Breast Cancer Screening Practices: Analyzing the Determinants of Participation

Abstract

Introduction

Early detection of breast cancer is crucial for reducing mortality rates and achieving successful treatments.

Objective

This study examined the relationship between individual characteristics, lifestyle behaviors, and participation in breast cancer screening practices among women residing in Jordan.

Method

A cross-sectional design was employed to collect data through self-administered questionnaires comprising the Overall Women's Information about Breast Cancer Form and the Arab Culture-Specific Barriers of Breast Cancer Questionnaire.

Results

A total of 650 women participated. Most women had information about screening and appreciated the importance of these practices, and less than two-thirds had prior formal training in breast self-examination. Less than one-third of participants reported performing regular breast self-examination, only 10.5% of them reported receiving a clinical breast examination by a specialist, and only 11% reported having a regular mammogram. The study found generally low levels of breast cancer screening practices among the population. Breast cancer screening practices are associated with several lifestyle behaviors, such as smoking, alcohol intake, a healthy diet, and regular exercise. Further, age, employment, having information about breast cancer and breast self-examination, receiving training about breast self-examination, and disease susceptibility influenced the frequency of screening practices.

Conclusion

Early detection is crucial for reducing mortality rates and achieving successful treatments. The study found that low levels of screening practices were associated with the population's profile. Enhanced education and support around breast self-examination, clinical breast exam, and mammography can improve health outcomes and increase breast health awareness.

Keywords

breast cancer breast cancer screening breast self-examination cancer screening clinical breast exam breast mammography early detection of cancer health behavior

Introduction

Breast cancer is the most common cancer to affect women and is currently considered one of the primary causes of cancer-related morbidity and mortality worldwide (Fahad Ullah, 2019; Wilkinson & Gathani, 2022). According to the Global Cancer Statistics 2024, breast cancer accounts for a significant proportion of newly diagnosed cancer cases, indicating its increasing burden on public health systems worldwide (Siegel et al., 2024). Beyond physical health, breast cancer profoundly has an impact on an individual's and family's psychological wellbeing, quality of life, and economic stability (Aitken & Hossan, 2022; Al-Ghabeesh et al., 2019).

Global trends are closely reflected in the Middle East, where increased incidence rates of breast cancer have been noted in several Arab countries (Safiri et al., 2022). Jordan is no exception, where breast cancer continues to be the most prevalent cancer among women. According to the Jordan Cancer Registry report, 1765 new instances of breast cancer were diagnosed in 2022, accounting for 20.1% of all newly discovered cancer cases in the country. Among Jordanian women, more than 36.8% of all cancer cases were breast cancer (Jordan Cancer Registry, 2022). These statistics underscore the urgent need to enhance screening programs and awareness campaigns to promote early detection and reduce mortality rates.

Given this high social burden, reducing breast cancer-associated mortality is crucial, and can occur through early detection and diagnosis and the prompt delivery of effective treatment (Smolarz et al., 2022; Waks & Winer, 2019). Unfortunately, delayed diagnosis is often associated with increased symptom burden, a lower quality of life, and poorer survival rates (Arndt et al., 2002; Cuthrell & Tzenios, 2023; Othman et al., 2023). Despite improvements in early detection methods and treatment, disparities in screening participation persist, particularly in middle- and low-income countries, where significant social, cultural, and economic barriers hinder access to preventive care (Albadawi et al., 2025; Ginsburg et al., 2020).

Early detection remains the cornerstone of successful breast cancer management (Borgquist et al., 2018). Several countries have achieved successful high early detection rates by implementing screening programs targeting women in specific age groups or those with known increased risk for breast cancer (Anderson et al., 2003; Ginsburg et al., 2020). Breast screening guidelines are established to guide screening practices, enabling the detection of disease as early as possible. The screening guidelines differ between women at average risk and those at high risk of developing breast cancer. Differences include variations in breast self-examination (BSE), clinical breast exam (CBE), breast mammography, ultrasound, and breast magnetic resonance imaging (MRI) (Shah & Guraya, 2017).

