Nada A.S. Alwan; Wafa' M. Alattar; Nawar Al Mallah; Thamira K. Hassoun
Abstract: Background Breast cancer ranks the first malignancy among the Iraqi population since three decades. The reported gap in the knowledge regarding that disease emphasizes the necessity for practical policy decisions to elevate the level of awareness among the Iraqi women, who often rely on their primary health care providers to obtain adequate guidance. Objectives To assess the baseline needs for breast cancer awareness among paramedical health care providers in Iraq through exploring the level of knowledge, beliefs and attitudes towards the practice and management of breast cancer.. Methodology One hundred paramedical health care providers including nurses, biologists and laboratory technicians, working in different departments of the Medical City Teaching Hospital, were involved in the current study. Each was asked to complete a structured questionnaire format which was prepared to evaluate the level of knowledge and beliefs towards breast cancer and its risk factors (18 items), barriers to screening (16 items) and the attitudes regarding the practice and management of early detection (8 items). Results The answers of the respondents regarding the knowledge on breast cancer and its risk factors were remarkably good, approximately 83 % had a score of 70 % and over. It was interesting to observe that 95 % expressed willingness to join our National Cancer Research Program and 97 % were interested to learn more about breast cancer. Nevertheless, their positive impact on the beliefs towards the management and barriers to early detection of breast cancer in Iraq was relatively fair. While 77 % actively proposed instructing all patients on the technique of Breast Self-Examination, only 52 % had positive attitudes regarding providing Clinical Breast Examination if the women have no complaints, over 60 % believed that women generally refuse to expose their breasts to a male physician and less than 50 % agreed on offering Ultrasound to all women presenting with breast pain. On the other hand, about 70 % readily accepted screening mammography if there is any breast complaint, 86 % emphasized that patients actually go for needle aspiration when prescribed by the specialist and 64 % confirmed that all diagnosed cases in their practice are usually scheduled for operations by examining surgeons in the same hospital. Conclusion and Recommendations Our findings reveal insufficient conformity in the attitudes towards the practice of breast cancer management among the general paramedical providers in spite of their acceptable level of awareness. Abiding to protocol guidelines, through directed interventions, is mandatory to ensure overcoming the existing barriers and adopting a successful nationwide public health educational program on breast cancer control.
Keywords: Assessment, breast cancer, awareness, management, paramedical health care providers, Iraq.