{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T09:13:43Z","timestamp":1775466823887,"version":"3.50.1"},"reference-count":30,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Kelantan State Government","award":["304.PPSP.6150307.J144\/R504-KR-GAL006-0006150307-J144"],"award-info":[{"award-number":["304.PPSP.6150307.J144\/R504-KR-GAL006-0006150307-J144"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Clinical breast examination (CBE) is an important component of an early detection strategy for breast cancer in settings where organized screening coverage is limited. This study aimed to determine CBE uptake and its associated factors among women in Kelantan, Northeastern Peninsular Malaysia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted among 242 women recruited during community health programs across nine districts in Kelantan. Data were collected using a structured questionnaire adapted from the Breast Cancer Awareness Measure Malaysia (BCAM-M). Descriptive analyses summarized participants\u2019 sociodemographic characteristics, breast cancer awareness, and perceived barriers to healthcare-seeking. Multivariable logistic regression was performed among screening-eligible women aged \u226540 years to identify factors associated with CBE uptake.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among all 242 participants, awareness of breast cancer signs and symptoms was observed in 59.5%, while awareness of breast cancer risk factors (33.5%) and age-related risk (17.4%) was observed in smaller proportions. Perceived barriers to healthcare-seeking were reported by 10.3% of participants. Of the total sample, 112 women (46.3%) were aged \u226540 years and considered screening eligible. Among these women, 72 (64.3%) reported having ever undergone a CBE. Multivariable logistic regression analysis showed that women living in households with \u22656 members had significantly higher odds of undergoing CBE compared with those living in households with 1\u20135 members (adjusted OR 3.32; 95% CI [1.16\u20139.49];\n                      <jats:italic>p<\/jats:italic>\n                      = 0.025). Timely healthcare-seeking behaviour was also significantly associated with CBE uptake, with women who sought healthcare within \u22642 months having higher odds of undergoing CBE compared with those who delayed seeking care (adjusted OR 3.78; 95% CI [1.14\u201312.54];\n                      <jats:italic>p<\/jats:italic>\n                      = 0.030). Education level, income, employment status, marital status, awareness, perceived barriers, and accessibility were not significantly associated with CBE uptake.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Household size and timely healthcare-seeking behaviour were key predictors of CBE uptake among screening-eligible women in Kelantan. Although CBE uptake appeared relatively high, it likely reflects opportunistic or symptom-driven examinations rather than routine screening. Interventions promoting timely healthcare-seeking and leveraging family and social support may help improve early breast cancer detection in settings without organized screening programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.21029","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T08:37:53Z","timestamp":1775464673000},"page":"e21029","source":"Crossref","is-referenced-by-count":0,"title":["Enhancing clinical breast examination (CBE) uptake: insights from women in northeastern Peninsular Malaysia"],"prefix":"10.7717","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6798-0838","authenticated-orcid":true,"given":"Nik Rosmawati","family":"Nik Husain","sequence":"first","affiliation":[{"name":"Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2312-1691","authenticated-orcid":true,"given":"Mohd Khairul Hanan","family":"Mohd Wajiah","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nani","family":"Draman","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2593-1832","authenticated-orcid":true,"given":"Razlina","family":"Abdul Rahman","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1541-9504","authenticated-orcid":true,"given":"Jamilah Al-Muhammady","family":"Mohammad","sequence":"additional","affiliation":[{"name":"Department of Medical Education, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9333-1957","authenticated-orcid":true,"given":"Mahaneem","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Department of Physiology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wan Zainira","family":"Wan Zain","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, 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