Breast Cancer Awareness among Rural Women in Terengganu, Malaysia

  • Harmy Mohamed Yusoff Faculty of Medicine, UniSZA, Medical Campus, Kuala Terengganu
  • Zainab Mohd Shafie School of Nursing Science, Faculty of Medicine, UniSZA, Gong Badak Campus, 21400 Kuala Nerus, Terengganu
  • Farrahdilla Hamzah School of Nursing Science, Faculty of Medicine, UniSZA, Gong Badak Campus, 21400 Kuala Nerus, Terengganu
  • Nor Ayliwati Ali School of Nursing Science, Faculty of Medicine, UniSZA, Gong Badak Campus, 21400 Kuala Nerus, Terengganu
Keywords: breast cancer, breast cancer awareness, rural


In Malaysia, breast cancer cases show increasing in numbers especially those diagnosed at the advanced stages and becoming a high health burden to the country. Most of these cases are reported in rural areas. The late presentation at the time of diagnosis resulted in a low survival rate and poor prognosis to the affected women. This study conducted to determine the level of knowledge, attitude, and the perception toward breast cancer especially among women in rural Terengganu. A cross-sectional study was conducted in 2017 among 383 women in rural areas in Terengganu. Multivariable analyses using multiple logistic regression revealed that perceived barrier scores (p < 0.002) were found to be significantly associated with preventive activities after controlling the cofounders. This study revealed that women in rural Terengganu have good awareness of breast cancer, including general knowledge and its’ risk factors but they perform poorly when it comes to its preventive activities. There is a crucial need to increase the awareness regarding breast cancer so that early intervention can be carried out because the worrying number of advanced cases are reported from the rural area in Malaysia.


Download data is not yet available.


Aidalina, M., & ASJ, S. M. (2018). The uptake of Mammogram screening in Malaysia and its associated factors: A systematic review. The Medical Journal of Malaysia, 73(4), 202-211.

Akhtari-Zavare, M., Juni, M. H., Ismail, I. Z., Said, S. M., & Latiff, L. A. (2015). Barriers to breast self examination practice among Malaysian female students: a cross sectional study. SpringerPlus, 4(1), 1–6.

Alaudeen, S. R. B. S., & Ganesan, K. (2019). Knowledge, attitude, and practice of Malaysian medical students towards breast cancer: A cross-sectional study. Internal Medicine and Care, 3(1), 1-7. https://doi: 10.15761/IMC.1000125

Al-Dubai, S. A. R., Qureshi, A. M., Saif-Ali, R., Ganasegeran, K., Alwan, M. R., & Hadi, J. I. S. (2011). Awareness and knowledge of breast cancer and mammography among a group of Malaysian women in Shah Alam. Asian Pacific Journal of Cancer Prevention, 12(10), 2531–2538.

Ali, A. N., Yuan, F. J., Ying, C. H., & Ahmed, N. Z. (2019). Effectiveness of intervention on awareness and knowledge of breast self-examination among the potentially at risk population for breast cancer. Asian Oncol Res J, 2(1), 1-13

Al Thoubaity, F. (2019). Assessment of knowledge, attitudes and practices of women on breast cancer detection, screening and breast self-examination: A public awareness study. 30(6), 839–844.

American Cancer Society. (2011). Breast Cancer Prevention and Early Detection What is breast cancer. American Cancer Society, 2, 5.

Azizah AM., B., H., K., N., AR., S. Z., NA., P., A., N., R., S., B., B., SMR., N., SSS., S., O., R., O., N. I., & AA., A. (2019). Malaysia National Cancer Registry Report 2012-2016.

Bogusz, R., Humeniuk, E., Walecka, I., & Bojar, I. (2016). Level and conditioning of knowledge about breast cancer displayed by women in perimenopausal age. Annals of Agricultural and Environmental Medicine, 23(2). https:// doi/org/10.5604/12321966.1203899

Bolarinwa O. A. (2015). Principles and methods of validity and reliability testing of questionnaires used in social and health science researches. The Nigerian postgraduate medical journal, 22(4), 195–201.

Chelliah, K. K., Voon, N. S. M. F., & Ahamad, H. (2013). Breast density: Does it vary among the main ethnic groups in Malaysia?. Open Journal of Medical Imaging, 03(04), 105–109.

Champion, V. L., & Skinner, C. S. (2008). The health belief model. Health behavior and health education: Theory, research, and practice, 4, 45-65.

