title: Breast Cancer Knowledge, Perception and Breast Self- Examination Practices among Yemeni Women: an Application of the Health Belief Model.
abstract: BACKGROUND
  The incidence of breast cancer is rapidly increasing in Yemen with recent indications of constituting one-third of female cancers. The main problem in Yemen remains very late presentation of breast cancer, most of which should have been easily recognisable. Since stage of disease at diagnosis is the most important prognostic variable, early diagnosis is an important option to be considered for control of breast cancer in low resourced settings like Yemen. In the present study, we aimed at describing breast cancer knowledge, perceptions and breast self-examination (BSE) practices among a sample of Yemeni women.
  
  
  METHODS
  This cross-sectional study covered 400 women attending four reproductive health centres in Aden, Yemen through face-to-face interview using a structured questionnaire during April - July 2014. We collected data on sociodemographic characteristics, knowledge about breast cancer, and screening practices as well as respondents' perceptions based on the five sub scales of the Health Belief Model (HBM): perceived susceptibility; perceived severity; perceived barriers; perceived benefits; and self-efficacy. The response format was a fivepoint Likert scale. Statistical Package for Social Sciences (SPSS 20) was used for statistical analysis. Statistical significance was set at p<0.05. Logistic regression analysis was conducted with BSE as a dependent variable.
  
  
  RESULTS
  The mean age of women was 26.5 (S.D=5.6) years. The majority (89.0%) had never ever performed any screening. Two-thirds of respondents had poor knowledge. Perceived BSE benefits and self-efficacy and lower BSE barriers perception were significant independent predictors of BSE practice.
  
  
  CONCLUSIONS
  Poor knowledge and inadequate BSE practices are prevailing in Yemen. The need for implementing culturally sensitive targeted education measures is mandatory in the effort to improve early detection and reduce the burden of breast cancer.
authors.affiliation: Aden Cancer Registry and Research Center and Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Aden University, Aden, Yemen E-mail : hudabasaleem92@yahoo.com.
authors.forename: Khaled Abdulla
authors.initials: KA
authors.lastname: Al-Sakkaf
authors.forename: Huda Omer
authors.initials: HO
authors.lastname: Basaleem
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / 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; D006801:Humans; D015233:Models, Statistical; D009042:Motivation; D009367:Neoplasm Staging; D010465:Perception; D011379:Prognosis; D012307:Risk Factors; D015006:Yemen / Q000453:epidemiology