Abstract
Background:
Breast cancer is the most prevalent cancer among women worldwide and a major public health concern in Saudi Arabia, where cases are increasingly diagnosed at younger ages and advanced stages. Early detection through screening is essential to improve survival outcomes.
Objective:
This study aimed to assess the level of awareness and screening practices related to breast cancer among women in Hafar Al-Batin, Saudi Arabia.
Methods:
A cross-sectional study was conducted among 411 adult women residing in Hafar Al-Batin using a self-administered electronic questionnaire distributed via social media and healthcare networks. The survey assessed socio-demographic characteristics, knowledge about breast cancer risk factors and symptoms, and screening practices, including mammography and clinical breast examination. Data were analyzed using SPSS version 26, with chi-square and Fisher’s exact tests applied to examine associations between knowledge, practices, and socio-demographic factors.
Results:
Most participants (97.8%) had heard about breast cancer, and 79.1% reported receiving health education. However, only 17.5% had ever undergone mammography screening, and 22.1% had received a clinical breast examination. Higher education and a positive family history were significantly associated with better knowledge levels (p < .05). Age, marital status, and employment were significantly linked to mammography screening uptake, with older, married, and employed women more likely to participate.
Conclusion:
Although awareness of breast cancer was generally high, participation in preventive screening remained low. Targeted health education and outreach programs focusing on younger, unmarried, and unemployed women are needed to enhance early detection and reduce breast cancer mortality in Saudi Arabia.
Keywords: Breast Cancer, Breast Cancer Awareness, Screening practices, Mammography, Hafar Al-Batin, Saudi Arabia
1. BACKGROUND
The Cancer remains a leading cause of mortality and a significant barrier to life expectancy improvements worldwide [1]. It is currently the leading or second leading cause of premature death in the majority of the world's countries, and the worldwide number of cancer incidents is predicted to rise in the coming years [2]. Among 36 cancer types, breast cancer is the most frequently diagnosed and surpasses lung cancer as the leading cause of cancer deaths among women in 185 countries. It ranks as the fifth leading cause of death from all cancers worldwide [3]. Breast cancer is the most common cancer among women worldwide, constituting a significant public health challenge [4].
In 2020, there were about 2,261,000 new cases of breast cancer and 684,000 breast cancer deaths globally [3]. Breast cancer is considered a serious health issue that impacts people in both wealthy and poor countries, and it is a primary cause of death and illness worldwide [5]. Early detection of cancer can enhance the curative rate, decrease the death rate in women, and extend lives [6]. Late cancer diagnosis significantly contributes to high mortality rates, as earlier detection and treatment greatly improve patient survival [7].
In Saudi Arabia, breast cancer has been rising significantly, with a notable trend of earlier age at diagnosis than in Western populations and diagnosed at advanced stages [8, 9].
According to the National Cancer Center (2020), breast cancer poses a significant health concern in Saudi Arabia, surpassing other cancer types in prevalence. It accounts for a substantial 17.8% of all cancer cases and a staggering 32.7% of cancers among adult women. Significantly, the Eastern Region shows the highest number of breast cancer cases, with a rate of 46.2 per 100,000 women [10].
Limited research has been conducted in Saudi Arabia on women in the remote area; therefore, further studies are necessary to evaluate preventive practices and mammography utilization among Saudi females [11]. Raising awareness about breast cancer is pivotal in promoting early detection and improving survival rates. Awareness encompasses knowledge about the disease, its risk factors, symptoms, and the importance of screening practices such as mammograms and BSE [12].
Based on the high incidence of breast cancer in Saudi Arabia, particularly in the Eastern Province [10], this study aims to evaluate breast cancer awareness and practices among women in Hafar Al-Batin, Saudi Arabia. By addressing the knowledge gaps in this area, the findings will contribute to the formulation of health education initiatives tailored to the needs of women to improve early detection and reduce breast cancer mortality rates [13]. Furthermore, by focusing on Hafar Al-Batin, this study will provide a nuanced understanding of the local context, thereby enabling policymakers and healthcare providers to devise effective strategies for enhancing breast cancer awareness and promoting breast cancer screening practices among women.
2. OBJECTIVE
This study aimed to assess the level of awareness and screening practices related to breast cancer among women in Hafar Al-Batin, Saudi Arabia.
