title: Do we need to maximise the breast cancer screening awareness? Experience with an endogamous society with high fertility.
abstract: BACKGROUND
  In the State of Qatar, breast cancer has become the most common form of cancer among women. The aim of this study was to explore knowledge, attitude and practice about breast cancer and to identify potential barriers to screening procedures among women.
  
  
  METHODS
  This multistage sampling cross sectional survey in primary health care centers and the outpatient department of the Women's Hospital in the State of Qatar targeted a representative sample of 1,200 Qatari women aged between 30 to 55 years of age during the period from December 2008 to April 2009. A total 1,002 subjects (83.5%) consented to participation. Face to face interviews were conducted with a designed questionnaire covering knowledge about breast cancer, attitudes and practices of breast cancer screening. Socio-demographic variables were included.
  
  
  RESULTS
  The majority of Qatari women demonstrated an adequate knowledge about breast cancer, with a significant relation to education status. Almost three quarters were aware that breast cancer is the most common cancer in women. A good proportion knew that nipple retraction (81.2%) and discharge of blood (74.6%) are warning signs. Of the studied Qatari women, 24.9% identified breast self examination, 23.3% clinical breast examination (CBE) and 22.5% mammography as methods for detection of breast cancer. The frequently reported barriers among the Qatari women were asking any doctor/nurse how to perform breast self examination (57.3%), embarrassment about CBE (53.3%) and fear of mammography results (54.9%). Univariate and multivariate logistic regression analysis showed that family history, level of education, living in an urban area and having medical check-ups when healthy were significant predictors for CBE and mammography.
  
  
  CONCLUSIONS
  The study findings revealed that although Qatari women had adequate general knowledge about breast cancer, the screening rates for BSE, CBE and mammography were low, these being performed most frequently by young Qatari women with a higher level of education.
authors.affiliation: Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, Hamad General Hospital, Qatar. abener@hmc.org.qa
authors.forename: Abdulbari
authors.initials: A
authors.lastname: Bener
authors.forename: Hanadi R
authors.initials: HR
authors.lastname: El Ayoubi
authors.forename: Malcolm A
authors.initials: MA
authors.lastname: Moore
authors.forename: Basma
authors.initials: B
authors.lastname: Basha
authors.forename: Sharen
authors.initials: S
authors.lastname: Joseph
authors.forename: Lotfi
authors.initials: L
authors.lastname: Chouchane
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D016504:Breast Self-Examination / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D005298:Fertility; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening; D008875:Middle Aged; D009042:Motivation; D011780:Qatar