knowledge, attitude, and practice of breast cancer and breast self-examination among female detainees in Khartoum, Sudan 2018.


breast cancer, prevention, breast self-examination, awareness, detainees


Introduction: breast cancer is the common cancer among females and a leading cause of mortality among them globally, its rates are three times higher in developing countries. Breast self-examination (BSE) had an important role in early detection, increasing the survival rate of breast cancer patients, despite these benefits, the rates of practicing BSE are low, especially in developing countries.

Objective: to assess the levels of awareness about breast cancer, and BSE among the detainees of Dar-Altaebat facility, a female’s detention facility in Khartoum, Sudan.

Methods: a cross-sectional study conducted at Dar-Altaebat a female imprisonment facility in Khartoum, Sudan. 354 participants were randomly selected from the total population of the facility. Data was collected using a self-administered structured questionnaire, which was composed of socio-demographic section, knowledge section, attitude section, and breast self-examination section. Data was analyzed using statistical package for social sciences(SPSS) software.

Results: 330 participants responded to the questionnaire, their mean age was (31, SD: 11.2) years, 126(38.2%) of them were illiterate, 196(59.4%) were married, and the majority of them 177(76.3%) were housewives. their overall knowledge score revealed that 185(56.2%) of them had poor knowledge about breast cancer. 218(66.3%) of them had poor knowledge about breast self-examination, however 314(95.3%) thought that it was important. 315(95.5%) of the participants had poor practice towards breast self-examination.

Conclusion: poor levels of knowledge about breast cancer were reported among the detainees. Additionally, their level of knowledge and practice of breast self-examination was also low, thus more health education campaigns are recommended in such facilities.


