Table 2.
Barriers to BCa Screening Based on Level of Income of the Countries
| Author, Country and Year | Study design and Methodology | Sampling technique & frame | Sample size (n) | Age group (yrs.) | Screening method used | Barriers themes | Quality rating* | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Low income countries | |||||||||||||
| No studies have found on barriers to BCa screening in Low income countries | |||||||||||||
| Lower-middle income countries | |||||||||||||
| Quantitative studies | |||||||||||||
| Aboserea M et al. | Quantitative | Multistage cluster random | 390 | Unclear | BSE, CBE, Mammography | A | Medium | ||||||
| Egypt, 2011 | Questionnaire survey | In one district | B D |
||||||||||
| Amoran OE et al. | Quantitative | Multistage cluster stratified | 495 | Unclear | BSE | A | Low | ||||||
| Nigeria, 2015 | Questionnaire survey | In one state | D | ||||||||||
| Frie KG et al. | Quantitative | Among intervention group of RCT | 52, 011 | 30-69 | BSE, CBE | A | High | ||||||
| India, 2013 | Questionnaire survey | B | |||||||||||
| Islam RM et al. | Quantitative | Multistage cluster random | 1590 | 30-59 | BSE, CBE, Mammography | A | High | ||||||
| Bangladesh, 2015 | Questinnaire survey | Nationally représentative | B | ||||||||||
| Rasu RS et al. | Quantitative | Convenience | 152 | 40+ | BSE, Mammography | A | Medium | ||||||
| Bangladesh, 2011 | Questionnaire survey | In one district | Women from uni and college | ||||||||||
| Sreedevi A et al. | Quantitative | Multistage random | 809 | 15-50 | BSE, CBE, Mammography | A | Medium | ||||||
| India, 2014 | Questionnaire survey | In one district | B D |
||||||||||
| Upper middle income countries | |||||||||||||
| Quantitative studies | |||||||||||||
| Ahmadian M et al. | Quantitative | Multistage cluster random | 400 | 35-69 | Mammography | A | |||||||
| Iran, 2012 | Questionnaire survey | In 4 outpatients clinic | B D |
Medium | |||||||||
| Al-Naggar RA et al. | Quantitative | Random | 200 | 40+ | Mammography | A | |||||||
| Malaysia, 2012 | Questionnaire survey | In one area | B D |
Low | |||||||||
| Avci IA et al. | Quantitative | Unclear | 387 | 35+ | Mammography | F | Medium | ||||||
| Turkey, 2008 | Questionnaire survey | In one health center | |||||||||||
| Cam O et al. | Quantitative | Stratified random | 382 | 40+ | BSE, CBE, Mammography | A | Medium | ||||||
| Turkey, 2009 | Questionnaire survey | In 3 health clinics in one area | B | ||||||||||
| Dunder PE et al. | Quantitative | Systematic random | 446 | 50-69 | Mammography | D | Medium | ||||||
| Turkey, 2012 | Questionnaire survey | In 2 districts | F | ||||||||||
| Gang M et al. | Quantitative | Convenience | 406 | 20+ | Mammography | B | |||||||
| China, 2013 | Questionnaire survey | In one city | D F |
High | |||||||||
| Gürsoy AA et al. | Quantitative | Cluster | 1342 | 18+ | BSE, CBE, Mammography | A | |||||||
| Turkey, 2011 | Questionnaire survey | In catchment area of 2 urban clinics | B E F |
Medium | |||||||||
| Hasan N et al. | Quantitative | Unclear | 1317 | 40-74 | Mammography | A | High | ||||||
| Malaysia, 2015 | Questionnaire survey | In one private hospital | C | ||||||||||
| Monatazeri A et al. | Quantitative | Convenience | 410 | 19-58 | BSE, CBE | A | |||||||
| Iran, 2003 | Questionnaire survey | In 7 health centres | B D |
Low | |||||||||
| Secginli S et al. | Quantitative | Convenience | 656 | 20+ | BSE | A | Low | ||||||
| Turkey, 2006 | Questionnaire survey | In 3 heath centres | Mammography | D | |||||||||
| Qualitative studies | |||||||||||||
| Khazaee-Pool M et al. | Qualitative | Convenience | 24 | 30+ | BSE, CBE, Mammography | A | |||||||
| Iran, 2014 | Focus group | In one health care centre | C D |
Medium | |||||||||
| Kissal A et al. | Qualitative | Convenience | 46 | 60-75 | BSE, CBE, Mammography | A | Medium | ||||||
| Turkey, 2011 | Focus group | In one district | C | ||||||||||
| Lamyian M et al. | Qualitative | Convenience | 31 | 40+ | Unknown | C | |||||||
| Iran, 2007 | In-depth interviews | Unclear | D E |
High | |||||||||
| Tuzco A et al. | Qualitative | Convenience | 39 | 20+ | BSE, CBE, Mammography | A | |||||||
| Turkey, 2015 | Focus group | In one area among migrants women | B D |
Medium | |||||||||
| *Not an independent sovereign country | |||||||||||||
| Azaiza F et al. | Quantitative | Stratified | 397 | 30-65 | BSE, CBE, Mammography | A | |||||||
| *Palestine, 2010 | Questionnaire survey | In 4 districts | B D E |
High | |||||||||
| Shaheen R et al. | Quantitative Questionnaire/telephone interviews | Convenience | 100 | 35+ | Diagnostic and Mammography | D | Low | ||||||
| *Palestine, 2011 | Unclear | ||||||||||||
Note: BCa, Breast cancer; BSE, Breast self-examination; CBE, Clinical breast examination; RCT, Randomised controlled trial; A, Barriers related to lack of knowledge and awareness about cervical cancer, and screening methods; B, Demographic factors include age, marital status, occupation; C, Psychological factors include fear, anxiety, depression etc.; D, structural barriers include education, income and cost associated with screening and treatment, distance to the service centres, access and availability to screening; E, Socio-cultural and religious barriers include that family does not allow screening, modesty mostly associated with religion, believing the disease caused by a curse; and F, Perceived barriers, particularly the health belief model.