Tackling breast cancer in developing countries: insights from the Knowledge, Attitudes and Practices on breast cancer and its prevention among Nigerian teenagers in secondary schools.
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Keywords

Breast self-examination
BSE
breast cancer
women
secondary schools
knowledge
attitude
practice.

Abstract

Background:

Breast cancer occurrences in developing countries are gradually matching caucasian levels. Since early detection is linked to reductions in morbidities and mortality, affordable screening techniques like breast self-examination (BSE) becomes imperative in these resource-limited economies. Ascertaining the Knowledge, Attitudes, and Practices (KAP) of breast cancers and BSE among young adult females will help provide baseline information for early and targeted interventions.

Method:

A cross sectional survey involving 432 female senior secondary school students in Otuocha Educational Zone of Anambra State, Nigeria.

Results:

A total of 321(74.3%) valid questionnaires were returned. Mean age was 16.79+/-1.48 years. Even though 84.6% and 55.2% had respectively heard about breast cancer and BSE, and the ‘General Knowledge’ of breast cancer was high (75.2%), specifics on ‘Risk Factors’ (41.5%) and ‘Symptoms’ (46.1%) were poor.

Knowledge on correct BSE ‘Techniques’ was 52.9%, but few know when to commence (43.1%), the right frequency (31.5%), or the right timing (24.6%). A large majority (73.6%) had positive attitudes, but only 6.1% practice it monthly, while 55.3% had never done it at all. No significant predictors of Knowledge and Practice of BSE was identified.

Conclusion:

Health campaigns on BSE and breast cancers should provide specific details on techniques, risk factors and symptoms, while emphasizing on the right methods, timing and frequency. The positive attitudes identified raise optimism that health interventions would be effective and can have long term benefits. If possible, BSE and breast cancer teachings should be included in the secondary school academic curricula of resource-limited countries.

https://doi.org/10.15167/2421-4248/jpmh2018.59.4.964
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References

REFERENCES

Ferlay, J., et al., Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. International journal of cancer, 2015. 136(5).

Anyanwu, S., Breast cancer in eastern Nigeria: a ten year review. West African journal of medicine, 1999. 19(2): p. 120-125.

World Health Organization. WHO | Cancer. WHO 2017 2017-03-23 [cited 2017 November 20th]; Available from: http://www.who.int/mediacentre/factsheets/fs297/en/.

Omoyeni, O.M., et al., Assessment of the Knowledge and Practice of Breast Self Examination among Female Cleaners in Obafemi Awolowo University Ile Ife, Nigeria. International Journal of Caring Sciences, 2014. 7(1): p. 239.

Harris, J.R., et al., Breast cancer. New England Journal of Medicine, 1992. 327(6): p. 390-398.

Adebamowo, C. and O. Adekunle, Case‐controlled study of the epidemiological risk factors for breast cancer in Nigeria. British Journal of Surgery, 1999. 86(5): p. 665-668.

Oluwatosin, O.A., Assessment of women's risk factors for breast cancer and predictors of the practice of breast examination in two rural areas near Ibadan, Nigeria. Cancer epidemiology, 2010. 34(4): p. 425-428.

Hallal, J.C., The relationship of health beliefs, health locus of control, and self concept to the practice of breast self-examination in adult women. Nursing Research, 1982. 31(3): p. 137-142.

Tavafian, S.S., et al., Prediction of breast self-examination in a sample of Iranian women: an application of the Health Belief Model. BMC women's health, 2009. 9(1): p. 37.

Isara, A. and C. Ojedokun, Knowledge of breast cancer and practice of breast self examination among female senior secondary school students in Abuja, Nigeria. Journal of preventive medicine and hygiene, 2011. 52(4).

Humphrey, L.L., et al., Breast cancer screening: a summary of the evidence for the US Preventive Services Task Force. Annals of internal medicine, 2002. 137(5_Part_1): p. 347-360.

Yakubu, A.A., M.A. Gadanya, and A.A. Sheshe, Knowledge, attitude, and practice of breast self-examination among female nurses in Aminu Kano teaching hospital, Kano, Nigeria. Nigerian Journal of Basic and Clinical Sciences, 2014. 11(2): p. 85.

Okobia, M.N., et al., Knowledge, attitude and practice of Nigerian women towards breast cancer: A cross-sectional study. World Journal of Surgical Oncology, 2006. 4(1): p. 11.

Doshi, D., et al., Breast self-examination: knowledge, attitude, and practice among female dental students in Hyderabad City, India. Indian journal of palliative care, 2012. 18(1): p. 68.

Thomas, D.B., et al., Randomized trial of breast self-examination in Shanghai: final results. Journal of the national Cancer Institute, 2002. 94(19): p. 1445-1457.

Kösters, J.P. and P.C. Gøtzsche, Regular self‐examination or clinical examination for early detection of breast cancer. The Cochrane Library, 2003.

Al-Haji, K.M. and S.A. Moawed, BREAsT CANCER, BREAsT sElf-ExAMINATION KNOwlEdgE AMONg fEMAlE HIgH sCHOOl sTUdENTs IN RIYAdH CITY. Middle East Journal of Nursing, 2015. 9(1): p. 25-33.