Review of Literature

A recent review study examined 23 screening guidelines in 11 countries that were generated between 2010 and 2021 by specialized organizations such as the World Health Organization, American Cancer Society, German Association of Scientific Medical Societies, Brazilian College of Radiology and Diagnostic Imaging, Canadian Task Force on Preventive Health Care; European Commission Initiative on Breast Cancer; Cancer Australia; National Cancer Centres in Japan and China (Ren et al., 2022). The review concluded that no country recommended using BSE and MRI as screening methods for average-risk women due to the lack of evidence of actual benefits. On the contrary, mammography was uniformly recommended as the primary screening modality for average-risk women.

In Jordan, the screening guidelines are regulated by the Jordan Breast Cancer Program (JBCP). The JBCP recommends that women at average risk aged 25 to 39 should perform monthly BSE and CBE every 1 to 3 years. Women over 40 years old are advised to include annual mammography in their screening regimen. Women at higher risk are encouraged to do annual mammography regardless of age (JBCP, 2024).

The JBCP is a national program established in 2007 and led by the King Hussein Cancer Foundation and Center in collaboration with the Ministry of Health (MOH), aiming to coordinate and lead breast cancer early detection efforts across Jordan (JBCP, 2019). The JBCP enhances public awareness and knowledge about breast cancer, ensuring that high-quality screening services are available across Jordanian cities. In 2023, the JBCP screened 6,399 women through mobile mammography units and partnership projects, with 87 cancer cases identified (JBCP, 2023).

Various factors, including knowledge levels, access to screening services, socioeconomic status, and cultural beliefs, significantly influence women's decisions regarding breast cancer screening. Studies show that many women hesitate to undergo screening due to fear of a potential diagnosis, a lack of awareness about the benefits of screening, or financial constraints (Al-Mousa et al., 2020; Hamadeh & Moonesar, 2022). Additionally, growing research in this area highlights that specific female characteristics and lifestyle practices can increase the risk of developing breast cancer (Obeagu & Obeagu, 2024; Pistelli et al., 2021; Winters et al., 2017). Hormonal factors, such as the age of first menstruation, first pregnancy, menopause, as well as pregnancies, miscarriages, and breastfeeding, also play a role in influencing breast cancer risk (Conte et al., 2024).

In Jordan, religious beliefs, misconceptions, and embarrassment hinder women's participation in screening programs (Ahmad et al., 2022; Al-Mousa et al., 2020). Women are further discouraged from accessing early detection services by systemic barriers, including high screening costs, insufficient insurance coverage, and limited access to specialist healthcare centers (Hamadeh & Moonesar, 2022). Notably, the incidence of female breast cancer in Jordan has risen over the years. Thus, the motivation to know more about the factors implicated in breast cancer is escalating. Nonetheless, limited research has been done in Jordan to explore these risk factors. Along the same line, various individual characteristics and modifiable lifestyle behaviors have not been thoroughly researched among women in Jordan. These associations, however, might shed light on the etiologies of female breast cancer in Jordan and offer a behavioral-preventive measure when implementing screening campaigns. The current study aimed to investigate the association between individual characteristics, lifestyle behaviors, and other factors and participation in breast cancer screening practices among women residing in Jordan.

Methods

Design

A cross-sectional design was used. Quantitative data were collected with self-administered questionnaires from January 2023 to July 2023.

Research Question

What are the lifestyle behaviors and knowledge of women regarding breast cancer screening practices?

What is the prevalence of breast cancer screening practices (e.g., mammograms and self-exams) among different demographic groups?

What lifestyle factors are most strongly associated with breast cancer screening practices?

Sample

The researchers recruited participants from various settings nationwide, including primary healthcare centers, hospitals, private and public universities, shopping malls, and conducted random household visits in multiple cities in Jordan. The first author collected data by visiting the mentioned settings and collecting data in person from potential participants, resulting in a 100% response rate. Furthermore, we developed and implemented an awareness symposium on breast cancer and breast cancer screening to recruit more women, during which data were collected from participants.

