{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:36:37Z","timestamp":1785404197516,"version":"3.56.0"},"reference-count":47,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:00:00Z","timestamp":1779494400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006393","name":"University of Granada","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006393","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/04njjy449","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxics"],"abstract":"<jats:p>Breast cancer (BC) remains the most prevalent malignancy among women. Prolonged exposure to chemical pollutants has been identified as one of its potential risk factors. Despite increased access to health information, important informational gaps persist regarding chemical exposure. This concern is particularly pronounced among female BC survivors due to their greater vulnerability. This study investigated unmet information needs related to chemical exposure among female BC survivors from Granada (Spain). The data were collected through 150 semi-structured interviews and focus groups between March 2023 and April 2024 and analyzed using the Framework Method. Most participants demonstrated limited awareness regarding BC and its potential association with chemical exposure. Nevertheless, 78.67% of them expressed concerns regarding the issue after diagnosis and anxiety surrounding the lack of reliable information from trusted sources on recurrence prevention. These findings highlight the need for public health communication that informs and empowers protective behavior.<\/jats:p>","DOI":"10.3390\/toxics14060456","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T01:45:08Z","timestamp":1779673508000},"page":"456","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Unmet Information Needs of Spanish Female Breast Cancer Survivors on Chemical Pollutants: A Cross-Sectional Mixed-Method Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Laura","family":"Garc\u00eda-Molina","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Avenida Doctor Jes\u00fas Candel F\u00e1bregas, 11, 18016 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0744-9105","authenticated-orcid":false,"given":"Bibiana","family":"Navarro-Matillas","sequence":"additional","affiliation":[{"name":"Department of Public Health, Environmental Health, and Citizen Services, Escuela Andaluza de Salud P\u00fablica, Cta. del Observatorio, 4, Beiro, 18011 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3422-7310","authenticated-orcid":false,"given":"Blanca","family":"Riquelme-Gallego","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Avenida Doctor Jes\u00fas Candel F\u00e1bregas, 11, 18016 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7121-1005","authenticated-orcid":false,"given":"Marina","family":"Molina-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Radiation Oncology Department, Virgen de las Nieves University Hospital, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Exp\u00f3sito","sequence":"additional","affiliation":[{"name":"Radiation Oncology Department, Virgen de las Nieves University Hospital, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8643-2423","authenticated-orcid":false,"given":"Juan","family":"Arrebola","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Avenida Doctor Jes\u00fas Candel F\u00e1bregas, 11, 18016 Granada, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria (ibs.GRANADA), 18012 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3343-9760","authenticated-orcid":false,"given":"Piedad","family":"Martin-Olmedo","sequence":"additional","affiliation":[{"name":"Department of Public Health, Environmental Health, and Citizen Services, Escuela Andaluza de Salud P\u00fablica, Cta. del Observatorio, 4, Beiro, 18011 Granada, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria (ibs.GRANADA), 18012 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,23]]},"reference":[{"key":"ref_1","first-page":"477","article-title":"Breast cancer statistic 2024","volume":"74","author":"Giaquinto","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","unstructured":"World Health Organization (2026, February 27). Breast Cancer. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/breast-cancer."},{"key":"ref_3","unstructured":"Sociedad Espa\u00f1ola de Oncolog\u00eda M\u00e9dica (SEOM) (2024). Las Cifras del C\u00e1ncer en Espa\u00f1a, SEOM. Dep\u00f3sito Legal: M-3222-2024."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"5889622","DOI":"10.1155\/2024\/5889622","article-title":"Health Information Needs of Breast Cancer Survivors: An Umbrella Review","volume":"15","author":"Gavili","year":"2024","journal-title":"Breast J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s13058-023-01636-1","article-title":"Modifiable risk factors in women at high risk of breast cancer: A systematic review","volume":"25","author":"Cohen","year":"2023","journal-title":"Breast Cancer"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3502","DOI":"10.1002\/cncr.34396","article-title":"Key risk factors for the relative and absolute 5-year risk of cancer to enhance cancer screening and prevention","volume":"128","author":"Patel","year":"2022","journal-title":"Cancer"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"20301","DOI":"10.1038\/s41598-023-45693-0","article-title":"Cumulative environmental quality is associated with breast cancer incidence differentially by summary stage and urbanicity","volume":"13","author":"Mills","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1186\/s12940-017-0287-4","article-title":"State of the evidence 2017: An update on the connection between breast cancer and the environment","volume":"16","author":"Gray","year":"2017","journal-title":"Environ. Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"172988","DOI":"10.1016\/j.scitotenv.2024.172988","article-title":"Pesticide exposure and increased breast cancer risk in women population studies","volume":"933","author":"Panis","year":"2024","journal-title":"Sci. Total Environ."},{"key":"ref_10","unstructured":"The European Consumer Organization (BEUC) (2023). Ubiquitous but Preventable: Harmful Chemicals in Everyday Consumer Products, BEUC. Available online: https:\/\/www.beuc.eu\/sites\/default\/files\/publications\/BEUC-X-2023-129_Harmful_chemicals_in_everyday_consumer_products.pdf."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"6549","DOI":"10.1080\/10408398.2021.1903382","article-title":"Endocrine disrupting chemicals and breast cancer: A systematic review of epidemiological studies","volume":"62","author":"Wan","year":"2022","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"133237","DOI":"10.1016\/j.chemosphere.2021.133237","article-title":"Epidemiologic evidence of exposure to polycyclic aromatic hydrocarbons and breast cancer: A systematic review and meta-analysis","volume":"290","author":"Stern","year":"2022","journal-title":"Chemosphere"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.reprotox.2011.10.015","article-title":"Predictors of the total effective xenoestrogen burden (TEXB) in human adipose tissue. A pilot study","volume":"33","author":"Arrebola","year":"2012","journal-title":"Reprod. Toxicol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"bqac034","DOI":"10.1210\/endocr\/bqac034","article-title":"Endocrine-Disrupting Chemicals and Breast Cancer: Disparities in Exposure and Importance of Research Inclusivity","volume":"163","author":"Lee","year":"2022","journal-title":"Endocrinology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"106607","DOI":"10.1016\/j.envint.2021.106607","article-title":"Associations of accumulated selected persistent organic pollutants in adipose tissue with insulin sensitivity and risk of incident type-2 diabetes","volume":"155","author":"Mustieles","year":"2021","journal-title":"Environ. Int."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Kumar, M., Sarma, D.K., Shubham, S., Kumawat, M., Verma, V., Prakash, A., and Tiwari, R. (2020). Environmental Endocrine-Disrupting Chemical Exposure: Role in Non-Communicable Diseases. Front. Public Health, 8.","DOI":"10.3389\/fpubh.2020.553850"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.scitotenv.2014.08.043","article-title":"Adipose tissue concentrations of persistent organic pollutants and total cancer risk in an adult cohort from Southern Spain: Preliminary data from year 9 of the follow-up","volume":"500\u2013501","author":"Arrebola","year":"2014","journal-title":"Sci. Total Environ."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1038\/s41370-023-00601-6","article-title":"Exploratory profiles of phenols, parabens, and per- and poly-fluoroalkyl substances among NHANES study participants in association with previous cancer diagnoses","volume":"33","author":"Cathey","year":"2023","journal-title":"J. Expo. Sci. Environ. Epidemiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"E268","DOI":"10.1503\/cmaj.160464","article-title":"Lifestyle modifications for patients with breast cancer to improve prognosis and optimize overall health","volume":"189","author":"Hamer","year":"2017","journal-title":"Can. Med. Assoc. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"107977","DOI":"10.1016\/j.maturitas.2024.107977","article-title":"The effects of lifestyle and behavioral interventions on cancer recurrence, overall survival and quality of life in breast cancer survivors: A systematic review and network meta-analysis","volume":"185","author":"Yeganeh","year":"2024","journal-title":"Maturitas"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1177\/13591053251336843","article-title":"Lifestyle behavior changes following breast cancer: A qualitative exploration of experiences and unmet support and information needs","volume":"31","author":"Matheson","year":"2025","journal-title":"J. Health Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e71121","DOI":"10.1002\/cam4.71121","article-title":"Voices of Survivorship: The Unmet Needs of Italian Cancer Survivors. A Qualitative Study","volume":"14","author":"Contri","year":"2025","journal-title":"Cancer Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1177\/1077800410383121","article-title":"Qualitative Quality: Eight \u201cBig-Tent\u201d Criteria for Excellent Qualitative Research","volume":"16","author":"Tracy","year":"2010","journal-title":"Qual. Inq."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Company-Morales, M., Zafra Aparici, E., Casad\u00f3, L., Alarc\u00f3n Montenegro, C., and Arrebola, J.P. (2021). Perception and Demands of Pregnant and Breastfeeding Women Regarding Their Role as Participants in Environmental Research Studies. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18084149"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Gale, N.K., Heath, G., Cameron, E., Rashid, S., and Rewood, S. (2013). Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med. Res. Methodol., 13.","DOI":"10.1186\/1471-2288-13-117"},{"key":"ref_26","first-page":"1","article-title":"Benefits of the Mediterranean diet: Epidemiological and molecular aspects","volume":"67","author":"Corella","year":"2019","journal-title":"Mol. Asp. Med."},{"key":"ref_27","unstructured":"World Health Organization (2013). WHO Framework Convention on Tobacco Control: Guidelines for Implementation Article 5.3; Article 8; Articles 9 and 10; Article 11; Article 12; Article 13; Article 14\u20142013 Edition, World Health Organization."},{"key":"ref_28","unstructured":"USA National Library of Medicine (2026, April 20). Concept ID: C0556298, Available online: https:\/\/www.ncbi.nlm.nih.gov\/medgen\/641401#:~:text=Definition,from%20NCI%5D."},{"key":"ref_29","unstructured":"USA National Library of Medicine (2026, April 20). Concept ID: C0556338, Available online: https:\/\/www.ncbi.nlm.nih.gov\/medgen\/641441."