Siahpush, M. and G.K. Singh, Sociodemographic variations in breast cancer screening behavior among Australian women: results from the 1995 National Health Survey. Preventive medicine, 2002. 35(2): p. 174-180.

Blamey, R., A. Wilson, and J. Patnick, ABC of breast diseases: screening for breast cancer. BMJ: British Medical Journal, 2000. 321(7262): p. 689.

Parkin, D.M. and C.S. Muir, Cancer Incidence in Five Continents. Comparability and quality of data. IARC scientific publications, 1992(120): p. 45-173.

Ihekwaba, F., Breast cancer in Nigerian women. British Journal of Surgery, 1992. 79(8): p. 771-775.

Okobia, M. and U. Osime, Clinicopathological study of carcinoma of the breast in Benin City. African journal of reproductive health, 2001. 5(2): p. 56-62.

Neave, L.M., B.H. Mason, and R.G. Kay, Does delay in diagnosis of breast cancer affect survival? Breast Cancer Research and Treatment, 1990. 15(2): p. 103-108.

Rossi, S., et al., Diagnostic delay in breast cancer: correlation with disease stage and prognosis. Tumori, 1990. 76(6): p. 559-562.

Hisham, A.N. and C.-H. Yip, Overview of breast cancer in Malaysian women: a problem with late diagnosis. Asian Journal of Surgery, 2004. 27(2): p. 130-133.

Adebamowo, C.A. and O. Ajayi, Breast cancer in Nigeria. West African journal of medicine, 1999. 19(3): p. 179-191.

Edino, S., et al., Clinico-pathological review of breast cancer in Kano. Nigerian Journal of Surgery, 2000. 7: p. 70-75.

Newman, L.A. and A.E. Alfonso, Age-related differences in breast cancer stage at diagnosis between black and white patients in an urban community hospital. Annals of surgical oncology, 1997. 4(8): p. 655-662.

Machiavelli, M., et al., Relation between delay and survival in 596 patients with breast cancer. Oncology, 1989. 46(2): p. 78-82.

Afzelius, P., et al., Patient's and doctor's delay in primary breast cancer: Prognostic implications. Acta Oncologica, 1994. 33(4): p. 345-351.

Khwaja, M., N. Nirodi, and J. Lawrie, Malignant tumours of the breast in Northern Savannah of Nigeria. East African medical journal, 1980. 57(8): p. 555-561.

Irurhe, N., et al., Knowledge and awareness of breast cancer among female secondary school students in Nigeria. Academic Journal of Cancer Research, 2012. 5(1): p. 01-05.

Banjo, A. Overview of breast and cervical cancers in Nigeria: are there regional variations. in Paper presentation at the International workshop on new trends in Management of breast and cervical cancers, Lagos, Nigeria. 2004.

Suh, M.A.B., et al., Breast self-examination and breast cancer awareness in women in developing countries: a survey of women in Buea, Cameroon. BMC research notes, 2012. 5(1): p. 627.

Hermon, C. and V. Beral, Breast cancer mortality rates are levelling off or beginning to decline in many western countries: analysis of time trends, age-cohort and age-period models of breast cancer mortality in 20 countries. British journal of cancer, 1996. 73(7): p. 955-960.

Ghazali, S.M., et al., Non-practice of breast self examination and marital status are associated with delayed presentation with breast cancer. Asian Pacific Journal of Cancer Prevention, 2013. 14(2): p. 1141-1145.

Gwarzo, U., K. Sabitu, and S. Idris, Knowledge and practice of breast self-examination among female undergraduate students. Annals of African medicine, 2009. 8(1).

Adetule, Y.C., Breast Self-Examination (BSE): A strategy for early detection of breast cancer in Nigeria. Annals of Oncology, 2016. 27(suppl_9).

Government of Anambra State, N. PPSSC OTUOCHA ZONE | ADMIN PAGE. 2017 2012 [cited 2017 30th November]; Available from: http://ppsscotuochazone.com/other_zones.php.

National Population Commission of Nigeria. Anambra (State, Nigeria) - Population Statistics, Charts, Map and Location. 2017 [cited 2017 30th Novemner]; Available from: http://www.citypopulation.info/php/nigeria-admin.php?adm1id=NGA004.

Segni, M., et al., Breast self-examination: knowledge, attitude, and practice among female health science students at Adama Science and Technology University, Ethiopia. Gynecol Obstet (Sunnyvale), 2016. 6(368): p. 2161-0932.1000368.

Karayurt, Ö., D. Özmen, and A.Ç. Çetinkaya, Awareness of breast cancer risk factors and practice of breast self examination among high school students in Turkey. BMC Public Health, 2008. 8(1): p. 359.

UNICEF. At a glance: Nigeria. 2013 [cited 2017 4th December]; Available from: https://www.unicef.org/infobycountry/nigeria_statistics.html#0.

US Department of State. Nigeria: International Religious Freedom Report 2009. 2009 [cited 2017 4th December]; Available from: https://www.state.gov/j/drl/rls/irf/2009/127249.htm.