3. MATERIAL AND METHODS
A cross-sectional study was conducted among adult women in Hafar Al-Batin, a city in Saudi Arabia. The required sample size was determined using Cochran’s formula, based on a 95% confidence level, a 5% margin of error, and an estimated variance of 0.5, with the calculation based on the number of adult women residing in Hafar Al-Batin, resulting in a minimum sample size of 384 participants.
Eligible participants were adult women aged 18 years or older residing in Hafar Al-Batin who were able to read and understand Arabic or English. Women were excluded if they had a previous or current diagnosis of breast cancer, as this could influence their level of awareness and screening behaviors. Data were collected from 411 participants through a convenience sampling approach using an anonymous, self-administered electronic questionnaire available in both Arabic and English. The questionnaire was disseminated through diverse channels, including healthcare networks, and social media platforms, to enhance accessibility and encourage broad participation.
The questionnaire consisted of three sections. The first section gathered demographic information. The second section assessed breast cancer awareness, covering topics such as risk factors, symptoms, general information about breast cancer, misconceptions, and sources of information. The questions in this section were adapted from previously validated instruments, with minor modifications to ensure cultural relevance [12, 14]. The knowledge scoring system in the study was based on participants’ responses to a series of questions related to breast cancer. Each correct answer was awarded one point, while incorrect or “don’t know” responses received zero points. The total knowledge score was calculated by summing the correct responses. Based on their total scores, participants were categorized into three levels of knowledge: poor (less than 50% of the total score), average (50% to less than 70%), and good (above 70%). Based on a comprehensive literature review of similar studies, the third section was developed to evaluate breast cancer-related practices, clinical breast examinations, and mammography screening.
Statistical Analysis
The statistical analysis presented in this study aims to evaluate the level of awareness, knowledge, and practices regarding breast cancer among women in Hafar Al-Batin, Saudi Arabia. Data were collected through a structured self-administered questionnaire covering socio-demographic factors, breast cancer knowledge, and preventive practices. All data were coded and entered into the Statistical Package for the Social Sciences (SPSS), version 26.0, for analysis. Descriptive statistics were applied to summarize the participants' socio-demographic characteristics, knowledge levels, and practices related to breast cancer. Frequencies and percentages were used to present categorical variables in a clear and interpretable manner. Tables and figures were used to visualize the results effectively, such as the distribution of responses to knowledge-based questions and sources of information on breast cancer. In addition to descriptive analysis, inferential statistics were applied to examine associations between selected socio-demographic variables and outcomes related to knowledge and practices. Chi-square tests were primarily used to assess the significance of relationships between categorical variables (e.g., age, education level, occupation) and breast cancer awareness or screening behaviors. Fisher’s Exact Test was applied in cases where the Chi-square test was deemed inappropriate. A significance level of p < 0.05 was considered statistically significant.
4. RESULTS
Table 1 presents the distribution of socio-demographic characteristics of the study participants. The majority of respondents were Saudi nationals (75.2%), while non-Saudis accounted for 24.8%. Regarding age, the largest proportion fell within the 35–44 years category (34.5%), followed by those aged 25–34 years (25.5%), 18–24 years (22.9%), and 45–54 years (15.6%). The proportion of individuals aged 55 and over was 1.5%. In terms of educational attainment, most participants had a Bachelor’s degree or higher (74.5%). Secondary education was reported by 21.2%, while small proportions had middle school education (2.9%), primary education (0.7%), or no formal education (0.7%). Concerning marital status, 62.5% of respondents were married, 32.1% were single, 4.4% were divorced, and 1.0% were widowed. In terms of employment, the majority were employees (55.2%), followed by students (22.6%), unemployed individuals (20.2%), freelancers (1.2%), and retirees (0.7%).
Table 1. The distribution of socio-demographic factors.
| Factor | N | % | |
|---|---|---|---|
| Nationality | Saudi | 309 | 75.2 |
| Non-Saudi | 102 | 24.8 | |
| Age | 18-24 | 94 | 22.9 |
| 25-34 | 105 | 25.5 | |
| 35-44 | 142 | 34.5 | |
| 45-54 | 64 | 15.6 | |
| 55 And above | 6 | 1.5 | |
| Education Level | No Formal Education | 3 | 0.7 |
| Primary Education | 3 | 0.7 | |
| Meddle School Education | 12 | 2.9 | |
| Secondary Education | 87 | 21.2 | |
| Bachelor's And Higher | 306 | 74.5 | |
| Marital Status | Single | 132 | 32.1 |
| Married | 257 | 62.5 | |
| Divorced | 18 | 4.4 | |
| Widowed | 4 | 1.0 | |
| Occupation | Student | 93 | 22.6 |
| Employee | 227 | 55.2 | |
| FreeLancer Work | 5 | 1.2 | |
| Retired | 3 | 0.7 | |
| Unemployed | 83 | 20.2 | |
| Family History of Breast Cancer | Yes | 46 | 11.2 |
| No | 346 | 84.2 | |
| I don't know | 19 | 4.6 | |
Regarding family history of breast cancer, 84.2% of participants reported having no family history, 11.2% reported a positive family history, and 4.6% were unsure.