},{"key":"ref_30","unstructured":"WHO (2026, April 20). The Global Health Observatory. Available online: https:\/\/www.who.int\/data\/gho\/indicator-metadata-registry\/imr-details\/457."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.1016\/j.pec.2021.12.012","article-title":"Worldwide review with meta-analysis of women\u2019s awareness about breast cancer","volume":"105","author":"Wang","year":"2022","journal-title":"Patient Educ. Couns."},{"key":"ref_32","first-page":"18","article-title":"Psychological stress and breast cancer incidence: A systematic review","volume":"91","author":"Chiriac","year":"2018","journal-title":"Clujul Med."},{"key":"ref_33","first-page":"1","article-title":"The relationship between psychological stress and cancer incidence: A systematic review and meta-analysis","volume":"3","author":"Petrova","year":"2025","journal-title":"Health Psychol. Rev."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"57617","DOI":"10.1007\/s11356-023-26564-7","article-title":"Spatiotemporal analysis of the surface urban heat island (SUHI), air pollution and disease pattern: An applied study on the city of Granada (Spain)","volume":"30","year":"2023","journal-title":"Environ. Sci. Pollut. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"119836","DOI":"10.1016\/j.envres.2024.119836","article-title":"Main factors influencing the perceived health risk of endocrine-disrupting chemicals: A systematic literature review","volume":"262","author":"Pravednikov","year":"2024","journal-title":"Environ. Res."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Afaya, A., Japiong, M., Konlan, K.D., and Solomon, M.S. (2023). Factors associated with awareness of breast cancer among women of reproductive age in Lesotho: A national population-based cross-sectional survey. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-15443-y"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Matis\u0101ne, L., Knudsen, L.E., Lobo Vicente, J., Uhl, M., Katsonouri, A., van den Brand, A.D., Berman, T., Dimovska, M., Anastasi, E., and Thoma, A. (2022). Citizens\u2019 Perception and Concerns on Chemical Exposures and Human Biomonitoring-Results from a Harmonized Qualitative Study in Seven European Countries. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19116414"},{"key":"ref_38","unstructured":"European Commission (2026, March 03). Attitudes of Europeans Towards the Environment: Eurobarometer Report, March\u2013April 2024. Available online: https:\/\/europa.eu\/eurobarometer\/surveys\/detail\/3173."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"111511","DOI":"10.1016\/j.fct.2020.111511","article-title":"Consumers\u2019 perceptions of chemical household products and the associated risks","volume":"143","author":"Bearth","year":"2020","journal-title":"Food Chem. Toxicol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s12302-017-0127-8","article-title":"Interested consumers\u2019 awareness of harmful chemicals in everyday products","volume":"29","author":"Hartmann","year":"2017","journal-title":"Environ. Sci. Eur."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Tariq, M.B., Jaffar, N., Farhan, K., Tanveer, M., Salomon, I., Anum, F., Ahmed, A., and Aaqil, I. (2025). Knowledge, attitudes, and practices regarding personal care products and their perceived link to breast cancer: A cross-sectional study. BMC Women\u2019s Health, 25.","DOI":"10.1186\/s12905-025-04051-0"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Trifunovski, A., Rotondi, N.K., Abbass-Dick, J., and Barakat, C. (2025). Analysis of Women\u2019s Knowledge, Health Risk Perceptions, Beliefs and Avoidance Behaviour in Relation to Endocrine-Disrupting Chemicals in Personal Care and Household Products. Toxics, 13.","DOI":"10.3390\/toxics13050414"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Janmaimool, P. (2017). Application of protection motivation theory to investigate sustainable waste management behaviors. Sustainability, 9.","DOI":"10.3390\/su9071079"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1007\/s10549-020-05657-8","article-title":"Healthcare providers\u2019 adherence to breast cancer guidelines in Europe: A systematic literature review","volume":"181","author":"Song","year":"2020","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1146\/annurev-publhealth-071723-120721","article-title":"Strategies for Effective Public Health Communication in a Complex Information Environment","volume":"46","author":"Niederdeppe","year":"2025","journal-title":"Annu. Rev. Public Health"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"103496","DOI":"10.1016\/j.esmoop.2024.103496","article-title":"Communication and support of patients and caregivers in chronic cancer care: ESMO Clinical Practice Guideline","volume":"9","author":"Stiefel","year":"2024","journal-title":"ESMO Open"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Kerstiens, S., Scherr, C.L., Jacobs, M., Carroll, A.J., Jayeoba, M., Daly, E.R., Phillips, S.M., Hitsman, B., Garcia, S.F., and Spring, B. (J. Cancer Surviv., 2025). Speaking of survival: Oncologists\u2019 approaches to risk behavior conversations with cancer survivors, J. Cancer Surviv., in press.","DOI":"10.1007\/s11764-025-01798-1"}],"container-title":["Toxics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2305-6304\/14\/6\/456\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T13:52:17Z","timestamp":1779803537000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2305-6304\/14\/6\/456"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,23]]},"references-count":47,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["toxics14060456"],"URL":"https:\/\/doi.org\/10.3390\/toxics14060456","relation":{},"ISSN":["2305-6304"],"issn-type":[{"value":"2305-6304","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,23]]}}}