We used the Raosoft Software to estimate the required sample size. The targeted population of our study is the 3.38 million women in Jordan who are 18 years or older, minus those women who are diagnosed with cancer and live during the study period (N = 3,380,000–16,268 = 3,363,732). Thus, using this number, the minimum required sample size was 385 subjects.

Inclusion/Exclusion Criteria

The target population for this study was all women residing in Jordan. The accessible population in this study was all women who met the inclusion criteria. These criteria include females aged 18 years and above, residing in Jordan from multiple cities, who speak Arabic, have not been diagnosed with breast cancer, and are willing to participate in the study. The exclusion criteria include women with a history of breast cancer.

Institutional Review Board Approval

The Institutional Review Board (IRB) of Hashemite University (No. 8/7/2021/2022) and the Ministry of Health Ethics Committee (No. 12097) approved the study.

Measurements

A descriptive survey consisted of 29 questions. The sociodemographic characteristics of participants were measured using items 1 to 8 and 10. Questions (9, 11–17, 27–29) measure the risk factors of breast cancer. Lastly, questions (18–26) measure breast cancer screening practices. The questionnaire is available in Supplemental file 1.

Statistical Analysis

The analysis was conducted using SAS software. Quality control was conducted to ensure proper data entry and coding. Double-checking the data entry was performed to verify the accuracy of the data and prevent errors in data entry. There was no missing data because the researcher checked every questionnaire upon submission and allowed sufficient rest between data collection sessions. All questionnaires were carefully reviewed to ensure form completion. Categorical variables were summarized using frequencies and percentages. The chi-square test was used to examine the association between women's lifestyle behaviors and screening practices, and logistic regression was employed to identify predictors of participation in various breast screening practices. A statistical significance of p = .05 was considered significant in the data analysis.

Results

Sample Characteristics

All participants were of Arabic descent, mainly from Jordan and surrounding countries. Most of these women lived in Jordan for more than 20 years. The age distribution of participants is predominantly young adults (61.8%), with more than two-thirds being married (73.4%). Most of these women are well-educated and have minimal diplomas. The distribution of participants based on work status shows a balanced representation, with 46.2% employed. Around two-thirds do have health insurance coverage (72.2%). Sample characteristics are shown in Table 1.

Table 1.

Sample Characteristics (N = 650).

Characteristics	Groups	N	%
Age (years)	20–39	402	61.8
	40–59	225	34.6
	≥ 60	23	3.6
Marital status	Single	143	22.0
	Married	477	73.4
	Widowed/divorced	30	4.6
Educational level	High school	132	20.3
	Professional college	104	16.0
	Bachelor's degree	338	52.0
	Postgraduate	76	11.7
Work status	Employed	300	46.2
Work status	Nonemployed	350	53.8
Health insurance	Yes	469	72.2
Health insurance	No	181	27.8

Prevalence of Predictors/Lifestyle Behavior and Screening Knowledge and Training

Table 2 summarizes the lifestyle behaviors and knowledge of women regarding breast cancer screening practices. Only 17 women (2.7%) reported consuming alcohol. Smoking was more frequently observed in more than 7% of the sample. Most women in our sample were physically active and used to a healthy vegetarian diet.

Table 2.

Prevalence of Predictors/Lifestyle Behavior and Screening Knowledge and Training.

Predictor variable	n (%)
History of breast disease	46 (7.1)
Current breast disease	40 (6.2)
Family history of breast cancer	101 (15.5)
Use of contraceptive	124 (19.1)
Alcohol use	17 (2.6)
Smoking	48 (7.4)
Physical wellness	447 (68.8)
Vegetarian food	422 (64.9)
Believe that regular breast self-examination is necessary	597 (91.8)
Have heard about breast self-examination	612 (94.2)
Have information about breast cancer and breast self-examination	517 (79.5)
Have any training about breast self-examination	409 (62.9)
Perform periodic routine investigations in the absence of disease	235 (36.2)

Only 40 women (6.2%) reported having a current nonmalignant breast disease, with similar figures reporting having a history of nonmalignant breast disease. Around 16% (n = 101) of women reported having a family history of breast cancer. Most women had information about screening and appreciated the importance of these practices. Less than two-thirds (63%) had prior formal training in breast self-examination.