Table 2 presents the distribution of participants' knowledge regarding various aspects of breast cancer. The vast majority of participants (97.8%) had heard about breast cancer, while only 1.7% had not, and 0.5% were unsure. A total of 79.1% reported having received breast cancer health education, whereas 15.1% had not, and 5.8% were uncertain. Regarding the belief that breast cancer can develop in one breast, 62.5% answered affirmatively, while 11.9% disagreed and 25.5% were unsure. Similarly, 62.5% of respondents believed that women under 30 years can develop breast cancer, although 11.9% disagreed and 25.5% were not sure. Misconceptions were evident in some responses. Only 12.2% believed that breast cancer is more common in women with large breasts, while 40.4% disagreed, and 47.4% were unsure. In contrast, 62.8% correctly identified aging as a risk factor for breast cancer, while 10.0% disagreed and 27.3% expressed uncertainty. With regard to nipple changes or retraction as a sign of breast cancer, 58.9% responded “yes,” while 9.0% said “no” and 32.1% were unsure. A large majority (96.8%) acknowledged that early detection of breast cancer improves survival chances, while 0.5% disagreed and 2.7% were unsure. Concerning heredity, 64.2% recognized that breast cancer could be hereditary, whereas 11.9% disagreed and 23.8% were uncertain. When asked whether injury to the breast could cause breast cancer, 20.0% believed it could, 32.1% disagreed, and a substantial proportion (47.9%) were unsure.
Table 2. The distribution of knowledge toward breast cancer.
| Statement | N | % | |
|---|---|---|---|
| Heard about breast cancer | Yes | 402 | 97.8 |
| No | 7 | 1.7 | |
| I am not sure | 2 | .5 | |
| Received breast cancer health education. | Yes | 325 | 79.1 |
| No | 62 | 15.1 | |
| I’m not sure | 24 | 5.8 | |
| Breast cancer can develop in one breast. | Yes | 257 | 62.5 |
| No | 49 | 11.9 | |
| I’m not sure | 105 | 25.5 | |
| Women under 30 years can develop breast cancer. | Yes | 257 | 62.5 |
| No | 49 | 11.9 | |
| I’m not sure | 105 | 25.5 | |
| Breast cancer is more common in women with big breasts. | Yes | 50 | 12.2 |
| No | 166 | 40.4 | |
| I’m not sure | 195 | 47.4 | |
| Aging increases breast cancer risk. | Yes | 258 | 62.8 |
| No | 41 | 10.0 | |
| I’m not sure | 112 | 27.3 | |
| Nipple changes or retraction are a sign of breast cancer. | Yes | 242 | 58.9 |
| No | 37 | 9.0 | |
| I’m not sure | 132 | 32.1 | |
| Early detection of breast cancer increases a woman’s chance of survival. | Yes | 398 | 96.8 |
| No | 2 | .5 | |
| I’m not sure | 11 | 2.7 | |
| Breast cancer can be hereditary. | Yes | 264 | 64.2 |
| No | 49 | 11.9 | |
| I’m not sure | 98 | 23.8 | |
| Injury to the breast can cause breast cancer. | Yes | 82 | 20.0 |
| No | 132 | 32.1 | |
| I’m not sure | 197 | 47.9 | |
Table 3 presents the distribution of participants according to their breast cancer screening practices. The findings indicate that only a small proportion of women reported engaging in recommended screening behaviors. Specifically, 17.5% of the respondents (n = 72) had ever undergone mammography screening, whereas the majority (82.5%, n = 339) had never had a mammogram. Similarly, only 22.1% of participants (n = 91) reported having ever undergone a clinical breast examination (CBE) performed by a healthcare provider, while 77.9% (n = 320) had never received such an examination.
