Public health care physicians' knowledge, attitudes and management about breast cancer (Al Khobar, Al Dammam and Al Qatif, KSA, 2004)

Introduction: Most breast cancer cases diagnosed in Saudi Arabia were at a terminal stage. Although there was reported risks in using mammography as screening procedure for breast cancer, studies of randomized controlled trials have indicated that mammography screening leads to a reduction in breast cancer mortality for certain age groups. Physicians play a key role in motivating women to undergo mammography screening. Physicians' knowledge and beliefs about breast cancer in older women were associated with reported screening practices.5 The study was done to assess female physicians' KAP about breast cancer prevention and early detection in PHCCs, and the demographic variables concerning female physicians' KAP. Methodology: This is a rider study to a nonrandomized quasi experimental design research with 45 PHCCs' female physicians in AlKhobar, and AlQatif cities (experimental group) and 41 PHHCs' female physicians in Al Dammam City (control group) using a workshop to promote about breast cancer screening. The specially-designed questionnaire was content validated based on experts' opinion and suggestions and was highly reliable (Cronbach α=0.80). Statistical analysis was done by SPSS version 10. Results and Discussions: 65% of the respondents were Saudis, 95% hold bachelor's degree and 5% held master's degree. The mean age was 40 years. The mean duration of PHHC practice was 6 years, and mean duration of practice is 8.35 years. The physicians had good knowledge about breast cancer and early detection (mean score = 67%) in general, and had 78% mean score in BC epidemiology, but low turnout of correct responses were seen in BC epidemiology in Saudi Arabia (mean score = 60%). Physicians had poor knowledge of BC presentation (mean score = 79%). The mean score for physicians' knowledge of recommendation for primary care follow up in BC survivors was 74% and for physician's knowledge of BC risk factors, the mean score was 67%. On the physicians' knowledge of BC screening test, 53% had poor knowledge and the mean score was 66%. They had excellent knowledge of BC screening guidelines (mean score = 73%). 63% of the physicians had negative attitude towards BC early detection and management with a mean score of 68%. Physicians scored low regarding practice, 93% got low scores, 5% got low scores, and 2% got excellent scores. 68% of the physicians reported advising their patients to attend breast cancer screening programs but only 17% of them gave health education on breast cancer screening the last year before the study. For breast examination skills, just 5% had good scores of breast examination skills. There was no significant relationship between the physicians' demographic characteristics and their knowledge, attitudes, and practice of BC early detection and management except in a negative relationship seen between physicians' attitudes and overall PHC practice (0.048). Conclusion: The physicians had good general knowledge about BC and early detection, negative attitudes toward BC screening and early detection, and scored low regarding management of BC. No demographic variables were seen to affect their KAP except that physicians who had worked in PHHC longer tend to be more negative toward BC screening and early detection.