Factors Associated with Late Detection of Breast Cancer: Application of Health Belief Model Theory

Authors

  • Wayan Wati Masters Program in Public Health, Universitas Sebelas Maret
  • Ambar Mudigdo Faculty of Medicine, Universitas Sebelas Maret
  • Isna Qadrijati Faculty of Medicine, Universitas Sebelas Maret

Abstract

Background: Primary prevention of breast cancer is still not available, so efforts to promote early detection continue to be the major focus in fighting breast cancer. Since early detection is as­sociated with decreased mortality, it is important to minimize delays in detection and di­agnosis. The purpose of this study was to examine factors associated with late detection of breast cancer in Surakarta, Central Java, using Health Belief Model.

Subjects and Method: A cross sectional study was carried out at Dr. Moewardi Hospital, Sura­karta, from October to December 2018. A sample of 200 breast cancer patients was selected by fixed disease sampling. The dependent variable was late detec­tion of breast cancer. The inde­pen­dent variables were perceived susceptibility, threat, benefit, barrier, self-efficacy, family sup­port, breast cancer detection, and family income. The data were collected by questionnaire and analyzed by a multiple logistic regression.

Results: Late detection of breast cancer decreased with perceived susceptibility (b= -1.49; 95% CI= -2.55 to -0.42; p= 0.006), perceived threat b= -1.87; 95% CI= -3.05 to -0.69; p= 0.002), per­ceived benefit (b= -3.27; 95% CI= -4.54 to -2.00; p<0.001), self-efficacy (b= -1.49; 95% CI= -2.52 to -0.46; p= 0.004), family support (b= -1.44; 95% CI= -2.49 to -0.39; p= 0.007), early breast cancer detection (b=-2.21; 95% CI= -3.33 to -1.09; p<0.001), and income (b= -1.75; 95% CI= -2.92 to -0.59; p= 0.003). It increased with perceived barrier (b= 1.64; 95% CI= 0.49 to 2.80; p= 0.005).

Conclusion: Late detection of breast cancer decreases with perceived susceptibility, perceived threat, perceived benefit, self-efficacy, family support, early breast cancer detection, and in­come. It increases with perceived barrier.

Keywords: late detection, breast cancer, Health Belief Model

Correspondence: Wayan Wati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: wayanwati99@­gmail.­com.Mobile: +62858­42842990.

Indonesian Journal of Medicine (2019), 4(2): 105-115
https://doi.org/10.26911/theijmed.2019.04.02.04

