title: Factors influencing the opinion of individuals in determining tumour spread after biopsy.
abstract: BACKGROUND
  People often have concerns regarding tumour spread after biopsy which leads to a delay in seeking expert medical advice. The data regarding this perception is scanty. Therefore, we conducted this cross sectional study to explore the beliefs and perceptions of individuals regarding tumour spread after biopsy and the basis of those beliefs.
  
  
  METHODS
  The survey was conducted in outpatient areas of two different tertiary care hospitals of Karachi namely Aga Khan University Hospital Karachi (AKUH) and Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN). We interviewed 600 individuals and documented their responses on a questionnaire. There were 400 responders from Aga Khan's Consulting Clinic and 100 each from Aga Khan's Oncology Clinic and KIRAN.
  
  
  RESULTS
  Only 50% of the respondents chose biopsy as the best test for diagnosis of cancer. The level of education was statistically significant in making this choice of answer (p = 0.02) only in univariate analysis. Those individuals who were involved in the work up of cancer patients irrespective of their educational status gave more intelligent answers (p = 0.003). The tumour disturbance after biopsy was regarded as a major factor among 127 respondents (53%) who believed that biopsy could lead to spread of tumour.
  
  
  CONCLUSIONS
  Our study revealed that awareness regarding cancer diagnosis and biopsy is lacking among general public and it does not co-relate well with the level of formal education. These misconception and taboos need to be addressed in public seminars and in the media in order to increase the awareness which could facilitate prompt diagnosis.
authors.affiliation: Aga Khan University Hospital, Stadium Road, P,O, Box 3500, Karachi 74800, Pakistan. drtayyaba@gmail.com.
authors.forename: Tayyaba Z
authors.initials: TZ
authors.lastname: Ansari
authors.forename: Adnan A
authors.initials: AA
authors.lastname: Zaidi
authors.forename: Asra
authors.initials: A
authors.lastname: Parekh
authors.forename: Owais
authors.initials: O
authors.lastname: Iqbal
authors.forename: Nehal
authors.initials: N
authors.lastname: Masood
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mateen
authors.forename: Tehseen
authors.initials: T
authors.lastname: Fatima