The 'Know Your Lemons' tools: a strategy to improve breast cancer warning signs recognition in Malaysia

Mary Chan Mei Yen, Tania Islam, Corrine Ellsworth-Beaumont, Sarinder Kaur Dhillon, Mogana Darshini Ganggayah, Nur Aishah Taib

Research output: Contribution to journalArticleResearchpeer-review


Background: Breast cancer (BC) is the most common cancer in Malaysia, with many diagnosed at late stages. The "Know Your Lemons"(KYL) visual educational tools were developed by KYL Foundation. This study aimed to evaluate participants' confidence levels and perceived knowledge in identifying BC symptoms before and after exposure to KYL tools. Materials and Methods: A cross-sectional study was carried out among 788 participants in three KYL health campaigns from 2017 to 2020. Perceived knowledge (a 5-item Likert scale was used, zero means "very poor"and 4 means "excellent knowledge") and confidence in identifying BC symptoms were studied. A Wilcoxon Matched-Paired Signed-Rank Test was performed to assess the perceived knowledge. Results: There was a significant improvement in the perceived knowledge Mean (±SD) score (2.84 ± 1.02) versus (4.31 ± 0.66) before and after the campaign (P < 0.01). About 95.6% agreed that the language used in KYL materials was clear and understandable, 89.8% agreed it is acceptable in Malaysian culture, and 80% felt more confident in identifying BC symptoms. Therefore, 90.8% had the intention of breast self-examination and 90.8% would consult a doctor if symptomatic. The majority (92.7%) agreed that the KYL tools clarified the BC tests needed. Conclusion: The KYL tools enhanced perceived BC symptom recognition knowledge and confidence levels.

Original languageEnglish
Article number231
Number of pages8
JournalJournal of Education and Health Promotion
Issue number1
Publication statusPublished - Jul 2023


  • Breast cancer
  • confidence
  • health literacy
  • knowledge
  • perceived

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