288O_PR - Determinants of cancer screening awareness and participation among Indonesian women: A nationwide study (288O_PR)

Date 18 November 2017
Event ESMO Asia 2017 Congress
Session Gynaecological cancers
Topics Cancer Aetiology, Epidemiology, Prevention
Gynaecologic Malignancies
Presenter Sumadi Lukman Anwar
Citation Annals of Oncology (2017) 28 (suppl_10): x186-x195. 10.1093/annonc/mdx729
Authors S.L. Anwar1, G. Tampubolon2, S. Hutajulu3, J. Watkins4, W. Wulaningsih5
  • 1Surgery, Gadjah Mada University/Dr. Sardjito General Hospital, 55281 - Yogyakarta/ID
  • 2Institute For Social Research, 4Cathie Marsh Institute for Social Research, University of Manchester, M13 9PL - Manchester/GB
  • 3Internal Medicine, Medical Oncology, Gadjah Mada University/Dr. Sardjito General Hospital, 55281 - Yogyakarta/ID
  • 4Bioinformatics, Epidemiology, PILAR Research Network, CB1 2JD - Cambridge/GB
  • 5Mrc Unit For Lifelong Health And Ageing, UCL - University College London, WC1B 5JU - London/GB

Abstract

Background

Cancer screening awareness may vary in low- and middle-income countries lacking established national screening programmes. Additionally, breast self-examination (BSE) to screen breast cancer is common in these countries despite evidence suggesting its lack of benefit. We evaluated co-morbidities as a potential determinant of awareness to breast and cervical cancer screening and BSE practice in older women in Indonesia.

Methods

From the fifth Indonesian Family Life Survey (2014-2015), 5,397 women aged 40 and older without any history of cancer who responded to questionnaires on Pap smear, mammography, and BSE were included. Multilevel regression analysis was used to assess potential determinants in relation to awareness to Pap smear and mammography, and participation to Pap smear and BSE practice. Multivariable analyses were performed to identify independent predictors of cancer screening and participation.

Results

Only 22% women were aware of Pap smears, and 32% among them had undergone the procedure at least once in their lifetime. Six percent of participants were aware of mammography, among which 4% had mammogram in the previous year. Twelve percent of women reported they performed BSE at least once a year. Among potential determinants, higher education and household expenditure were consistently associated to higher odds of awareness to Pap smear and mammography, participation to Pap smear and BSE. We also identified enabling factors linked with cancer screening awareness and participation, including health insurance, distance to health services, and social participation.

Conclusions

Socio-economic determinants were strongly associated with cancer screening awareness and participation among Indonesian women. Our findings may be useful to inform targeted health promotion and screening for cancer in the presence of limited infrastructure.

Clinical trial identification

Legal entity responsible for the study

Universitas Gadjah Mada

Funding

UK Medical Research Council

Disclosure

All authors have declared no conflicts of interest.