{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:45:35Z","timestamp":1787028335063,"version":"build-2736575974"},"reference-count":25,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2021,11,23]],"date-time":"2021-11-23T00:00:00Z","timestamp":1637625600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001779","name":"Monash University","doi-asserted-by":"publisher","award":["SGS 17-0628"],"award-info":[{"award-number":["SGS 17-0628"]}],"id":[{"id":"10.13039\/501100001779","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Newton-Ungku Omar Fund","award":["537084059"],"award-info":[{"award-number":["537084059"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Breast cancer (BC) is the commonest cancer in Malaysia. Delayed diagnosis is a significant cause of BC mortality in the country. Early diagnosis and screening are vital strategies in mortality reduction. This study assessed the level of utilisation and barriers for breast self-examination (BSE), clinical breast examination (CBE) and mammogram in a semi-rural population in Malaysia and compared these across the different ethnic groups. This cross-sectional study was conducted among women aged 40 years and above, embedded within a health and demographic surveillance site (HDSS) in Segamat, Malaysia. Trained data collectors collected data on screening and barriers during home visits. Study participants (n = 250) were aged 59.4 \u00b1 10.9 years and represented Malaysia\u2019s three major ethnic groups. Practice of regular BSE, CBE uptake (ever) and mammogram (ever) was 23.2%, 36% and 22.4%, respectively. Regular BSE practice was highest in the Malay ethnic group and least among the Chinese. Regular CBE was very low in all ethnic groups (&lt;5%). Mammogram uptake was highest among Chinese (34.4%), followed by Indians (30.4%) and Malays (16.6%). After adjusting for other socio-demographic variables, Malay ethnicity was positively associated with regular BSE (adjusted OR = 5.26, 95% CI 2.05, 13.50) and negatively associated with having had a mammogram (adjusted OR = 0.3, 95% CI 0.15, 0.57). Lower education was negatively associated (adjusted OR = 0.36, 95% CI 0.17, 0.74) with mammogram attendance (ever). Emotional and financial barriers were the most reported types of barriers, specifically, fear of diagnosis (74.8%), cost of diagnosis (69.6%) and fear of losing a breast (66.4%). Malay women more commonly reported most barriers compared to other ethnic groups. Screening uptake was low among semi-rural women in Malaysia. Implementing culturally appropriate interventions that consider ethnic differences is crucial to empowering women to engage in BC screening initiatives in these communities.<\/jats:p>","DOI":"10.3390\/ijerph182312293","type":"journal-article","created":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T02:46:08Z","timestamp":1637721968000},"page":"12293","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Breast Cancer Screening in Semi-Rural Malaysia: Utilisation and Barriers"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0898-2729","authenticated-orcid":false,"given":"Devi","family":"Mohan","sequence":"first","affiliation":[{"name":"Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0387-6406","authenticated-orcid":false,"given":"Tin Tin","family":"Su","sequence":"additional","affiliation":[{"name":"Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia"},{"name":"South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Segamat 85000, Malaysia"},{"name":"Centre of Public Health, Queen\u2019s University Belfast, Belfast BT12 6BA, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8380-7413","authenticated-orcid":false,"given":"Michael","family":"Donnelly","sequence":"additional","affiliation":[{"name":"Centre of Public Health, Queen\u2019s University Belfast, Belfast BT12 6BA, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2694-8871","authenticated-orcid":false,"given":"Wilfred Mok Kok","family":"Hoe","sequence":"additional","affiliation":[{"name":"Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia"},{"name":"South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Segamat 85000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8746-3002","authenticated-orcid":false,"given":"D\u00e9sir\u00e9e","family":"Schliemann","sequence":"additional","affiliation":[{"name":"Centre of Public Health, Queen\u2019s University Belfast, Belfast BT12 6BA, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Min","family":"Tan","sequence":"additional","affiliation":[{"name":"South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Segamat 85000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Reidpath","sequence":"additional","affiliation":[{"name":"Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia"},{"name":"International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nur Aishah","family":"Taib","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Universiti Malaya Cancer Research Institute, University of Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascale","family":"Allotey","sequence":"additional","affiliation":[{"name":"Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia"},{"name":"International Institute for Global Health, United Nations University, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA A Cancer J. 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