Table 3. The distribution of breast cancer practice.
| Statement | N | % | |
|---|---|---|---|
| Ever undergone mammography screening. | Yes | 72 | 17.5 |
| No | 339 | 82.5 | |
| Ever had a clinical breast examination by a healthcare provider. | Yes | 91 | 22.1 |
| No | 320 | 77.9 | |
Figure 1. Illustrates the various sources from which participants obtained information about breast cancer. The most frequently cited source was the media (including TV, radio, and internet), reported by 136 participants, followed closely by educational campaigns, mentioned by 130 respondents. Health centers or healthcare professionals were cited by 65 participants. Friends or family served as a source of information for 37 participants, while the least utilized category was “Other”, reported by only 32 participants (Fig. 1).
Figure 1. Sources of breast cancer information as reported by study participants.
Figure 2 illustrates the overall awareness levels of breast cancer among the study participants. Out of 411 individuals, 44.5% (approximately 183 participants) demonstrated an average level of awareness, making it the most common category. Good awareness was observed in 40.9% of participants (around 168 individuals), while low awareness was noted among 14.6% (approximately 60 participants) (Fig. 2).
Figure 2. Overall breast cancer awareness levels among participants based on knowledge scores.
Table 4 presents the distribution of participants’ knowledge levels regarding breast cancer in relation to their educational attainment and family history of the disease. The findings reveal a statistically significant association between education level and knowledge score (FET = 39.045, p = .000). Participants with higher education levels demonstrated markedly better knowledge about breast cancer compared to those with lower educational backgrounds. Specifically, 44.1% of respondents holding a bachelor’s degree or higher exhibited good knowledge, whereas only 9.7% in this group showed low knowledge levels. In contrast, all participants with no formal or primary education fell within the “average” knowledge category, with none achieving a good score. Similarly, among those with middle school education, only 6.3% demonstrated good knowledge, while 43.8% had low knowledge scores. Regarding family history, a significant association was also observed between having a family history of breast cancer and the level of knowledge (χ² = 10.919, p = .027). Over half of the participants with a family history (54.1%) exhibited good knowledge, compared to only 36.5% among those without such a history. Conversely, low knowledge scores were more prevalent among participants with no family history (14.4%) than among those who had affected relatives (2.1%).
Table 4. The different in Knowledge according to different Education Level and family history factors.
| Factors | Scoring | Statistic | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Good (N, %) | Average (N, %) | Low (N, %) | p-value | ||||||
| Education Level | No Formal Education | 0 | (0) | 3 | (100) | 0 | (0) | FET=39.045 | .000 |
| Primary Education | 0 | (0) | 3 | (100) | 0 | (0) | |||
| Meddle School Education | 1 | (6.3) | 4 | (25) | 7 | (43.8) | |||
| Secondary Education | 21 | (23.1) | 45 | (49.5) | 21 | (23.1) | |||
| Bachelor's And Higher | 146 | (44.1) | 128 | (38.7) | 32 | (9.7) | |||
| Family History of Breast Cancer | Yes | 26 | (54.1) | 19 | (39.6) | 1 | (2.1) | χ2=10.919 a | .027 |
| No | 137 | (36.5) | 155 | (41.3) | 54 | (14.4) | |||
| a .1 cells (11.1%) have expected count less than 5. The minimum expected count is 2.77. | |||||||||
Table 5 illustrates the relationship between participants’ knowledge levels and their breast cancer screening practices, specifically mammography and clinical breast examination (CBE). The findings reveal statistically significant associations between knowledge level and both screening practices, indicating that women with higher knowledge are more likely to engage in preventive behaviors. Regarding mammography screening, a significant association was observed (χ² = 7.087, p = .029). More than half of the respondents who had ever undergone mammography (54.2%) demonstrated good knowledge about breast cancer, compared to 38.1% among those who had never undergone the procedure. Conversely, low knowledge levels were more frequent among women who had never undergone mammography (16.0%) than among those who had (8.3%). This pattern suggests that higher knowledge may positively influence women’s likelihood of participating in mammography screening.
