Document Type: Research Articles
Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia.
Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen University, Khon Kaen, Thailand.
Biostatistics Center of Excellence, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Background: Globally, breast cancer is the second most common cancer in women and is a leading cause of mortality
in Indonesia. Raising awareness of breast cancer is particularly important to help at risk women seek medical treatment
for this disease. This study aimed to comprehensively investigate the Indonesian women’s level of knowledge about
breast cancer risk factors, barriers, attitude and breast cancer screening. Methods: This population-based cross-sectional
study administered the breast cancer awareness Indonesian scale (BCAS-I) to 856 Indonesian women. Samples were
selected in rural and urban combinations from three provinces by stratified random sampling. The ordinal logistic
model was used to investigate the clustering effect of the participant’s characteristics in this study. Results: Of the
women, 62% lived in rural areas and 38% lived in urban areas. Living in an urban area was significantly associated
with a lower knowledge of the risk factors. However, living in an urban area was significantly associated with better
attitudes and healthier behaviours related to breast cancer awareness. Women with higher education levels had 70%
worse attitudes toward breast cancer awareness. Women living South of Sumatera, women living in Yogyakarta, and
unmarried women were 5.03, 3.84, and 1.56 times as likely to have higher perceived barriers, respectively. Conclusion:
Urban women had a poorer level of knowledge of breast cancer risk factors compared to women living in more rural
areas. The result of this study may reflect inadequate breast cancer awareness campaigns or a lack of breast cancer
awareness campaigns. These findings suggest that additional education programs aiming to increase awareness and
educate the public are needed.