Clinical Practice Guidelines: Management of Breast Cancer, Third Edition (2019). Putrajaya: Ministry of Health, Malaysia;

Dahlui, M., Gan, D. E. H., Taib, N. A., Pritam, R., & Lim, J. (2012). Predictors of breast cancer screening uptake: a pre intervention community survey in Malaysia. Asian Pacific Journal of Cancer Prevention, 13(7), 3443-3449.

Farid, N. D. N., Aziz, N. A., Al-Sadat, N., Jamaludin, M., & Dahlui, M. (2014). Clinical breast examination as the recommended breast cancer screening modality in a rural community in Malaysia; what are the factors that could enhance its uptake?. PloS one, 9(9), https://doi:10.1371/journal.pone.0106469

Fouladi, N., Barahman, M., Amani, F., Bahadoram, M., & Eghbali, S. (2019). Factors associated with delayed diagnosis of breast cancer; a study in North-West of Iran. Immunopathologia Persa, 6(1), e02-e02. DOI: https://10.15171/ipp.2020.02

Hadi, M. A., Hassali, M. A., Shafie, A. A., & Awaisu, A. (2010). Knowledge and perception of breast cancer among women of various ethnic groups in the state of Penang: a cross-sectional survey. Medical Principles and Practice, 19(1), 61-67. https://doi/org/10.1159/000252837

Heena, H., Durrani, S., Riaz, M., Alfayyad, I., Tabasim, R., Parvez, G., & Abu-Shaheen, A. (2019). Knowledge, attitudes, and practices related to breast cancer screening among female health care professionals: A cross sectional study. BMC Women’s Health, 19(1), 1–11.

Hochbaum, G. M. (1958). Public participation in medical screening programs: A socio-psychological study (No. 572). US Department of Health, Education, and Welfare, Public Health Service, Bureau of State Services, Division of Special Health Services, Tuberculosis Program.

Htay, M. N. N., Donnelly, M., Schliemann, D., Loh, S. Y., Dahlui, M., Somasundaram, S., ... & Su, T. T. (2021). Breast cancer screening in Malaysia: A policy review. Asian Pacific Journal of Cancer Prevention: APJCP, 22(6), 1685 DOI: https:// 10.31557/APJCP.2021.22.6.1685

Johnson, N., & Dickson-Swift, V. (2008). “It usually happens in older women”: Young women’s perceptions about breast cancer. Health Education Journal, 67(4), 243–257.

Kanaga, K. C., Nithiya, J., & Shatirah, M. F. (2011). Awareness of breast cancer and screening procedures among Malaysian women. Asian Pac J Cancer Prev, 12(8), 1965-7.

Lee, M. S., Ma’ruf, C. A. A., Izhar, D. P. N., Ishak, S. N., Jamaluddin, W. S. W., Ya’acob, S. N. M., & Kamaluddin, M. N. (2019). Awareness on breast cancer screening in Malaysia: a cross sectional study. BioMedicine, 9(3). DOI: https://10.1051/bmdcn/2019090318

Liu, L. Y., Wang, Y. J., Wang, F., Yu, L. X., Xiang, Y. J., Zhou, F., ... & Yu, Z. G. (2018). Factors associated with insufficient awareness of breast cancer among women in northern and eastern China: a case–control study. BMJ open, 8(2), e018523. https:// dx. doi. org/ 10. 1136/ bmjopen- 2017- 018523.

M., S. L., & G., S. (2017). A cross-sectional study on knowledge about breast cancer among women aged 20-30 years. International Journal Of Community Medicine And Public Health, 4(11), 4131.

Mahfouz, A. A., Hassanein, M. H., Nahar, S., Farheen, A., Gaballah, I. I., Mohamed, A., ... & Aftab, R. (2013). Breast cancer knowledge and related behaviors among women in Abha city, southwestern Saudi Arabia. Journal of Cancer Education, 28(3), 516-520. https://doi/org/10.1007/s13187-013-0495-8

Marzouni, H. Z., Lavasani, Z., Shalilian, M., Najibpour, R., Fakhr, M. S., Nazarzadeh, R., Farshad, A., & Bahrami, N. (2015). Women’s awareness and attitude toward breast Self-Examination in Dezful city, Iran, 2013. Iranian Red Crescent Medical Journal, 17(1), 1–6.

Mena, M., Wiafe‐Addai, B., Sauvaget, C., Ali, I. A., Wiafe, S. A., Dabis, F., ... & Sasco, A. J. (2014). Evaluation of the impact of a breast cancer awareness program in rural Ghana: a cross‐sectional survey. International journal of cancer, 134(4), 913-924. https://doi/org/ 10.1002/ijc.28412

Mohan, D., Su, T. T., Donnelly, M., Hoe, W. M. K., Schliemann, D., Tan, M. M., ... & Allotey, P. (2021). Breast cancer screening in semi-rural Malaysia: Utilisation and barriers. International Journal of Environmental Research and Public Health, 18(23), 12293.

