Cent Eur J Public Health 2022, 30(2):119-130 | DOI: 10.21101/cejph.a6305

Knowledge and barriers to early detection of breast cancer among female primary care patients in Serbia

Milena Šantrić Milićević¹, Ana Djurin², Zorica Terzić-Šupić¹, Jovana Todorović¹, Dejan Nikolić³, Ivan Soldatović⁴

¹ Faculty of Medicine, Institute of Social Medicine, University of Belgrade, Belgrade, Serbia

² Primary Healthcare Centre of Kikinda, Kikinda, Serbia

³ University Children's Hospital, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

⁴ Faculty of Medicine, Institute for Statistics and Medical Informatics, University of Belgrade, Belgrade, Serbia

Objectives: Breast cancer is the leading cause of cancer mortality among women in Serbia and accounts for 22.8% of total cancer mortality in 2018. This study assessed the knowledge and barriers to early detection of breast cancer in women.

Methods: In March 2019, at the Primary Healthcare Centre Kikinda, Serbia, a 22-item questionnaire was distributed to a series of patients (N = 403, response rate 91.8%) to assess the odds ratio (OR) and 95% confidence interval (CI) between variables explaining knowledge of breast cancer symptoms and risk factors and barriers to screening, and four types of early detection of breast cancer.

Results: The majority of patients (85.4%) know that a lump in a breast is a common symptom of breast cancer and that a family history of breast cancer is a risk factor (80.1%); 63.8% of respondents aged ≥ 30 years self-examined their breasts in the past month, 39.1% of patients aged ≥ 40 years had clinical, while 34.4% had ultrasound breast examination in the past year, and 51.1% of patients aged ≥ 50 years had mammography once in the past two years. Patients aged ≥ 40 years retired and those with a positive family history were 84% and 63% less likely not to undergo a clinical breast examination in the past year. Participants over 40 years of age who reported a lack of funds were 2.46 times more likely to miss a clinical breast examination than those who did not have that barrier. Among participants aged 50-69 years, the likelihood of not receiving the mammography increases by 2.82 with an increase in wealth status and it was 65% lower for those who lack information about the available treatment.

Conclusion: Women under the age of 50 rarely practice breast cancer screening. Study findings can be used to improve breast cancer screening at the primary level.

Keywords: breast cancer, early detection, knowledge, practice, primary healthcare centre, Serbia

Received: May 25, 2020; Revised: May 16, 2022; Accepted: May 16, 2022; Published: June 30, 2022  Show citation