Table 5. The differences in breast cancer practice according to different in knowledge.
| Factor | Scoring | χ2 | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Good (N, %) | Average (N, %) | Low (N, %) | p-value | ||||||
| Ever undergone mammography screening. | Yes | 39 | (54.2) | 27 | (37.5) | 6 | (8.3) | 7.087a | .029 |
| No | 129 | (38.1) | 156 | (46.1) | 54 | (16) | |||
| Ever had a clinical breast examination by a healthcare provider. | Yes | 54 | (59.3) | 31 | (34.1) | 6 | (6.6) | 17.751c | .000 |
| No | 114 | (35.6) | 152 | (47.5) | 54 | (16.9) | |||
| a .0 cells (0.0%) have expected count less than 5. The minimum expected count is 10.51., b .0 cells (0.0%) have expected count less than 5. The minimum expected count is 21.75., c .0 cells (0.0%) have expected count less than 5. The minimum expected count is 13.28. | |||||||||
Table 6 presents the relationship between mammography screening practices and various socio-demographic characteristics of the study participants. The findings reveal that certain demographic factors, particularly age, marital status, and occupation, were significantly associated with undergoing mammography screening, whereas nationality, educational level, and family history showed no statistically significant associations.
Table 6. The differences in mammography screening practice according to different socio-demographic.
| Mammography screening | |||||||
|---|---|---|---|---|---|---|---|
| Factor | Yes Good (N, %) | No Good (N, %) | Statistic | p-value | |||
| Nationality | Saudi | 55 | (17.8) | 254 | (82.2) | χ2=.068a | .794 |
| Non-Saudi | 17 | (16.7) | 85 | (83.3) | |||
| Age | 18-24 | 4 | (4.3) | 90 | (95.7) | FET=40.799 | .000 |
| 25-34 | 13 | (12.4) | 92 | (87.6) | |||
| 35-44 | 26 | (18.3) | 116 | (81.7) | |||
| 45-54 | 25 | (39.1) | 39 | (60.9) | |||
| 55 And above | 4 | (66.7) | 2 | (33.3) | |||
| Education Level | No Formal Education | 0 | 0 | 3 | (100) | FET=3.438 | .438 |
| Primary Education | 0 | 0 | 3 | (100) | |||
| Meddle School Education | 2 | (16.7) | 10 | (83.3) | |||
| Secondary Education | 10 | (11.5) | 77 | 88.5 | |||
| Bachelor's And Higher | 60 | (19.6) | 246 | (80.4) | |||
| Marital Status | Single | 10 | (7.6) | 122 | (92.4) | FET= 15.670 | .001 |
| Married | 59 | (23) | 198 | (77) | |||
| Divorced | 3 | (16.7) | 15 | (83.3) | |||
| Widowed | 0 | 0 | 4 | (100) | |||
| Occupation | Student | 4 | (4.3) | 89 | (95.7) | FET= 21.517 | .000 |
| Employee | 54 | (23.8) | 173 | (76.2) | |||
| FreeLancer Work | 0 | (0) | 5 | (100) | |||
| Retired | 1 | (33.3) | 2 | (66.7) | |||
| Unemployed | 13 | (15.7) | 70 | (84.3) | |||
| Family History of Breast Cancer | Yes | 14 | (30.4) | 32 | (69.6) | FET=5.545 | .057 |
| No | 55 | (15.9) | 291 | (84.1) | |||
| a .0 cells (0.0%) have expected count less than 5. The minimum expected count is 17.87. | |||||||
In terms of nationality, the proportion of women who reported having undergone mammography was similar between Saudi (17.8%) and non-Saudi participants (16.7%), with no significant difference (χ² = 0.068, p = .794). However, age demonstrated a strong and statistically significant association with screening behavior (FET = 40.799, p < .001). The likelihood of having had mammography increased with age: only 4.3% of women aged 18–24 years had undergone the test compared with 39.1% among those aged 45–54 years and 66.7% among women aged 55 years and above. This finding highlights that older women were considerably more likely to engage in mammography screening.
Educational level did not show a significant relationship with mammography practice (FET = 3.438, p = .438). Although screening prevalence was slightly higher among women with a bachelor’s degree or higher (19.6%) compared with those with lower education levels, the difference was not statistically significant.
Marital status, however, was found to be significantly associated with screening behavior (FET = 15.670, p = .001). Married women had the highest rate of mammography screening (23.0%), while the lowest rate was observed among single women (7.6%). None of the widowed participants reported having undergone mammography.
Similarly, occupation demonstrated a significant relationship with screening uptake (FET = 21.517, p < .001). Employed women reported the highest screening rate (23.8%), followed by unemployed women (15.7%), while students and freelancers reported the lowest rates (4.3% and 0%, respectively).
Although women with a family history of breast cancer were more likely to have undergone mammography (30.4%) compared to those without such a history (15.9%), this difference did not reach statistical significance (FET = 5.545, p = .057).
