Breast self-examination and death from breast cancer: a meta-analysis.
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ABSTRACT:
SUBMITTER: Hackshaw AK
PROVIDER: S-EPMC2376382 | biostudies-other | 2003 Apr
REPOSITORIES: biostudies-other
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Project description:BackgroundIn resource limited countries breast self-examination has been recommended as the most appropriate method for early detection of breast cancer. Available studies conducted on breast self-examination practice in Africa currently are inconsistent and inclusive evidences. On top of that the available studies are unrepresentative by regions with small sample size. Therefore, this systematic review and meta-analysis were conducted to summarize and pool the results of individual studies to produce content level estimates of breast self-examination practice in Africa.MethodsA systematic review and meta-analysis were done among studies conducted in Africa using Preferred Item for Systematic Review and Meta-analysis (PRISRMA) guideline. Studies were identified from PubMed, Google Scholar, HINARI, EMBASE, CINAHL, Cochrane, African Journals Online and reference lists of identified prevalence studies. Unpublished sources were also searched to retrieve relevant articles. Critical appraisal of studies was done through Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). The meta-analysis was conducted using STATA 13 software. Heterogeneity was assessed using I2 statistics while publication was assessed through funnel plot. Forest plot were used to present the pooled prevalence with a 95% confidence interval (CI) using the random effect model.ResultsIn this meta-analysis 56 studies were included with a total of 19, 228 study participants. From the included studies 25(44.64%) were from West Africa, 22(39.29%) East Africa, 5(8.93%) North Africa, 3(5.36%) Central Africa and 1(1.79%) South Africa. The overall pooled prevalence of ever and regular breast self-examination practice in Africa was found to be 44.0% (95% CI: 36.63, 51.50) and 17.9% (95% CI: 13.36, 22.94) respectively. In the subgroup analysis there was significant variations between sub regions with the highest practice in West Africa, 58.87% (95 CI%: 48.06, 69.27) and the lowest in South Africa, 5.33% (95 CI%: 2.73, 10.17).ConclusionThis systematic review and meta-analysis revealed that breast self-examination practice among women in Africa was low. Therefore, intensive behavioral change communication and interventions that emphasize different domains should be given by stakeholders.Prospero registration numberCRD42020119373.
| S-EPMC8379892 | biostudies-literature
Project description:BackgroundBreast self-examination (BSE) is one of the most feasible methods of screening for early stages of breast cancer. However, the practice rate is insufficient in many low and middle-income countries including Ethiopia. Hence, this study aimed to estimate the pooled prevalence of BSE practice among female university students in Ethiopia.MethodsPubMed, Cochrane Library, Scopus, and Google Scholar were searched for studies that assessed BSE practice among female students in Ethiopian universities. The study included articles published from January 1st, 2010 to June 16th, 2020. The Cochran's Q chi-square and the respective I2 test statistics were used to check heterogeneity among the included studies. To assess publication biases, the funnel plot and Egger's regression tests were employed. Subgroup analysis was done by using different characteristics of studies. Sensitivity analysis was also run to assess the effect of a single study on the pooled outcome. STATA™ Version 14 software packages were employed for data analysis.ResultsSixteen (n = 16) studies with 5,743 participants were included to estimate the pooled prevalence of BSE practice. The prevalence of regular BSE practice reported in the studies ranges from 0% to 26.4%. The estimated pooled prevalence of regular BSE practice among university students in Ethiopia is 11.23% which is very low. The prevalence of BSE practice was high, 13.6% in studies published before 2015, 12.0% among health science students, and 12.6% in studies with a sample size of 384 participants and above. In addition, the estimated pooled prevalence of irregular self-breast-examination practice was 33.28%.ConclusionThe rate of BSE practice among female university students is low. Thus, awareness strategies need to be designed to increase the practice rate among women in the country as BSE is one of the most feasible strategies in early detection of breast cancer if properly implemented.
| S-EPMC8236787 | biostudies-literature
Project description:Breast cancer (BC) is a heavy burden for Indonesian healthcare, but there is still no thorough evaluation for Breast self-examination (BSE) practice as routine BC screening. In this study, we aimed to synthesize the pooled prevalence data of BSE practice, compare BSE practice prevalence between Java Island and non-Java Islands in Indonesia, and identify the determinants that we thought could affect the BSE practice in the Indonesian population. Intensive searches were conducted in Cochrane Library, PubMed, Google Scholar, and SINTA (Indonesian Web of Science and Technology Index) from September 2017-2022. We utilized Review Manager 5.4 for conducting the meta-analysis. We found the overall national prevalence of BSE practice was 43.14% (95% CI: 36.08, 50.20, p < 0.00001). BSE practice in Java Island was higher compared to non-Java Island (44.58% vs. 41.62%). The highest prevalence of BSE practice was found among university students, with a 49.90% prevalence. Good knowledge, good attitude toward BSE, family history of BC, family support, and BC information exposure were all statistically associated with a higher determinant of BSE practice. We concluded that BSE practice in Indonesia is still low, especially in non-Java Islands. Integrative and collaborative programs should be established to promote BSE as routine screening for BC.
