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Psychometric Properties of the Breast Cancer Awareness Measure (Breast-CAM): A Systematic Review and Meta-Analysis
Andrea Fejer1, Mohammad Amin Atbaei2, Afshin Zand1
1Department of Public Health Medicine, Medical School, University of Pecs, 7622 Pecs, Hungary.
Cancers
|March 28, 2026
Summary
The Breast Cancer Awareness Measure (Breast-CAM) shows good internal consistency, but its reliability is questionable due to insufficient structural validity across diverse populations. Further research is needed to confirm its measurement properties.
Area of Science:
- Public Health
- Psychometrics
- Cancer Prevention
Background:
- Breast cancer awareness is crucial for early detection and prevention.
- The Breast Cancer Awareness Measure (Breast-CAM) is a key tool for assessing awareness.
- Its psychometric properties require comprehensive evaluation across diverse populations.
Purpose of the Study:
- To systematically review and meta-analyze the psychometric properties of the Breast-CAM.
- To evaluate the instrument's reliability and validity across cultural adaptations.
- To adhere to COSMIN standards for measurement instrument evaluation.
Main Methods:
- Systematic literature search of databases and trial registries (2010-2025).
- Inclusion of studies evaluating Breast-CAM psychometric properties in adult women.
- Methodological quality assessment using COSMIN Risk of Bias checklist and GRADE approach.
Main Results:
- Seventeen studies were included; eleven underwent meta-analysis, representing fourteen cultural adaptations.
- Pooled Cronbach's α was 0.89, but structural validity was frequently insufficient.
- Reliability and measurement error were often inadequately assessed; evidence certainty was low to moderate.
Conclusions:
- Content validity was generally sufficient, but structural validity issues limit the reliability of Breast-CAM.
- Internal consistency is not considered sufficient without adequate structural validity per COSMIN standards.
- Further high-quality psychometric studies are essential, especially in diverse populations, to support Breast-CAM's use.
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