# Association Between Screening Practices and Other Risks and Breast Cancer Among Indonesian Women: A Case—Control Study

## TL;DR

This study found that breast cancer screening practices and other risk factors vary between urban and rural Indonesian women, with implications for prevention and early diagnosis.

## Contribution

The study provides new insights into breast cancer risk factors and screening effectiveness in urban and rural Indonesian populations.

## Key findings

- Women who performed breast self-examination had higher odds of breast cancer diagnosis in both urban and rural areas.
- Mammography was strongly associated with higher odds of breast cancer diagnosis in urban areas.
- A paternal history of cancer-related death increased breast cancer risk in rural areas.

## Abstract

Breast cancer is the predominant cause of cancer in developing nations, and screening through breast self-examinations and mammograms is crucial in mitigating morbidity and mortality. Nonetheless, geographic disparities in screening methods persist, attributable to sociodemographic variation and healthcare accessibility. Background/Objectives: This study aimed to analyze the influence of women’s screening practices for breast cancer and other risks, stratified by urban and rural areas in Indonesia. Methods: A case–control design was adopted, including all women who had breast cancer in 2014 as the study subjects. The Indonesian Family Life Survey data from 2007, with subjects aged at least 15 years, and from 2014 were used. Unconditional logistic regression was used to analyze the risk factors of breast cancer. Results: After controlling for confounders, the odds of breast cancer diagnosis were higher in women who performed breast self-examination (BSE) (aOR 10.22; 95% CI 1.04–50.81 and aOR 11.10; 95% CI 3.32–37.08) and those married before the age of 19 (aOR 4.81; 95% CI 1.93–6.05 and aOR 5.35; 95% CI 1.49–19.7), in urban and rural areas, respectively. In addition, women who had undergone mammography (aOR 48.04; 95% CI 10.33–83.45) had significantly higher odds of being diagnosed with breast cancer in urban areas. In rural areas, a paternal history of cancer-related death had higher odds of breast cancer (aOR 30.63; 95% CI 6.04–60.41) than those without a parental history of cancer. Conclusions: This study highlights the importance of intensifying national breast cancer screening, including BSE campaigns and expanding mammography infrastructure, particularly in rural areas, for improving breast cancer prevention and early diagnosis.