Prevalence of Outcomes/Breast Cancer Screening Practices

Less than one-third of participants (n = 166) reported performing regular breast self-examination. While only 68 women reported receiving a clinical breast examination by a specialist, double this number (130) reported undergoing a mammogram. Only 11% of the sample (n = 72) reported having a regular mammogram. The frequency of breast cancer screening practices among women is reported in Table 3.

Table 3.

Prevalence of Outcomes/Screening Practices.

Outcome variable	n (%)
Do regular breast self-exams	166 (25.5)
Have a clinical breast examination before	68 (10.5)
Had undergone a mammogram before	130 (20)
Have a regular mammogram	72 (11.1)

Lifestyle Behaviors and Breast Cancer Screening Practices

The results from the Chi-squared analysis identified that women's lifestyle behaviors can be associated with their screening practices. We found a significant association (p < .05) between alcohol use and engagement in regular breast self-exams and mammography. Smoking also had a significant association with clinical breast exams and mammography. Women who performed regular breast self-exams were more likely to consume a healthy diet and exercise regularly.

Other factors were also associated with breast cancer screening practices. The age of the women and having a history or a current breast disease were significantly associated with the four outcomes of screening practices. Further, having information about breast cancer and breast self-examination, or receiving training about breast self-examination, were significantly associated with screening practices. Similarly, performing periodic routine investigations without disease was significantly associated with screening practices. A family history of breast cancer was only associated with regular breast self-examination. Table 4 shows the cross-tabulation between women's lifestyle behaviors and screening practices.

Table 4.

Cross-tabulation Between Exposure Factors and Screening Practices.

Factor	Outcomex²p-Value
Factor	Do regular breast self-exams	Have a clinical breast examination	Had undergone a mammogram	Have a regular mammogram
Marital status	9.7 <.01^*	8.6 <.05^*	26.3 <.001^*	5.6 .06
Education	2.1 .7	2.0 .7	8.5 .07	6.8 .1
Employment	8.1 .5	11.1 .2	25.1 <.01^*	9.3 .4
Insurance	0.2 .6	0.9 .7	0.8 .3	0.01 .9
History of breast disease	8.4 <.01^*	12.9 <.001^*	17.1 <.001^*	11.3 <.001^*
Current breast disease	16.3 <.001^*	13.2 <.001^*	23.9 <.001^*	19.8 <.001^*
Family history of breast cancer	6.9 <.05^*	1.0 .6	3.1 .2	0.9 .6
Use of contraceptive	7.9 <.01^*	2.6 .1	0.01 .9	0.1 .8
Alcohol use	4.3 <.05^*	3.1 .07	2.5 .1	10.4 <.01^*
Smoking	0.3 .6	8.5 <.001^*	5.7 <.05^*	13.5 <.001^*
Physical wellness	5.3 <.05^*	2.9 .08	0.01 .9	0.4 .5
Vegetarian food	24.4 <.001^*	11.9 <.001^*	2.4 .1	4.7 <.05
Believe that regular breast self-examination is necessary	4.2 <.05^*	4.5 <.05^*	2.7 .09	1.7 .1
Have heard about breast self-examination	8.7 <.01^*	2.6 .1	5.4 <.05^*	1.3 .2
Have information about breast cancer and breast self-examination	44.6 <.001^*	16.8 <.001^*	14.4 <.001^*	15.5 <.001^*
Have any training about breast self-examination	65.7 <.001^*	25.9 <.001^*	20.3 <.001^*	12.5 <.001^*
Perform periodic routine investigations in the absence of disease	23.6 <.001^*	32.6 <.001^*	20.2 <.001^*	24.3 <.001^*

*: Significant p-value (<.05).