References

Brzozowska A, Duma D, Mazurkiewicz, T, Brzozowski W, & Mazurkiewicz M. (2014). Reasons for delay in treatment of breast cancer detected due to breast self-examination in wo­men from the lubelskie region Przyczyny opó?nie? leczenia cho­r­ych na raka piersi wykry­tego w trakcie samobadania u kobiet w województwie lubelskim. Gineko­logia Polska, 85(1):14–17. doi: 10.17772/­gp/1684. Bandura A (1998). Self-efficacy. In V. S. Ramachaudran (Ed.), Encyclo­pedia of human behavior (Vol. 4, pp. 71-81). New York: Academic Press. (Reprinted in H. Friedman [Ed.], Encyclopedia of mental health. San Diego: Academic Press, 1998)., 4(1994):71–81. doi: 10.1002/978047­0­4­79216.corpsy0836. Bebis H, Altunkurek SZ, Acikel C, Akar I, Altunkurek SZ (2013). Evaluation of Breast Self-Exa­mi­n­ation (BSE) Appli­ca­tion in First and Second Degree Relatives of Patients with Breast Cancer. Asian Pacific Journal of Cancer Prevention, 14(8): 4925–4930. doi:10.7314/APJCP.2013.14.8.4925 Cancer Research (2018). Breast can­cer statistics. Retrieved from https://www.cancerresearchuk.org/health-profes­sio­nal/cancer-sta­tistics/statistics-by-cancer-ty­pe/breast-cancer#heading-Four Desanti OI, Sunarsih I, Supriyati (2010). Persepsi Wanita Berisiko Kanker Payudara Tentang Peme­riksaan Payu­dara Sendiri di Kota Semarang, Jawa Tengah. Berita Kedokteran Masya­ra­kat, 26(3): 152–161. Despitasari NL, Nofrianti D (2017). Hubungan Dukungan Keluarga dan Pemeriksaan Payudara Sen­diri (SADARI) dengan Keter­lam­batan Pemeriksaan Kanker Payu­dara Pada Penderita Kanker Pa­yu­dara di Poli Bedah. Journal. UmSurabaya.Ac.Id, 2(1). Retrie­ved from http://journal.­um-su­rabaya.ac.id/index.php/­JKM/­article/view/1110 Djatmiko A, Octovianus J, Fortunata N, Andaru I (2013). Profil Cancer Delay pada Kasus Kanker Payudara di RS Onkologi Sura­baya. Indonesian Jour­nal of Can­cer, 7(2):47–52. Ghazali SM, Othman Z, Cheong KC, Lim KH, Wan Mahiyuddin WR, Kamalud­din MA, Mustafa AN (2013). Non-Practice of Breast Self Examination and Marital Status are Associated with Dela­yed Presentation with Breast Cancer. Asian Pacific Journal of Cancer Prevention, 14(2):1141–1145. doi:10.7314/APJCP.2013.14.2.1141. Kemenkes (2015). Pusat data dan informasi kementrian kesehatan Republik Indo­nesia, InfoDatin “STOP KANKER.” Ministry of Health Indonesia. Kemenkes (2016). Oktober 2016 Bulan Peduli Kanker Payudara. InfoDATIN. Khan MA, Hanif S, Iqbal S, Shahzad MF, Shafique S, Khan MT (2015). Presen­tation delay in breast cancer patients and its as­so­ciation with sociodemo­gra­phic factors in North Pakistan. Chi­nese Journal of Cancer Research = Chung-Kuo Yen Cheng Yen Chiu, 27(3):288–293. doi:10.3978/j.issn.10009­604.20­15­.0­4.­11. Khanjani N, Rastad H, Saber M, Khandani BK, Tavakkoli L (2018). Causes of delay in seeking treatment in Iranian patients with breast cancer based on the health belief model (HBM). Inter­national Journal of Cancer Mana­gement, 11(6). doi: 10.5812/ijcm.61383 Dyanti R, Luh N (2016). Faktor-Faktor Keterlambatan Penderita Kanker Payudara Dalam Melaku­kan Pemerik­saan Awal Ke Pela­ya­nan Kesehatan Info Artikel De­la­ying Factors In Breast Cancer Patients Taking Early Exami­na­tion Into Health Ser­vices. Kemas, 11(2). doi: 10.15294/kemas.v11i2.3742. Murti B (2018). Teori Promosi dan Perilaku Kesehatan (1st ed.). Surakarta: Bintang Fajar Offset. Norsa’adah B, Rampal KG, Rahmah MA, Naing NN, Biswal BM (2011). Diag­nosis delay of breast cancer and its associated factors in Malaysian women. BMC Can­cer, 11:2–9. doi: 10.1186/14­71-2­40­7-11-141 Odongo J, Makumbi T, Kalungi S, Galukande M (2015). Patient delay factors in women pre­senting with breast cancer in a low income country Cancer. BMC Research Notes, 8(1):4–9. doi: 10.­11­8­6­/s­13104-015-1438-8. Pace LE, Mpunga T, Hategekimana V, Dusengimana JMV, Habineza H, Bigi­rimana JB, Keating NL (2015). Delays in Breast Cancer Presentation and Diagnosis at Two Rural Cancer Refer­ral Cen­ters in Rwanda. The Oncologist, 20(7):780–788. doi: 10.16­34/­th­eo­nco­logist.2014-0493 Piñeros M, Sánchez R, Cendales R, Perry F, Ocampo R (2009). Patient delay among Colombian women with breast cancer. Salud Pública de México, 51(5). doi: 10.1590/S003636342009­000­50­0­004. Poum A, Promthet S, Duffy SW, Parkin DM (2014). Factors As­sociated With Delayed Diag­nosis of Breast Cancer in North­east Thailand. Journal of Epide­mio­logy, 24(2):102–108. doi:10.2188/jea.JE20130090 Prihantini W, Yunitasari E, Pradanie R (2013). Hubungan perceived Benefit dan Perceived Barrier Dengan Stadium Kanker Payu­dara Berdasarkan Teori Health Belief Model Pada Pasien Yang Berkunjung Di Posa Rsud Dr. Soe­tomo. Journal Universitas Airlangga, 3(2):50–54. Retrieved from http://www.journal.unair.ac.id/abstract.­download.php?page=798. Putu N, Rossalia P, Bagus I, Wibawa T (2016). Faktor-Faktor yang Berhu­bungan dengan Ke­ter­lambatan Peng­obatan pada Penderita Kanker Payu­dara di Ru­mah Sakit Umum Pusat (RS­UP) Sanglah Denpasar. E-Jour­nal Medika, 5(12):1–7. Retrieved from http://ojs.unud­.ac.id/inde­x.php­/eum Rahmatari A (2014). Hubungan Karakteristik, Pengetahuan, Dan Ang­gapan (Perceived) Wanita Usia Subur Dengan Perilaku Me­meriksakan Payudara Sejak Dini (Studi di Pusat Deteksi Dini dan Diagnostik Kanker Surabaya Tahun 2014). Universitas Air­lang­ga. Retrieved from http://repository­.unair.ac.id/id/eprint/23765. Rasjidi I (2011). Deteksi Dini dan Pencegahan Kanker pada Wa­nita. Jakarta: Sugeng Seto. Rivera-Franco MM, Leon-Rodri­guez E. (2018). Delays in breast cancer detec­tion and treatment in developing coun­tries. Breast Cancer: Basic and Clinical Research, 12. doi:10.1177/11­782­2341­7752677. Seifeldin IA, Banerjee M, Soliman AS. (2015). presentation of breast cancer in Egypt, 20(5):532–537. doi: 10.1002/pon.1767.Patient-mediated. Setiawan F (2012). Hubungan Penge­tahuan dan Deteksi Dini (SADA­RI) dengan Keterlambatan Pen­de­rita Kanker Payudara Mela­kukan Pemeriksaan di RSUD Kra­ton Kabupaten Pekalongan. Sekolah Tinggi Ilmu Kesehatan Muhammadiyah Pekajangan. Sharma K, Costas A, Shulman LN, Meara JG (2012). A systematic review of barriers to breast cancer care in deve­loping countries resulting in delayed patient presentation. Journal of Onco­logy, 2012. doi:10.1155/­2012/­12­1­873. Tavafian SS, Hasani L, Aghamolaei T, Zare S, Gregory D (2009). Prediction of breast self-exa­mi­nation in a sample of Iranian women: An application of the Health Belief Model. BMC Wo­men’s Health, 9:1–7. doi.org/10.­1186­/1472-6874-9-37 World Health Organization (2014). Cancer Country Profile: Indo­nesia. Cancer Country Profiles. World Health Organization. (2018). Cancer. Retrieved from https://­www­.who.int/newsroom/fact-sheets/detail/cancer

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Published

2019-03-10

Issue

Vol. 4 No. 2 (2019)

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Articles