Validity and Reliability of Malay Language Breast Cancer Awareness Scale for Male-to-Female Transgender

INTRODUCTION: Risks of breast cancer occurring among female transgender using hormonal therapy is emerging. However, most transgenders are also engaged in breast implant procedures resembling female sexual characteristics and satisfaction without realizing the risk of cancer development. Thus, breast cancer risk assessment of female transgenders in Malaysia should be evaluated further. This study aims to develop and validate an assessment tool in the Malay language version to measure breast cancer awareness among female transgenders in Malaysia. MATERIALS AND METHODS: A cross-sectional study with a purposive sampling method was conducted among 300 respondents in districts in the states of Pahang, Kedah, and Kelantan. The minimum number of respondents required was 300 persons based on the Nunnally method, with an item ratio of 1:10. All the subjects were given questionnaires on sociodemographic data and breast cancer-related items, consisting of five domains; knowledge of symptoms and clinical features, breast cancer risk factors, breast screening programmes, barriers in seeking medical help, and lastly, the confidence, skills and behaviour concerning breast self-examination. Each domain consisted of five to seven items. All the responses were recorded as 'Yes,' 'No,' or 'Not Sure'. Reliability was determined using Cronbach's alpha for internal consistency, while construct validity was assessed using exploratory factor analysis. RESULTS: The reliability of the 28 items for Malay Version of Breast Cancer Awareness scale by Cronbach Alpha was 0.864, suggesting that the constructs were reliable and acceptable. In addition, the construct validity was assessed using exploratory factor analysis highlights five meaningful domain. DISCUSSION AND CONCLUSION: This Malay language breast cancer awareness scale is a convenient self-assessment method, inexpensive and understandable which highlights common issues faced by male-to-female transgender with targeted domains. This scale is valid and reliable by achievable internal consistency value of 0.864.