title: Knowledge, barriers and attitudes towards breast cancer mammography screening in jordan.
abstract: BACKGROUND
  Breast cancer is the most common type of cancer in Jordan. Current efforts are focused on annual campaigns aimed at increasing awareness about breast cancer and encouraging women to conduct mammogram screening. In the absence of regular systematic screening for breast cancer in Jordan, there is a need to evaluate current mammography screening uptake and its predictors, assess women's knowledge and attitudes towards breast cancer and screening mammograms and to identify barriers to this preventive service.
  
  
  METHODS
  This cross-sectional study was conducted in six governorates in Jordan through face- to-face interviews on a random sample of women aged 40 to 69 years.
  
  
  RESULTS
  A total of 507 participants with mean age of 46.8±7.8 years were interviewed. There was low participation rate in early detection of breast cancer practices. Breast self-examination, doctor examination and periodic mammography screening were reported by 34.9%, 16.8% and 8.6% of study participants, respectively. Additionally 3.8% underwent breast cancer screening at least once but not periodically, while 87.6% had never undergone mammography screening. Reported reasons for conducting the screening were: perceived benefit (50%); family history of breast cancer (23.1%); perceived severity (21.2%); and advice from friend or family member (5.8%). City residents have shown higher probability of undergoing mammogram than those who live in towns or villages. Results revealed negative perceptions and limited knowledge of study participants on breast cancer and breast cancer screening. The most commonly reported barriers for women who never underwent screening were: fear of results (63.8%); no support from surrounding environment (59.7); cost of the test (53.4%); and religious belief, i.e. Qadaa Wa Qadar (51.1%).
  
  
  CONCLUSIONS
  In the absence of regular systematic screening for breast cancer in Jordan, the uptake of this preventive service is very low. It is essential for the country of Jordan to work on applying regular systematic mammography screening for breast cancer. Additionally, there is a need for improvement in the current health promotion programmes targeting breast cancer screening. Other areas that could be targeted in future initiatives in this field include access to screening in rural areas and removal of current barriers.
authors.affiliation: Epidemiology and Preventive Medicine, Department of Public Health, Faculty of Medicine, Mutah University, Karak, Jordan E-mail : mabuhelalah@yahoo.co.uk.
authors.forename: Munir Ahmad
authors.initials: MA
authors.lastname: Abu-Helalah
authors.forename: Hussam Ahmad
authors.initials: HA
authors.lastname: Alshraideh
authors.forename: Ala-Aldeen Ahmad
authors.initials: AA
authors.lastname: Al-Serhan
authors.forename: Mariana
authors.initials: M
authors.lastname: Kawaleet
authors.forename: Adel Issa
authors.initials: AI
authors.lastname: Nesheiwat
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000523:psychology*; D016504:Breast Self-Examination / Q000523:psychology*; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D008327:Mammography / Q000523:psychology*; D008875:Middle Aged; D009367:Neoplasm Staging; D010465:Perception; D011379:Prognosis