible for a negative perception of the durability of cancer detected early and of the efficacy of the screening tests.
As observed from daily practice in the local community, many of the women diagnosed with BC and referred for more advanced screening procedures, such as mammograms and biopsies, refused to continue with the required final diagnosis.
Such behavior usually generates a lot of questions as to whether these women are aware of BC, its risk factors, and its screening methods.
Detecting BC at an early stage remains the most essential step for BC control; however, Yemeni women are diagnosed at advanced stages of the disease, which eventually leads to poor prognosis. Mammography was noted to be a rare practice by this group, and thus it is lower than global and regional reports.
The highest reported barrier to the performance of all screening methods was “not having health problems,” which is a miscon-ception that needs to be corrected among this group of women.
Lack of information or being afraid of the results is another re-ported barrier to practicing screening among women in this community.
Primary health care clinics should play a pivotal role in strengthening awareness about breast health and BC prevention behaviors among the female population.
The authors declare no competing interests.
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4. Olowokere AE, Onibokun AC, Oluwatosin AO. Breast cancer knowledge and screening practices among women in selected rural communities of Nigeria. J Public Health Epidemiol 2012; 4:238-45.
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13. Baron-Epel O, Friedman N, Lernau O. Reducing disparities in mammography-use in a multicultural population in Israel. Int J Equity Health 2009; 8:19.