{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T04:32:08Z","timestamp":1791952328188,"version":"4.3.4"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2015,9,28]],"date-time":"2015-09-28T00:00:00Z","timestamp":1443398400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Millennium Challenge Account\u2014Mongolia"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background.<\/jats:title><jats:p>Mongolia bears the second-highest cancer burden in the world (5,214 disability-adjusted life years per 100,000 people, age standardized). To determine drivers of the growing burden of noncommunicable diseases, including breast and cervical cancers, a national knowledge, attitudes, and practices (KAP) survey was implemented in 2010.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>This paper analyzed the results of the 2010 KAP survey, which sampled 3,450 households nationally. Reflecting Mongolian screening policies, women aged 30 and older were included in analyses of questions regarding breast and cervical cancer (n = 1,193). Univariate and multivariate odds ratios (MORs) were derived through logistic regression to determine associations between demographic covariables (residence, age, education, employment) and survey responses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>This study found that 25.7% (95% confidence interval [CI]: 23.3\u201328.3) and 22.1% (95% CI: 19.8\u201324.5) of female participants aged 30 years or older self-rated their knowledge of breast and cervical cancers, respectively, as \u201cnone.\u201d Employment and education were associated with greater awareness of both cancers and participation in screening examinations (p &amp;lt; .05). Clinical breast examinations were more common among rural than urban participants (MOR: 1.492; 95% CI: 1.125\u20131.979). Of all female participants, 17% (95% CI: 15.3\u201318.5) knew that cervical cancer is vaccine preventable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>Our results suggest that cancer control in Mongolia should emphasize health education, particularly among lower-educated, rural, and unemployed women. The health infrastructure should be strengthened to reflect rural to urban migration. Finally, although there is awareness that early detection improves outcomes, a significant proportion of women do not engage in screening. These trends warrant further research on barriers and solutions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Implications for Practice:<\/jats:title><jats:p>The rising burden of breast and cervical cancers, particularly in low- and middle-income countries, necessitates the development of effective strategies for cancer control. This paper examines barriers to health service use in Mongolia, a country with a high cancer burden. The 2010 national knowledge, attitude and practices survey data indicate that cancer control efforts should focus on improving health education among lower-educated, rural, and unemployed populations, who display the least knowledge of breast and cervical cancers. Moreover, the findings support the need to emphasize individual risk for disease in cancer education and ensure that the health-care infrastructure reflects Mongolia's urbanization.<\/jats:p><\/jats:sec>","DOI":"10.1634\/theoncologist.2015-0119","type":"journal-article","created":{"date-parts":[[2015,9,29]],"date-time":"2015-09-29T02:08:13Z","timestamp":1443492493000},"page":"1266-1273","source":"Crossref","is-referenced-by-count":13,"title":["Exploring Knowledge, Attitudes, and Practices Related to Breast and Cervical Cancers in Mongolia: A National Population-Based Survey"],"prefix":"10.1093","volume":"20","author":[{"given":"Pooja","family":"Yerramilli","sequence":"first","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otgonduya","family":"Dugee","sequence":"additional","affiliation":[{"name":"Public Health Institute, Ministry of Health of Mongolia, Ulaanbaatar, Mongolia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Palam","family":"Enkhtuya","sequence":"additional","affiliation":[{"name":"Public Health Institute, Ministry of Health of Mongolia, Ulaanbaatar, Mongolia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicia M.","family":"Knaul","sequence":"additional","affiliation":[{"name":"Harvard Global Equity Initiative, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro R.","family":"Demaio","sequence":"additional","affiliation":[{"name":"Harvard Global Equity Initiative, Harvard Medical School, Boston, Massachusetts, USA"},{"name":"School of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2015,9,28]]},"reference":[{"key":"2021122309355718900_B1","article-title":"National Cancer Control Program 2007-2017 Mongolia","volume-title":"World Health Organization: Western Pacific Region, National Cancer Center","author":"Stjernsward"},{"key":"2021122309355718900_B2","volume-title":"Health of adolescents in Mongolia. WHO: Western Pacific Regional Office. 2011","author":"World Health Organization"},{"key":"2021122309355718900_B3","volume-title":"Annual health indicators report 2009","author":"Mongolia Ministry of Health","year":"2009"},{"key":"2021122309355718900_B4","volume-title":"Mongolia country data [Internet]. Millennium development goals indicators. 