Assessing personal and health system barriers to breast cancer early diagnosis practices for women over 20 years old in Cluj-Napoca, Romania
Background and aims. Breast cancer diagnosis is established late in Romania. This led to 3918 potentially avoidable deaths by breast cancer in 2020. Statistics show that women seldom perform monthly breast self-examinations or mammographies. This research aims to identify personal and health system barriers to breast cancer screening, with the purpose of enabling participation in future breast screening programs.
Methods. A quantitative cross-sectional, online survey of a convenience sample of 184 women aged 20-65 years old from Cluj-Napoca, Romania was used to evaluate the practice of breast self-exam and ammographies and personal and health system barriers against them.
Results. The sample’s mean age was 34.73 years (SD=11.31, range 20-65). Women in the sample had a high level of education, most holding a Master’s degree (36.4%). The majority declared practicing breast self-examinations from time to time (57.2%) and only (35.5%) did it monthly as per existing guidelines. Personal barriers to breast examination were lack of knowledge (16.3%) and mistrust in self examination (10.3%). Women with higher education engaged in the examination of the breast at least once (X2= (0.047, N = 184), p = 0.003, (CI 95%: 5.515–6.773). Concerning health system barriers, access to information from public health authorities on the availability of mammographies was rated very poor (21.7%). The cost was not a significant barrier to mammographies for 72.8% of the women in the sample.
Conclusions. Our study contributes to the limited data on preventive practices for breast cancer in Romania, the EU country that ranks last for breast control among females and where 13% of the 9000+ cases diagnosed annually are stage IV cancers. Based on the reported factors of a successful breast cancer screening program by our sample, we suggest valuable insights to be taken into consideration when organizing a future breast screening program. Both personal and system barriers to breast self-exam and mammographies must be considered in organizing breast cancer screenings. The focus should be on educational initiatives to improve women’s knowledge about the process of self-screening and on improving access to information on the availability of free screening and mammograms as part of a well-promoted screening program designed with a simple enrolment process.