| S-EPMC10416892 | biostudies-literature
Project description:BackgroundThe survival rate from breast cancer is lowest in African countries and the distribution of breast self-examination practice of and its determinants are not well investigated in Ethiopia. Therefore, this systematic review and meta-analysis was designed to determine the pooled prevalence of breast self-examination and its associated factors among women in Ethiopia.MethodsPreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for this systematic review and meta-analysis. The databases used were; PUBMED, Cochrane Library, Google Scholar, CINAHL, African Journals Online, Dimensions and Summon per country online databases. Search terms used were; breast self-examination, breast cancer screening, early detection of breast cancer and Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. The meta-analysis was conducted using STATA 15 software. The pooled meta-analysis was computed to present the pooled prevalence and relative risks (RRs) of the determinate factors with 95% confidence intervals (CIs).ResultsWe identified 2,637 studies, of which, 40 articles (with 17,820 participants) were eligible for inclusion in the final meta-analysis. The pooled estimate of breast self-examination in Ethiopia was 36.72% (95% CI: 29.90, 43.53). The regional distribution breast self-examination ranged from 21.2% (95% CI: 4.49, 37.91) in Tigray to 61.5% (95% CI: 53.98, 69.02) in Gambela region. The lowest prevalence of breast self-examination was observed among the general population (20.43% (95% CI: 14.13, 26.72)). Women who had non-formal educational status (OR = 0.4 (95% CI: 0.21, 0.77)), family history of breast cancer (OR = 2.04 (95% CI: 1.23, 3.39)), good knowledge of breast self-examination (OR = 4.8 (95% CI: 3.03, 7.6)) and favorable attitude toward breast self-examination (OR = 2.75, (95% CI: 1.66, 4.55)) were significantly associated with practice of breast self-examination.ConclusionsOnly a third of women in Ethiopia practiced breast examination despite WHO guidelines advocating for this practice among all women of reproductive age. Intervention programs should address the factors that are associated with breast self-examination. Population specific programs are needed to promote breast self-examination.
| S-EPMC7808636 | biostudies-literature
Project description:BackgroundBreast cancer is common global public health problem. It is the principal cause of cancer related death. In Ethiopia, study findings regarding prevalence and associated factors of BSE among female healthcare workers have been inconsistently reported and highly variable. Thus, this systematic review and meta-analysis aimed to determine the pooled prevalence of breast self-examination practice and determinants in Ethiopia.MethodsA systematic search of PubMed, Medline, EMBASE, Global Health, Google Scholar, CINAHL and Scopus from April 2, 2020 to April 24, 2020. Data were extracted from articles included in the review using a data extraction tool which was adapted from the Joanna Briggs Institute. the quality of each included article was evaluated using the Newcastle-Ottawa scale. Data analysis was done using STATA 11. The Cochrane Q and I2 test were used to assess heterogeneity between the studies; and publication bias was assessed using funnel plots and Egger's test. A random effects meta-analysis was computed to determine the pooled prevalence of breast self-examination. The determinants for breast self-examination were examined. Forest plots were used to present the prevalence and odds ratio with 95% confidence interval.ResultsAfter reviewing 9605 studies, 12 studies involving 4129 female healthcare workers were included for this review and meta-analysis. The pooled prevalence of breast self-examination practice among healthcare workers in Ethiopia was 56.31% (95% CI: 44.37, 68.25). The subgroup analysis further revealed that the higher breast self-examination practice was observed among other healthcare workers, 58.60% (95% CI: 43.31, 73.90). Good knowledge (AOR = 3.02; 95% CI: 1.24, 7.35), positive attitude (AOR = 2.73; 95% CI: 1.95, 4.13) and family history of breast cancer (AOR = 3.21; 95% CI: 1.22, 6.52) were significantly associated with breast self-examination practice among healthcare workers.ConclusionThis meta-analysis found that nearly half of the female healthcare workers were not performed breast self-examination. The finding of this study suggests the need of strengthening early diagnosis of breast cancer and control strategies with a collaborative effort of policymakers and other concerned stakeholders.