5. DISCUSSION
Breast cancer is one of the most significant health challenges affecting women globally, contributing to high rates of illness and death. Timely identification via screening plays a crucial role in enhancing survival rates and lowering mortality [15]. In Saudi Arabia, breast cancer cases have risen significantly, with patients often developing the disease at a younger age compared to Western populations. To ensure timely diagnosis and effective treatment, ongoing monitoring, mammograms, and increased patient awareness are essential [16, 17].
The findings of this study provide insights into knowledge and practices related to breast cancer among participants in Hafar Al-Batin, Saudi Arabia. The results highlight several key areas of concern and opportunities for targeted interventions to improve breast cancer awareness and preventive practices. The majority of participants indicated they had heard of breast cancer, consistent with a study conducted in Jeddah, where almost all participants demonstrated knowledge of breast cancer [9]. A large proportion of participants reported receiving breast cancer awareness, comparable to findings from the Eastern Province region of Saudi Arabia, where many participants had received health education about breast cancer signs and risk factors [18].
Almost all of participants recognized the link between early breast cancer detection and improved women’s survival rates, consistent with findings from a recent study in Saudi Arabia [19]. Additionally, a notable proportion of our believed that breast cancer can be hereditary, which aligns with findings from a study among school teachers in Saudi Arabia, where approximately two-thirds acknowledged family history as a risk factor [20]. A notable proportion of participants correctly identified aging as a risk factor for breast cancer. However, a small proportion held the misconception that breast cancer is more common among women with larger breasts, which was also observed in a previous study [21]. Regarding awareness of symptoms, a moderate proportion of participants identified nipple changes as a potential sign of breast cancer, similar to findings reported in Al Baha, Saudi Arabia [22]. Additionally, a notable proportion of participants reported that women under the age of 30 are at risk of developing breast cancer. This perception may be influenced by their prior education on the disease. Only a small proportion believed breast injury causes breast cancer, consistent with previous findings in which a similar belief was noted among about a quarter of respondents [23].
In terms of preventive measures, the study indicated low adherence to breast cancer preventive practices. Only a small proportion of participants had undergone mammography screening, these findings are consistent with previous studies documenting suboptimal engagement in these preventive behaviors [24].
This study found a statistically significant association between the level of breast cancer awareness and both family history and educational level. Similar relationships were identified in other research, demonstrating a link between awareness levels and education [25]. A related study also supported the association between breast cancer screening knowledge and educational level, in addition to medical history [26].
With regard to mammography practice and socio-demographic characteristics, significant associations were found with age, marital status, and occupation. Participants aged over 45 years were more likely to have undergone mammography than younger individuals. Married women were more frequently screened compared to single women. Employed individuals were also more likely to have participated in mammography screening compared to those not employed. These findings are consistent with a study conducted in Madinah, which showed that age and employment were statistically associated with mammogram screening, with older and employed women more likely to be screened than younger and unemployed women [27].
6. CONCLUSION
This study provides valuable insights into breast cancer awareness and preventive practices among women in Hafar Al-Batin, Saudi Arabia, highlighting both strengths and areas for improvement. While many participants demonstrated adequate awareness of breast cancer, a notable gap was observed in translating this awareness into preventive behaviors—particularly in undergoing mammography screening and consulting healthcare providers for regular checkups. These findings indicate the presence of barriers to screening participation and emphasize the need for strategies that encourage behavioral change. Targeted interventions focusing on education, accessibility, and motivation to engage in early detection practices are essential. Strengthening such efforts could not only enhance breast cancer awareness and promote regular screening but also contribute to earlier diagnosis, improved treatment outcomes, and reduced disease burden on the healthcare system, thereby advancing overall public health outcomes in Saudi Arabia.
* Ethics approval and consent to participate: The study protocol was reviewed and approved by the Institutional Review Board (IRB) of the Ministry of Health, Saudi Arabia (IRB Log No: 25-32M). All participants were informed about the purpose of the study, and their participation was entirely voluntary. Informed consent was obtained electronically from all participants prior to data collection. Participants were assured that they could withdraw from the study at any time without any consequences. The study was conducted in accordance with the ethical principles of the Declaration of Helsinki.
Consent for publication:
The necessary approval for the publication of this study has been received.
Data availability:
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
Author’s contribution:
Both authors were involved in all steps of preparation this article including final proofreading.
Conflicts of interest:
There are no conflicts of interest.
Financial support and sponsorship:
This study was conducted without any external financial support.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.