Translation and Validation of the Breast Cancer Awareness Measurement Tool in Malaysia (B-CAM-M)

Document Type : Research Articles


1 Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia.

2 Department of Community Medicine, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka, Malaysia.

3 Centre for Public Health and UKCRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, UK.

4 Department of Rehabilitation Medicine, University of Malaya, Kuala Lumpur, Malaysia.

5 Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.

6 Ministry of Health, Putrajaya, Malaysia.

7 National Cancer Society, Kuala Lumpur, Malaysia.

8 South East Asia Community Observatory (SEACO), Monash University Malaysia, Bandar Sunway, Malaysia.


Background: Breast cancer is the most common cancer among women in Malaysia, and the incidence of 31.1 per 100,000 population is comparatively higher than other Southeast Asian countries. Diagnosis tends to occur at later stages which may be due, partly, to inadequate knowledge about warning signs and symptoms. Therefore, this study investigated the validity and reliability of a UK-developed measure in the context of assessing women’s awareness of breast cancer in Malaysia. Aims: This study aimed to translate, adapt and validate the internationally recognised Breast Cancer Awareness Measure (B-CAM) into the Malay language. Methods: The original B-CAM (Cancer Research UK) was forward and backward translated and content validation was ascertained. Face validity (n=30), test-retest reliability (n=50) and the internal consistency of the B-CAM-M (M for Malay language) were assessed in a community sample of adults (n=251) in 2018. Results: The translated B-CAM-M was validated by an expert panel. The Item-Content Validity Index ranged from .83 to 1.00. The results from the survey (n=251) indicated that the B-CAM-M was well received by Malay-speaking women across the main ethnic groups (85 Malay, 84 Chinese and 82 Indian adults). Cronbach alpha scores for the knowledge about breast cancer symptoms (0.83) and the barriers to healthcare seeking items (0.75) were high. Test-retest reliability (separated by 2-week-interval) with 50 randomly selected participants from the community survey produced intra-class correlations ranging from 0.39 to 0.69. Conclusion: The Malay-version, the B-CAM-M, is a culturally acceptable, valid and reliable assessment tool with which to measure breast cancer awareness among Malay-speaking women.


Main Subjects

Volume 21, Issue 1
January 2020
Pages 217-223
  • Receive Date: 13 October 2019
  • Revise Date: 27 November 2019
  • Accept Date: 19 December 2019
  • First Publish Date: 01 January 2020