| S-EPMC7654829 | biostudies-literature
Project description:The United States Preventive Services Task Force (USPSTF) has recommended against testicular self-examinations (TSE) or clinical examination for testicular cancer screening. However, in this recommendation there was no consideration of the significant fiscal cost of treating advanced disease versus evaluation of benign disease. In this study, a cost-utility validation for TSE was performed. The cost of treatment for an advanced-stage testicular tumor (both seminomatous and nonseminomatous) was compared to the cost of six other scenarios involving the clinical assessment of a testicular mass felt during self-examination (four benign and two early-stage malignant). Medicare reimbursements were used as an estimate for a national cost standard. The total treatment cost for an advanced-stage seminoma ($48,877) or nonseminoma ($51,592) equaled the cost of 313-330 benign office visits ($156); 180-190 office visits with scrotal ultrasound ($272); 79-83 office visits with serial scrotal ultrasounds and labs ($621); 6-7 office visits resulting in radical inguinal orchiectomy for benign pathology ($7,686) or 2-3 office visits resulting in treatment and surveillance of an early-stage testicular cancer ($17,283: seminoma, $26,190: nonseminoma). A large number of clinical evaluations based on the TSE for benign disease can be made compared to the cost of one missed advanced-stage tumor. An average of 2.4 to 1 cost benefit ratio was demonstrated for early detected testicular cancer versus advanced-stage disease.
| S-EPMC4298389 | biostudies-literature
Project description:Background: The correlation between programmed cell death-ligand 1 (PD-L1) which may affect T cell to form the immune tolerance and breast cancer (BC) still maintains to be uncovered. This meta-analysis was about to explore PD-L1 expression as well as its prognostic role in BC.Methods: First of all, we performed 3 databases: PubMed, Embase, and Web of Science to explore publications between January of 2015 and January of 2020. Strict inclusion and exclusion criteria were conducted: immunohistochemistry shall be used to detect target molecule expression and at least 1 survival indicator and related data we need should be included. The hazard ratio and 95% confidence interval were pooled related with survival as well as clinicopathological parameters. The effects of PD-L1 in differed aspects like sample size and age of each cohort were demonstrated by subgroup analyses as well as sensitivity analyses which may complain the potential source of heterogeneity. P?<?.05 indicates factors were charge of the heterogeneity of prognosis. Begg and Egger tests were used to identify publication bias.Results: We identified 12 studies containing a blanket of 4336 patients with BC for whom PD-L1 positive tumor cells were related with higher tumor stage, lymph node metastasis, estrogen receptor negativity, human epidermal growth factor receptor 2 positivity, luminal B and triple negative BC molecular subtype and high nuclear-associated antigen Ki- 67 expression. Meanwhile, compared to patients with PD-L1 negative expression, PD-L1 positivity associated with worse overall survival (Hazard ratio [HR]:1.43; 95% CI:0.98-2.10; P?<?.001) and might have no obvious tight connection with disease free survival (HR:1.40; 95% CI:1.11-1.78; P = .101) and recurrence free survival (HR:2.36; 95% CI:1.04-5.34; P?=?.145). The outcome of the meta-analysis was confirmed to be credible by sensitivity analysis. Publication bias was not existed indicated (P?=?.640).Conclusion: Positive PD-L1 expression has a worse clinical outcome in patients with BC demonstrated by our meta-analysis. Being urgent to catch attention to the role of PD-L1 in BC, it may be considered as prognostic marker of immune microenvironment for improving therapy efficacy.
| S-EPMC7717727 | biostudies-literature
Project description:Recently, the interest in programmed death ligand-1 (PD-L1) as a prognostic marker in several types of malignant tumors has increased. In the present meta-analysis, we aimed to explore the prognostic and clinicopathological value of PD-L1 in breast cancer. We searched Medline/PubMed, Web of Science, EMBASE, the Cochrane Library databases, and grey literature from inception until January 20, 2016. Studies concerning breast cancer that focused on PD-L1 expression and studies reporting survival data were included; two authors independently performed the data extraction. The pooled risk ratio (RR) and 95% confidence interval (CI) were assessed to determine the association between the clinicopathological parameters of patients and PD-L1 expression. Five studies involving 2061 patients were included in this meta-analysis. The results indicated that positive/higher PD-L1 expression was a negative predictor for breast cancer, with an RR of 1.64 (95% CI, 1.14-2.34) for the total mortality risk and an RR of 2.53 (95% CI, 1.78-3.59) for the mortality risk 10 years after surgery. Moreover, positive/higher PD-L1 expression was significantly associated with positive lymph node metastasis (RR, 1.33; 95% CI, 1.04-1.70), poor nuclear grade (RR, 1.24; 95% CI, 1.07-1.43), and negative estrogen receptor status (RR, 2.45; 95% CI, 1.31-4.60) in breast cancer patients. Our findings suggest that PD-L1 can serve as a significant biomarker for poor prognosis and the adverse clinicopathologic features of breast cancer and could facilitate the better management of individual patients.