Table 5 illustrates the exposure factors that predict screening practices while accounting for other factors in the model. Predictors for regular breast self-exams were age, current breast disease, vegetarian food, belief that regular breast self-examination is necessary, having information about breast cancer and breast self-examination, having any training about breast self-examination, and performing periodic routine investigations in the absence of disease. On the other hand, predictors for Clinical Breast Examination were Age, Current Breast Disease, Smoking, Vegetarian Food, information about breast cancer and breast self-examination, any training about breast self-examination, and periodic routine investigations in the absence of disease.

Table 5.

Odd Ratios of Screening Practices Based on Different Exposure Factors (Multivariate Analyses).

Exposure factors	Screening practicesOR [95% CI]p-Value
Exposure factors	Do regular breast self-exams	Have a clinical breast examination	Had undergone a mammogram	Have a regular mammogram
Age	OR = 0.97 [0.95, 0.99] p = .042 *	OR = 0.94 [0.91, 0.97] p < .001 *	OR = 0.90 [0.87, 0.92] p < .001 *	OR = 0.94 [0.91, 0.97] p < .001 *
Current breast disease	OR = 3.51 [1.63, 7.52] p = .001 *	OR = 3.25 [1.38, 7.66] p = .007 *	OR = 4.67 [2.21, 9.86] p < .001 *	OR = 4.14 [1.85, 9.26] p < .001 *
Smoking	p = .367	OR = 3.90 [1.55, 9.77] p = .003 *	p = .095	OR = 4.17 [1.83, 9.50] p < .001 *
Vegetarian food	OR = 2.46 [1.55, 3.91] p < .001 *	OR = 2.50 [1.20, 5.19] p = .013 *	p = .941	p = .143
Believe that regular breast self-examination is necessary	OR = 12.05 [1.59, 91.12] p = .015 *	p = .328	p = .334	p = .763
Have information about breast cancer and breast self-examination	OR = 5.87 [1.94, 17.73] p = .001 *	OR = 9.90 [1.16, 83.85] p = .035 *	OR = 4.01 [1.90, 8.44] p < .001 *	OR = 11.33 [2.63, 48.75] p = .001 *
Have any training about breast self-examination	OR =3.25 [1.81, 5.85] p < .001 *	OR = 2.77 [1.07, 7.15] p = .034 *	p = .085	p = .621
Perform periodic routine investigations in the absence of disease	OR = 1.91 [1.27, 2.84] p = .001 *	OR = 3.71 [2.08, 6.62] p < .001 *	OR = 2.39 [1.53, 3.73] p < .001 *	OR = 3.41 [1.97, 5.89] p < .001 *

Note. Variables included in the multivariate analysis were Age, Marital Status, Education, Employment, Insurance, History of Breast Disease, Current Breast Disease, Family History of Breast Cancer, Use of Contraceptive, Alcohol Use, Smoking, Physical Wellness, Vegetarian Food, Believe that regular breast self-examination is necessary, Have heard about breast self-examination, Have information about breast cancer and breast self-examination, Have any training about breast self-examination, and Perform periodic routine investigations in the absence of disease.

CI: confidence interval; OR=odds ratio.

Predictors for undergoing a mammogram were age and current breast disease, having information about breast cancer and breast self-examination, and performing periodic routine investigations in the absence of disease. Moreover, predictors for having a regular mammogram were age, current breast disease, smoking, information about breast cancer and breast self-examination, and performing periodic routine investigations in the absence of disease.

Discussion

The current study examined the relationship between individual characteristics, lifestyle behaviors, and participation in breast cancer screening practices among women in Jordan. Early detection of breast cancer is a crucial factor in reducing mortality rates and in achieving successful treatments. Early diagnosis in Jordan is supported by the implementation of the JBCP, high awareness, and improved access to mammography services. There are 90 mammography units distributed between the public and private sectors that offer screening and early detection for breast cancer (JBCP, 2023).

