Exploring Knowledge and Awareness of Genetic Testing for Breast Cancer Risk in Iraqi Women
Article Sidebar
Main Article Content
Abstract
Background: Genetic testing plays a crucial role in identifying individuals at risk for hereditary breast cancer. However, substantial gaps in understanding genetic risk factors, including BRCA1/BRCA2 mutations, and key barriers such as high costs, limited access, and cultural stigma remain significant challenges in Iraq. These barriers hinder the adoption of genetic testing, particularly in low-resource settings. This study aims to evaluate the knowledge and awareness of genetic testing among Iraqi women in Baghdad, highlighting key barriers and their implications for healthcare delivery.
Methods: A cross-sectional study was conducted among 520 Iraqi women in Baghdad using a structured self-administered questionnaire. The questionnaire assessed knowledge of genetic risk factors, awareness of genetic testing services, and perceived barriers to testing. The collected data were then subjected to analysis using descriptive statistics and chi-square tests to ascertain the associations between socio-demographic factors and the levels of knowledge and awareness. A p-Value less than 0.05 was considered statistically significant.
Results: The study revealed moderate knowledge of genetic testing, with 280 respondents recognizing its role in identifying individuals at risk and 300 acknowledging the importance of genetic counseling. However, the study also revealed a lack of awareness regarding the significance of specific genetic mutations, such as BRCA1 and BRCA2, with only 190 respondents reporting familiarity with these mutations. Furthermore, the study noted a general lack of awareness about available genetic testing services, with only 260 participants reporting knowledge of their availability and 200 aware of the availability of genetic counseling services. The analysis identified several key barriers to genetic testing and counseling, including perceived financial constraints (320 respondents), limited access to facilities (300 respondents), and societal stigma (240 respondents). Significant associations were identified between higher education level and urban residency, on the one hand, and better knowledge and awareness, on the other.
Conclusion: The findings underscore the necessity for targeted educational programs, improved access to testing services, and culturally sensitive interventions to enhance the uptake of genetic testing in Iraq, ultimately contributing to early detection and prevention of breast cancer.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Al Alwan, N. A. S. (2022). General Oncology Care in Iraq. In Cancer in the Arab World (pp. 63–82). Springer Singapore. https://doi.org/10.1007/978-981-16-7945-2_5
Alwan, N. A. S. (2010). Breast cancer: demographic characteristics and clinico-pathological presentation of patients in Iraq. Eastern Mediterranean Health Journal = La Revue de Sante de La Mediterranee Orientale = Al-Majallah al-Sihhiyah Li-Sharq al-Mutawassit, 16(11), 1159–1164.
Bruno, M., Tommasi, S., Stea, B., Quaranta, M., Schittulli, F., Mastropasqua, A., Distante, A., Di Paola, L., & Paradiso, A. (2004). Awareness of breast cancer genetics and interest in predictive genetic testing: a survey of a southern Italian population. Annals of Oncology, 15, i48–i54. https://doi.org/10.1093/annonc/mdh658
Chappuis, P. O., Kapusta, L., Bégin, L. R., Wong, N., Brunet, J.-S., Narod, S. A., Slingerland, J., & Foulkes, W. D. (2000). Germline BRCA1/2 mutations and p27(Kip1) protein levels independently predict outcome after breast cancer. Journal of Clinical Oncology, 18(24), 4045–4052. https://doi.org/10.1200/JCO.2000.18.24.4045
Emmet, M., Stein, Q., Thorpe, E., & Campion, M. (2018). Experiences of Genetic Counselors Practicing in Rural Areas. Journal of Genetic Counseling, 27(1), 140–154. https://doi.org/10.1007/s10897-017-0131-6
Fogleman, A. J., Zahnd, W. E., Lipka, A. E., Malhi, R. S., Ganai, S., Delfino, K. R., & Jenkins, W. D. (2019). Knowledge, attitudes, and perceived barriers towards genetic testing across three rural Illinois communities. Journal of Community Genetics, 10(3), 417–423. https://doi.org/10.1007/s12687-019-00407-w
Grech, C. T., Pils, D., Aust, S., Grimm, C., Polterauer, S., Reinthaller, A., Müllauer, L., Reischer, T., & Bekos, C. (2022). Corrected Allele Frequency of BRCA1/2 Mutations Is an Independent Prognostic Factor for Treatment Response to PARP-Inhibitors in Ovarian Cancer Patients. Journal of Personalized Medicine, 12(9), 1467. https://doi.org/10.3390/jpm12091467