| S-EPMC4882023 | biostudies-literature
Project description:BackgroundIn most resource constrained settings like Nigeria, breast self-examination self-breast examination (BSE) is culturally acceptable, religious friendly and attracts no cost. Women's knowledge and beliefs about breast cancer and its management may contribute significantly to medical help-seeking behaviours. This study aimed to assess knowledge and beliefs of BSE among market women.MethodsA descriptive cross-sectional study was conducted among 603 market women in Ibadan, Nigeria. Data was collected using semi-structured interviews and analyzed using descriptive and analytic statistical methods.ResultsThe mean age of the respondents was 34.6±9.3 years with 40% of the women aged between 30-39years. The proportion of married women was 339 (68.5%) with 425 (70.8%) respondents reporting that they do not know how to perform BSE. However, 372 (61.7%) women strongly agreed that BSE is a method of screening for breast cancer. Highest proportion 219 (36.3%) reported that the best time for a woman to perform BSE was 'anytime'. Most of the respondents believed breast cancer is a dangerous disease that kills fast and requires a lot of money for treatment.ConclusionMore efforts are needed in creating awareness and advocacy campaigns in the grassroots in order to detect early breast cancer and enhance prevention strategies that would reduce the burden of breast cancer in Nigeria.
| S-EPMC4659560 | biostudies-literature
Project description:BackgroundBreast cancer is the leading cause of mortality among women worldwide. However, female patients often feel reluctant and embarrassed about meeting physicians in person to discuss their intimate body parts, and prefer to use social media for such interactions. Indeed, the number of patients and physicians interacting and seeking information related to breast cancer on social media has been growing. However, a physician may behave inappropriately on social media by sharing a patient's personal medical data excessively with colleagues or the public. Such an act would reduce the physician's trustworthiness from the patient's perspective. The multifaceted trust model is currently most commonly used for investigating social media interactions, which facilitates its enhanced adoption in the context of breast self-examination. The characteristics of the multifaceted trust model go beyond being personalized, context-dependent, and transitive. This model is more user-centric, which allows any user to evaluate the interaction process. Thus, in this study, we explored and evaluated use of the multifaceted trust model for breast self-examination as a more suitable trust model for patient-physician social media interactions in breast cancer screening.ObjectiveThe objectives of this study were: (1) to identify the trustworthiness indicators that are suitable for a breast self-examination system, (2) design and propose a breast self-examination system, and (3) evaluate the multifaceted trustworthiness interaction between patients and physicians.MethodsWe used a qualitative study design based on open-ended interviews with 32 participants (16 outpatients and 16 physicians). The interview started with an introduction to the research objective and an explanation of the steps on how to use the proposed breast self-examination system. The breast self-examination system was then evaluated by asking the patient to rate their trustworthiness with the physician after the consultation. The evaluation was also based on monitoring the activity in the chat room (interactions between physicians and patients) during daily meetings, weekly meetings, and the articles posted by the physician in the forum.ResultsBased on the interview sessions with 16 physicians and 16 patients on using the breast self-examination system, honesty had a strong positive correlation (r=0.91) with trustworthiness, followed by credibility (r=0.85), confidence (r=0.79), and faith (r=0.79). In addition, belief (r=0.75), competency (r=0.73), and reliability (r=0.73) were strongly correlated with trustworthiness, with the lowest correlation found for reputation (r=0.72). The correlation among trustworthiness indicators was significant (P<.001). Moreover, the trust level of a patient for a particular physician was found to increase after several interactions.ConclusionsMultifaceted trustworthiness has a significant impact on a breast self-examination system. Evaluation of trustworthiness indicators helps to ensure a trustworthy system and ethical interaction between a patient and physician. A new patient can obtain a consultation by referring to the best physician according to preference of other patients. Patients can also trust a physician based on another patient's recommendation regarding the physician's trust level. The correlation analysis further showed that the most preferred trustworthiness indicator is honesty.
| S-EPMC7542407 | biostudies-literature