The frequency of breast cancer screening practices among the population surveyed should be interpreted in light of the JBCP guidelines. For instance, there are critically low levels of BSE and CBE practices, which should be encouraged for all age groups. However, the practice of regular mammography is slightly low, considering that only 38% of the sample is eligible for this test (i.e., those 40 years or older). Still, there is generally a low level of breast cancer screening practices, highlighting a significant area for improvement in public health initiatives. Enhancing education and support around BSE, CBE, and mammography can improve health outcomes and increase breast health awareness.

Worldwide variations exist in the frequency of breast cancer screening and are influenced by several factors, including awareness of guidelines, socioeconomic status, and healthcare provider recommendations. Charkazi et al. (2013) highlighted very poor adherence to breast cancer screening among Iranian Turkmen women, with compliance rates of 13.1% for SBE, 2.5% for CBE, and 0.9% for mammography. Similarly, a review study that explored factors influencing Arab women's breast cancer screening behavior revealed that breast cancer screening participation rates (CBE, mammography, and BSE) are alarmingly low for women throughout the region (Donnelly et al., 2013). In summary, the frequency of breast cancer screening practices is not uniform. It is affected by a complex interplay of knowledge of guidelines, socioeconomic and marital status, healthcare provider influence, and cultural beliefs.

Women's lifestyle behaviors are associated with their screening practices, as evidenced by the findings across multiple studies. For instance, demographic factors and attitudes toward health check-ups have been shown to influence breast screening behaviors among Hong Kong Chinese women (Kwok & Fong, 2014). We found that older women, especially those whose ages ranged from 40 to 59 years, were more likely to do breast cancer screening. In general, health beliefs may be affected by age. According to Deeks et al. (2009), men and women older than 50 years were more likely to have screening health checks than younger people. Our results can be explained on the basis that this age group (older than 40 years) perceives themselves as susceptible to breast cancer. According to a systematic review of reports of breast cancer in Arab countries, the average age at diagnosis among 7455 patients was 48 years (SD = 2.8, range: 43–52 years) (Najjar & Easson, 2010). This could be attributed to the awareness campaigns conducted by the JBCP that targeted this age group. The program conducted 56 training workshops and scientific seminars in 2023. Last year, they implemented more than 5100 awareness-raising activities (JBCP, 2023).

Moreover, employment status has been associated with BSE practices, which resonates with the findings of Halbert et al. (2006). Demi˙rhan et al. (2023) identified employment status as one of the factors impacting women's health literacy, which in turn affects their knowledge and practices of screening. Interestingly, while some studies highlight a direct relationship between employment and health practices, others focus on indirect associations. For instance, there is a significant difference in the quality of life between employed and unemployed individuals (Carlier et al., 2013; Norström et al., 2019), which could indirectly affect their engagement in health-promoting behaviors like breast cancer screening practices. In summary, while the direct impact of employment status on screening practices is not consistently demonstrated across studies, employment appears to influence factors such as health literacy, insurance, and quality of life, which may, in turn, affect breast cancer screening practices. Further research is warranted to clarify these relationships and to understand how employment status can be leveraged to improve BSE practices and breast cancer outcomes.

Having a current nonmalignant breast disease was associated with all the screening practices. At the same time, the family history was only associated with regular BSE. These results could be interpreted in light of the Health Belief Model, which assumes that individuals who are susceptible to a condition (Perceived Susceptibility) or believe that the condition is serious (Perceived Severity) will take action to prevent, screen for, or control the illness (Champion & Skinner, 2008). The relationship between history or current breast disease and breast cancer screening practices was highlighted by previous literature. Hibler and Chagpar (2012) showed that a family history of a first-degree relative with breast cancer is associated with a higher likelihood of adherence to mammography and CBE guidelines. Additionally, having a medical history, including a family history, can influence participation in breast cancer screening programs (Schoofs et al., 2017).