2010","author":"United Nations Statistics Division, Department of Economic and Social Affairs, United Nations"},{"key":"2021122309355718900_B5","volume-title":"Global burden of disease. 2013","author":"Institute for Health Metrics and Evaluation"},{"key":"2021122309355718900_B6","volume-title":"GLOBOCAN 2012 estimated cancer incidence, mortality, and prevalence worldwide in 2012","author":"International Agency for Research on Cancer; World Health Organization"},{"key":"2021122309355718900_B7","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1007\/s10552-012-9973-2","article-title":"Breast cancer incidence in Mongolia","volume":"23","author":"Troisi","year":"2012","journal-title":"Cancer Causes Control"},{"issue":"Suppl 1","key":"2021122309355718900_B8","doi-asserted-by":"crossref","first-page":"i44","DOI":"10.1093\/jjco\/hyq126","article-title":"Cervical Cancer Working Group report","volume":"40","author":"Konno","year":"2010","journal-title":"Jpn J Clin Oncol"},{"key":"2021122309355718900_B9","volume-title":"Tsilaajav T, Ser-Od E, Baasai B et al. Mongolia health system review. Health systems in transition. Geneva: World Health Organization, 2013"},{"key":"2021122309355718900_B10","volume-title":"Saving women's lives in Mongolia through cancer screening. 2014","author":"World Health Organization"},{"key":"2021122309355718900_B11","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1186\/1471-2458-11-961","article-title":"Protocol for a national, mixed-methods knowledge, attitudes and practices survey on non-communicable diseases","volume":"11","author":"Demaio","year":"2011","journal-title":"BMC Public Health"},{"key":"2021122309355718900_B12","first-page":"203","article-title":"Knowledge, attitudes, and behaviour regarding breast cancer screening among women from different socio-economic regions in southwest China: A cross-sectional study","volume":"12","author":"Huang","year":"2011","journal-title":"Asian Pac J Cancer Prev"},{"key":"2021122309355718900_B13","volume-title":"Cooperation Strategy at a glance: Mongolia. 2013","author":"World Health Organization"},{"key":"2021122309355718900_B14","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1046\/j.1523-5394.2002.105005.x","article-title":"Perceived risk of breast cancer: Influence of heuristic thinking","volume":"10","author":"Facione","year":"2002","journal-title":"Cancer Pract"},{"key":"2021122309355718900_B15","volume-title":"Mongolian STEPS survey on the prevalence of noncommunicable disease and injury risk factors\u20142009. 2010","author":"World Health Organization"},{"key":"2021122309355718900_B16","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1007\/s13187-014-0622-1","article-title":"The effect of breast cancer health education on the knowledge, attitudes, and practice: A community health center catchment area","volume":"29","author":"Ouyang","year":"2014","journal-title":"J Cancer Educ"},{"key":"2021122309355718900_B17","volume-title":"Preventing Mongolia's leading killers. 2013","author":"Millennium Challenges Corporation"},{"key":"2021122309355718900_B18","first-page":"632","article-title":"[Effectiveness and health economic analysis of strategies on cervical cancer screening and early diagnosis and treatment]","volume":"34","author":"Zhao","year":"2012","journal-title":"Zhonghua Zhong Liu Za Zhi"},{"key":"2021122309355718900_B19","volume-title":"Effective vaccine management in Mongolia. 2014","author":"World Health Organization Western Pacific Region, WHO Representative Office Mongolia"},{"key":"2021122309355718900_B20","doi-asserted-by":"crossref","first-page":"e98","DOI":"10.2196\/jmir.1883","article-title":"Internet-based brief personalized feedback intervention in a non-treatment-seeking population of adult heavy drinkers: A randomized controlled trial","volume":"14","author":"Hansen","year":"2012","journal-title":"J Med Internet Res"},{"key":"2021122309355718900_B21","volume-title":"Breast cancer: Prevention and control. 2015","author":"World Health Organization"},{"key":"2021122309355718900_B22","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1093\/jnci\/94.19.1445","article-title":"Randomized trial of breast self-examination in Shanghai: Final results","volume":"94","author":"Thomas","year":"2002","journal-title":"J Natl Cancer Inst"},{"key":"2021122309355718900_B23","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1002\/ijc.24840","article-title":"A cluster randomized, controlled trial of breast and cervix cancer screening in Mumbai, India: Methodology and interim results after three rounds of screening","volume":"126","author":"Mittra","year":"2010","journal-title":"Int J Cancer"},{"key":"2021122309355718900_B24","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1207\/s15430154jce2103_18","article-title":"Breast self-examination: Self-reported frequency, quality, and associated outcomes","volume":"21","author":"Tu","year":"2006","journal-title":"J Cancer Educ"},{"key":"2021122309355718900_B25","volume-title":"Early detection: breast health awareness and early detection strategies. 2015","author":"Union for International Cancer Control"},{"key":"2021122309355718900_B26","volume-title":"Breast cancer facts & figures 2013-2014. 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