WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

*Zainab Ali Hadi, Jawad K. Al- Diwan and Haider Jalil Raheef

ABSTRACT

Breast cancer remains a predominant global health concern, accounting for considerable morbidity and mortalityworldwide. It is one of the leading causes of death globally, responsible for an estimated 9.6 million deaths in2018.[1] Among women, breast cancer has the highest global prevalence, posing a significant threat to femalehealth.[2,3] Early detection and appropriate treatment are paramount in improving breast cancer prognosis.[4] Theincidence of breast cancer in Iraq has seen a notable increase from 2000 to 2019, during this period, 72,022 casesof breast cancer among women were identified. The average age-standardized incidence rate (ASIR) was 37.883per 100,000 women, with a significant rising trend observed throughout the study period. The average annualpercentage change (AAPC) was +3.192%. This increase was particularly significant in various age groups,including those aged 40-49, 50-59, 60-69, and over 70 years. Compared to other countries, Iraq's rate of breastcancer ASIR is considered moderate.[5] Two key components define the early detection strategy: education forearly diagnosis and rigorous screening. Regular screening tests, such as breast self-examination, clinical breastexamination (CBE) and mammography, are essential for early diagnosis, offering a better chance for effectivetreatment and recovery.[6] The Centers for Disease Control and Prevention recommend biennial mammographyscreening for women aged 50–74 years, a practice proven to reduce mortality rates and lessen the healthcaresystem's burden.[7] Despite the known benefits of screening, disparities in access and utilization of breast cancerscreening services are evident, influenced significantly by socioeconomic status (SES).[8,9] Education level andoccupational class significantly influence the likelihood of women undergoing screening, with those who arebetter educated and hold higher occupational positions being more inclined to do so.[10] Interestingly, countrieswith universal access to healthcare exhibit lower socioeconomic inequalities in breast cancer screening.[11]Addressing these disparities is crucial. Government agencies are encouraged to implement comprehensivescreening programs accessible to all social classes, thereby increasing attendance and reducing inequalities.[4]However, challenges persist, particularly in developed countries where women of higher SES are more likely toparticipate in screening programs and consequently exhibit higher survival rates.[12] To promote equitablescreening uptake, understanding the distribution of breast cancer screening across social groups is vital. Thisknowledge can inform policies targeting specific socioeconomic groups, ensuring that all segments of thepopulation benefit from organized screening programs. Such equitable access has been shown to reducesocioeconomic disparities in breast cancer mortality, as evidenced in Florence, Italy.[13] Breast cancer in Iraqpresents significant challenges due to late diagnoses, cultural stigmas, and limited healthcare access. Manywomen delay seeking medical advice because of social barriers and a lack of awareness, leading to advanceddisease stages and higher mortality. Iraq's healthcare system, strained by economic issues and conflicts, struggleswith providing adequate cancer care. Efforts are underway to improve outcomes, including public educationcampaigns and the development of specialized cancer centers. A multi-faceted approach involving government,healthcare providers, and international aid is essential for enhancing breast cancer care in Iraq.[14,15] The aim ofstudy is to identify the reluctance toward breast cancer screening services and its relationship to educational level.

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