1- Anderson BO, Yip CH, Smith RA, Shyyan R, Sener SF, Eniu A, Carlson RW, Azavedo E, Harford J. Guideline implementation for breast healthcare in low‐income and middle‐income countries: Overview of the Breast Health Global Initiative Global Summit 2007. Cancer. 2008 Oct 15;113(S8):2221-43. doi: 10.1002/cncr.23844.
2- Jemal A, Center MM, DeSantis C, Ward EM. Global patterns of cancer incidence and mortality rates and trends. Cancer Epidemiology and Prevention Biomarkers. 2010 Aug 1;19(8):1893-907. doi: 10.1158/1055-9965.EPI-10-0437.
3- Jemal A, Bray F, Forman D, O'Brien M, Ferlay J, Center M, Parkin DM. Cancer burden in Africa and opportunities for prevention. Cancer. 2012 Sep 15;118(18):4372-84. doi: 10.1002/cncr.27410
4- Black E, Richmond R. Improving early detection of breast cancer in sub-Saharan Africa: why mammography may not be the way forward. Globalization and health. 2019 Dec;15(1):3. doi: 10.1186/s12992-018-0446-6
5- Cancer Facts & Figures 2009 | American Cancer Society [Internet]. 2019 [cited 15 October 2019]. Available from:
6- Azubuike SO, Okwuokei SO. Knowledge, attitude and practices of women towards breast cancer in Benin City, Nigeria. Annals of medical and health sciences research. 2013;3(2):155-60. doi: 10.4103/2141-9248.113653.
7- Nelson HD, Tyne K, Naik A, Bougatsos C, Chan BK, Humphrey L. Screening for breast cancer: an update for the US Preventive Services Task Force. Annals of internal medicine. 2009 Nov 17;151(10):727-37. DOI: 10.7326/0003-4819-151-10-200911170-00009
8- Nystrom L. How effective is screening for breast cancer?. British Medical Journal. 2000 Sep 16;321(7262):647-. doi:
9- Siahpush M, Singh GK. Sociodemographic predictors of pap test receipt, currency and knowledge among Australian women. Preventive medicine. 2002 Oct 1;35(4):362-8. DOI: 10.1006/pmed.2002.1086.
10- Hamad HM. Cancer initiatives in Sudan. Ann Oncol 2006;17(suppl 8): 32–36.
11- Elgaili EM, Abuidris DO, Rahman M, Michalek AM, Mohammed SI. Breast cancer burden in central Sudan. International journal of women's health. 2010;2:77.
12- Elamin A, Ibrahim ME, Abuidris D, Mohamed KE, Mohammed SI. Part I: cancer in Sudan—burden, distribution, and trends breast, gynecological, and prostate cancers. Cancer medicine. 2015 Mar;4(3):447-56. doi: 10.1002/cam4.378
13- Karayurt Ö, Özmen D, Çetinkaya AÇ. Awareness of breast cancer risk factors and practice of breast self examination among high school students in Turkey. BMC Public Health. 2008 Dec;8(1):359. doi: 10.1186/1471-2458-8-359
14- Al-Sharbatti SS, Shaikh RB, Mathew E, Al-Biate MA. Breast self-examination practice and breast cancer risk perception among female university students in Ajman. Asian Pacific Journal of Cancer Prevention. 2013;14(8):4919-23. Doi: 10.7314/APJCP.2013.14.8.4919.
15- Freddie B, Peter M, Maxwell P. The changing global patterns of female breast cancer incidence and mortality. Breast Cancer Res. 2004; 6: 229-39. DOI: 10.1186/bcr932.
16- Breast cancer: prevention and control [Internet]. World Health Organization. 2019 [cited15October2019].Availablefrom:
17- Okobia MN, Bunker CH, Okonofua FE, Osime U. Knowledge, attitude and practice of Nigerian women towards breast cancer: a cross-sectional study. World journal of surgical oncology. 2006 Dec;4(1):11. DOI: 1186/1477-7819-4-11
18- Gwarzo UM, Sabitu K, Idris SH (2009). Knowledge and practice of breast-self-examination among female undergraduate students of Ahmadu Bello university Zaria, Northwestern Nigeria. Ann Afr Med, 8, 55-8.
19- Tilaki KH, Auladi S. Awareness, attitude, and practice of breast cancer screening women, and the associated socio-demographic characteristics, in Northern Iran. Iranian journal of cancer prevention. 2015 Aug;8(4). doi: 10.17795/ijcp.3429
20- Gangane N, Ng N, Sebastian MS. Women's knowledge, attitudes, and practices about breast cancer in a rural district of Central India. Asian Pacific Journal of Cancer Prevention. 2015;16(16):6863-70. DOI: 10.7314/APJCP.2015.16.16.6863
21- Nde FP, Assob JC, Kwenti TE, Njunda AL, Tainenbe TR. Knowledge, attitude and practice of breast self-examination among female undergraduate students in the University of Buea. BMC research notes. 2015 Dec;8(1):43. DOI: 1186/s13104-015-1004-4
22- Haji‐Mahmoodi M, Montazeri A, Jarvandi S, Ebrahimi M, Haghighat S, Harirchi I. Breast Self‐Examination: Knowledge, Attitudes, and Practices Among Female Health Care Workers in Tehran, Iran. Breast J. 2002;8(4):222–5. Doi: 10.1046/j.1524-4741.2002.08406.x
23- Rosmawati NH. Knowledge, attitudes and practice of breast self-examination among women in a suburban area in Terengganu, Malaysia. Asian Pac J Cancer Prev. 2010 Jan 1;11(6):1503-8.
24- Saadeldin A. Idris, Aamir A. Hamza, Mohamed M. Hafiz, Mohammed Eltayeb A. Ali, Gamal E. H. A. El Shallaly. Knowledge, Attitude and Practice of Breast Self Examination among Final Years Female Medical Students in Sudan. International Journal of Public Health Research. Vol. 1, No. 1, 2013, pp. 6-10.
25- Who we are [Internet]. International Federation of Medical Students' Associations (IFMSA). 2019 [cited 15 October 2019]. Available from:
26- Choi JS, Park M. Factors predicting young women’s willingness to conduct vulvar self-examinations in Korea. Health care for women international. 2019 Jun 3;40(6):653-64. Doi: 10.1080/07399332.2018.1531003.
27- Al-Naggar RA, Al-Naggar DH, Bobryshev YV, Chen R, Assabri A. Practice and barriers toward breast self-examination among young Malaysian women. Asian Pac J Cancer Prev. 2011 Jan 1;12(5):1173-8.