Association of Knowledge and Cultural Perceptions of Malaysian Women with Delay in Diagnosis and Treatment of Breast Cancer: a Systematic Review

Background: Breast cancer is the most common cancer and the leading cause of cancer mortality amongwomen of all ethnic and age groups in Malaysia. Delay in seeking help for breast cancer symptoms is preventableand by identifying possible factors for delayed diagnosis, patient prognosis and survival rates could be improved.
Objectives: This narrative review aimed to understand and evaluate the level of in-depth breast cancerknowledge in terms of clinical breast examination and breast self-examination, and other important aspectssuch as side-effects and risk factors in Malaysian females. Since Malaysia is multicultural, this review assessedsocial perceptions, cultural beliefs and help-seeking behaviour in respect to breast cancer among different ethnicgroups, since these may impinge on efforts to ‘avoid’ the disease. Materials and
Methods: A comprehensiveliterature search of seven databases was performed from December 2015 to January 2015. Screening of relevantpublished journals was also undertaken to identify available information related to the knowledge, perceptionand help-seeking behaviour of Malaysian women in relation to breast cancer.
Results: A total of 42 articles wereappraised and included in this review. Generally, women in Malaysia had good awareness of breast cancer and itsscreening tools, particularly breast self-examination, but only superficial in-depth knowledge about the disease.Women in rural areas had lower levels of knowledge than those in urban areas. It was also shown that books,magazines, brochures and television were among the most common sources of breast cancer information. Delayin presentation was attributed mainly to a negative social perception of the disease, poverty, cultural and religionpractices, and a strong influence of complementary and alternative medicine, rather than a lack of knowledge.
Conclusions: This review highlighted the need for an intensive and in-depth breast cancer education campaignsusing media and community health programmes, even with the existing good awareness of breast cancer. Thisis essential in order to avoid misconceptions and to frame the correct mind-set about breast cancer amongwomen in Malaysia. Socio-cultural differences and religious practices should be taken into account by healthcare professionals when advising on breast cancer. Women need to be aware of the risk factors and symptomsof breast cancer so that early diagnosis can take place and the chances of survival improved.