Hasan, T. N., Shah, S. A., Hassan, M. R., Safian, N., Azhar, Z. I., Syed Abdul Rahim, S. S., & Ghazi, H. F. (2015). Poor Knowledge and Practice Towards Breast Cancer among Women in Baghdad City, Iraq. Asian Pacific Journal of Cancer Prevention, 16(15), 6669–6672. https://doi.org/10.7314/APJCP.2015.16.15.6669
Hassan, B. A. R., Mohammed, A. H., Alsammarraie, A. Z. A., Alabboodi, M. K., Wayyes, A. M., Ahmed, A. A., & Shanshal, A. (2022). Knowledge, Attitude, and Practice of Oncologists toward Chemotherapy Resistance: A Questionnaire Development and Pilot Testing. Asian Pacific Journal of Cancer Prevention : APJCP, 23(12), 4275–4284. https://doi.org/10.31557/APJCP.2022.23.12.4275
JOKIĆ-BEGIĆ, N., & ARAMBAŠIĆ, L. (2010). Psychological Factors Related to Genetic Testing. Društvena Istraživanja, 19(3), 355–376. https://hrcak.srce.hr/55440
Jones, T., Howard, H., Freeman-Costin, K., Creighton, A., Wisdom-Chambers, K., & Underhill-Blazey, M. (2021). Knowledge and perceptions of BRCA1/2 genetic testing and needs of diverse women with a personal or family history of breast cancer in South Florida. Journal of Community Genetics, 12(3), 415–429. https://doi.org/10.1007/s12687-021-00507-6
Kuchenbaecker, K. B., Hopper, J. L., Barnes, D. R., Phillips, K.-A., Mooij, T. M., Roos-Blom, M.-J., Jervis, S., van Leeuwen, F. E., Milne, R. L., Andrieu, N., Goldgar, D. E., Terry, M. B., Rookus, M. A., Easton, D. F., Antoniou, A. C., McGuffog, L., Evans, D. G., Barrowdale, D., Frost, D., … Olsson, H. (2017). Risks of Breast, Ovarian, and Contralateral Breast Cancer for BRCA1 and BRCA2 Mutation Carriers. JAMA, 317(23), 2402. https://doi.org/10.1001/jama.2017.7112
Li, S.-T., Yuen, J., Zhou, K., Binte Ishak, N. D., Chen, Y., Met-Domestici, M., Chan, S. H., Tan, Y. P., Allen, J. C., Lim, S. T., Soo, K. C., & Ngeow, J. (2017). Impact of subsidies on cancer genetic testing uptake in Singapore. Journal of Medical Genetics, 54(4), 254–259. https://doi.org/10.1136/jmedgenet-2016-104302
McCall-Hosenfeld, J. S., & Weisman, C. S. (2011). Receipt of preventive counseling among reproductive-aged women in rural and urban communities. Rural and Remote Health, 11(1), 1617.
McCuaig, J. M., Stockley, T. L., Shaw, P., Fung-Kee-Fung, M., Altman, A. D., Bentley, J., Bernardini, M. Q., Cormier, B., Hirte, H., Kieser, K., MacMillan, A., Meschino, W. S., Panabaker, K., Perrier, R., Provencher, D., Schrader, K. A., Serfas, K., Tomiak, E., Wong, N., … Kim, R. H. (2018). Evolution of genetic assessment for BRCA-associated gynaecologic malignancies: a Canadian multisociety roadmap. Journal of Medical Genetics, 55(9), 571–577. https://doi.org/10.1136/jmedgenet-2018-105472
Metcalf, M. P., Bradley Tanner, T., & Buchanan, A. (2010). Effectiveness of an online curriculum for medical students on genetics, genetic testing and counseling. Medical Education Online, 15(1), 4856. https://doi.org/10.3402/meo.v15i0.4856
Radford, E. J., Parker, A. P. J., & Firth, H. V. (2021). Genetic testing in paediatric neurology – which test to choose? Paediatrics and Child Health, 31(5), 195–206. https://doi.org/10.1016/j.paed.2021.02.004
Rebbeck, T. R., Mitra, N., Wan, F., Sinilnikova, O. M., Healey, S., McGuffog, L., Mazoyer, S., Chenevix-Trench, G., Easton, D. F., Antoniou, A. C., Nathanson, K. L., Laitman, Y., Kushnir, A., Paluch-Shimon, S., Berger, R., Zidan, J., Friedman, E., Ehrencrona, H., Stenmark-Askmalm, M., … Andrulis, I. (2015). Association of Type and Location of BRCA1 and BRCA2 Mutations With Risk of Breast and Ovarian Cancer. JAMA, 313(13), 1347. https://doi.org/10.1001/jama.2014.5985
Singh, R., Kumar, S., Nakash, P., Kumar, R., Kumar, G., Pal, P., Mishra, S., Raj, P., Rajotiya, S., Singh, A. K., Debnath, S., Chaturvedi, B., Bareth, H., Patel, A., Singh, M., Srivastava, A., Nathiya, D., & Tomar, B. S. (2024). Prevalence of breast cancer in rural population of Jaipur: a survey-based observational study. Scientific Reports, 14(1), 8865. https://doi.org/10.1038/s41598-024-58717-0
Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71(3), 209–249. https://doi.org/10.3322/caac.21660
Vadaparampil, S. T., McIntyre, J., & Quinn, G. P. (2010). Awareness, Perceptions, and Provider Recommendation Related to Genetic Testing for Hereditary Breast Cancer Risk among At‐Risk Hispanic Women: Similarities and Variations by Sub‐Ethnicity. Journal of Genetic Counseling, 19(6), 618–629. https://doi.org/10.1007/s10897-010-9316-y