Having information or receiving training about breast cancer and BSE was significantly associated with screening practices. This is consistent with the results of previous studies. A cross-sectional study of 305 women aged 40 years and above revealed that less than half of the women who never had a mammogram and nearly half of the women who never had a CBE stated they were unaware that these screening methods existed and available to them (Elobaid et al., 2014). The gap in knowledge and awareness about screening guidelines can affect adherence to recommended practices. Hence, interventions to improve knowledge and address barriers to screening could potentially enhance adherence to breast cancer screening recommendations.

Strengths and Limitations of the Study

The study has several strengths that contribute to its significance and value. Firstly, it is the first study conducted in Jordan and the Arab world that focused on the determinants of breast cancer screening. Also, the study's large sample size of 650 Women residing in Jordan is another strength. As with any research study, some limitations should be taken into consideration. One limitation is that the study sample was limited to women, even though men are also at risk for breast cancer. Additionally, data were collected through a self-administered questionnaire using a cross-sectional design, which makes it challenging to infer changes and trends over time. Convenience sampling might also introduce sampling bias, leading to potential distortions in data and limited generalizability.

Recommendations and Implications

The current study provides important insights into several key areas, such as increased participation in breast cancer screening, which can lead to earlier detection of cancer, which is associated with better treatment outcomes and higher survival rates. Understanding the determinants of participation can help in designing more effective targeted public health interventions that encourage higher participation rates in breast cancer screening programs. Besides, identifying which demographics are less likely to participate can assist in efficiently allocating resources and efforts to ensure these groups are reached. Community organizations can use the findings to develop programs that raise awareness and encourage participation in breast cancer screening, particularly in underserved communities. The findings can help healthcare providers tailor their educational efforts to address specific barriers to participation, such as misconceptions about screening, fear, or lack of knowledge. Enhancing education and support around BSE, CBE, and mammography can improve health outcomes and increase breast health awareness.

Policymakers can create or modify policies that reduce barriers to screening, such as offering screenings at more convenient times or locations, providing transportation, or reducing costs. Further Research such as exploring in more depth the reasons behind the low participation rate, or the effectiveness of different intervention strategies is suggested. Further research is warranted to understand how employment status can be leveraged to improve BSE practices and breast cancer outcomes. In summary, the implications of this study are broad and impactful, potentially influencing public health strategies, healthcare delivery, policy development, community engagement, further research, and patient outcomes.

Conclusion

The study explored the relationship between individual characteristics, lifestyle behavior, and breast cancer screening practices among women in Jordan. Early detection is crucial for reducing mortality rates and achieving successful treatments. The study found low levels of BSE and CBE practices among the population. Demographics, awareness of guidelines, and disease susceptibility influence the frequency of screening practices. Enhanced education and support around BSE, CBE, and mammography can improve health outcomes and increase breast health awareness.

Supplemental Material

sj-docx-1-son-10.1177_23779608251343500 - Supplemental material for Breast Cancer Screening Practices: Analyzing the Determinants of Participation

Supplemental material, sj-docx-1-son-10.1177_23779608251343500 for Breast Cancer Screening Practices: Analyzing the Determinants of Participation by Anas Alsharawneh, Elham H. Othman and Reham S Albadawi in SAGE Open Nursing

Supplemental Material

sj-docx-2-son-10.1177_23779608251343500 - Supplemental material for Breast Cancer Screening Practices: Analyzing the Determinants of Participation

Supplemental material, sj-docx-2-son-10.1177_23779608251343500 for Breast Cancer Screening Practices: Analyzing the Determinants of Participation by Anas Alsharawneh, Elham H. Othman and Reham S Albadawi in SAGE Open Nursing

Footnotes

ORCID iDs

Anas Alsharawneh

Elham H. Othman

Ethics Approval and Consent to Participate

The study was performed in accordance with the Declaration of Helsinki. The Research Ethics Committee in Hashemite University (No 8/7/2021/2022) and the Ministry of Health Ethics Committee (No 12097) approved this study. Informed consent was obtained from participants.

Authors’ Contributions

AA and RA were involved in study design and data collection; and AA, RA, and EO in data analysis and manuscript writing.:

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Supplemental Material

Supplemental material for this article is available online.

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