Muthoni, A., & Miller, A. N. (2010). An Exploration of rural and urban Kenyan women’s knowledge and attitudes regarding breast cancer and breast cancer early detection measures. Health Care for Women International, 31(9), 801–816.

National Breast Cancer Foundation, 2015

National Institutes of Health. (2005). National Health and Morbidity Survey 2019 Non-communicable diseases, healthcare demand, and health literacy.

Norlaili, A. A., Fatihah, M. A., Nik Daliana, N. F., & Maznah, D. (2013). Breast cancer awareness of rural women in Malaysia: Is it the same as in the cities? Asian Pacific Journal of Cancer Prevention, 14(12), 7161–7164.

Nurulhuda, M. H., Daud, N., & Husbani, M. A. R. (2018). Improvement of Awareness and Knowledge in Breast Cancer Using Online Learning. Asian Journal of Medicine and Biomedicine, 2(1), 50-54.

Poum, A., Promthet, S., Duffy, S. W., & Parkin, D. M. (2014). Factors associated with delayed diagnosis of breast cancer in northeast Thailand. Journal of Epidemiology, 24(2), 102-108.https:// doi/10.2188/jea.JE20130090

Rosmawati, N. H. N. (2010). Attitude and Practice of Breast Self Examination in Malaysia. Asian Pacific Journal of Cancer Prevention, 11, 1503–1508.

Sayed, S., Ngugi, A. K., Mahoney, M. R., Kurji, J., Talib, Z. M., Macfarlane, S. B., ... & Moloo, Z. (2019). Breast Cancer knowledge, perceptions and practices in a rural Community in Coastal Kenya. BMC public health, 19(1), 1-13.

Schliemann, D., Htay, M. N. N., Dahlui, M., Paramasivam, D., Cardwell, C. R., Tamin, N. S. B. I., ... & Donnelly, M. (2020). Impact of a mass media campaign on breast cancer symptoms awareness and screening uptake in Malaysia: Findings from a quasi-experimental study. BMJ open, 10(8), e036503. . https://doi:10.1136/ bmjopen-2019-036503

Schliemann, D., Hoe, W. M. K., Mohan, D., Allotey, P., Reidpath, D. D., Tan, M. M., ... & Su, T. T. (2022). Challenges and opportunities for breast cancer early detection among rural dwelling women in Segamat District, Malaysia: A qualitative study. Plos one, 17(5), e0267308.

Shah, P., Save, M., Khadilkar, R., Shah, P., Kader, H., & Eswarawaka, M. (2020). Locally advanced breast cancer: an observational study for the delay in presentation of patients. International Surgery Journal, 7(6), 1758-1762. DOI:

Subramanian, P., Oranye, N. O., Masri, A. M., Taib, N. A., & Ahmad, N. (2013). Breast cancer knowledge and screening behaviour among women with a positive family history: A cross sectional study. Asian Pacific Journal of Subcancer Prevention, 14(11), 6783–6790.

Tran, L., & Tran, P. (2019). US urban–rural disparities in breast cancer-screening practices at the national, regional, and state level, 2012–2016. Cancer Causes & Control, 30(10), 1045-1055

World Health Organization. (2018). Latest global cancer data: Cancer burden rises to 18.1 million new cases and 9.6 million cancer deaths in 2018. International agency for research on cancer. Geneva: World Health Organization.

Wu, T. Y., & Lee, J. (2019). Promoting breast cancer awareness and screening practices for early detection in low-resource settings. European Journal of Breast Health, 15(1), 18. DOI: https://10.5152/ejbh.2018.4305

Yılmaz, M., & Durmuş, T. (2016). Health beliefs and breast cancer screening behavior among a group of female health professionals in Turkey. The journal of breast health, 12(1), 18. DOI: https://10.5152/tjbh.2015.2715

Yip, C. H., Buccimazza, I., Hartman, M., Deo, S. V. S., & Cheung, P. S. Y. (2015). Improving outcomes in breast cancer for low and middle income countries. World Journal of Surgery, 39(3), 686–692.

How to Cite
Wan Sulong, W. S., Mohamed Yusoff, H., Mohd Shafie, Z., Farrahdilla Hamzah, & Nor Ayliwati Ali. (2023). Breast Cancer Awareness among Rural Women in Terengganu, Malaysia. The Journal of Management Theory and Practice (JMTP), 3(3), 28-38.
Marketing & Management