Knowledge, Attitude and Practice on Breast Cancer Screening among First Degree Relative of Breast Cancer Patient using Validated Malay Language Questionnaire

Assessment of knowledge, attitude and practice (KAP) related to breast cancer (BC) is essential to ensure that screening promotion strategies are effective and culturally appropriate. Using questionnaires in the local language enhances cultural sensitivity and improves understanding of the subject. However, validated Malay-language KAP questionnaires are limited, as most studies rely on English versions. This study aimed to validate a Malay-translated version of a KAP questionnaire on BC screening for use among first-degree relatives of BC patients. The original KAP questionnaire developed by Madubogwu was translated into Malay using a forward-backward translation method. Content validation was conducted by ten radiology medical officer and five mammographer. Pilot study was carried out with 32 participants, followed by a full survey involving 112 respondents using the validated Malay version. Experts scored the questionnaire between 124 and 140 out of 144 for consistency, clarity, accuracy and grammar, with an average content validity index of 0.920. The internal consistency (Cronbach’s alpha) was 0.704, and the pilot test generated 0.870, indicating good reliability. Of the 112 respondents, 95.5% were aware of BC. The main sources of information were hospitals (57.1%) and media (23.2%). A total of 81.3% agreed that breast self-examination is useful for early detection, and 63.4% practiced it regularly. Knowledge of clinical breast examination and mammograms was moderate, with 65.2% and 82.1%, respectively recognising their usefulness. The validated Malay version of the KAP questionnaire demonstrates strong psychometric properties and is a valid instrument for assessing breast cancer screening knowledge, attitudes and practices.