Abstract
Introduction Despite the rising trend in breast cancer incidence and mortality across Sub-Saharan Africa, there remains a critical knowledge gap about the burden and patterns of breast disease and breast cancer screening practices at the population level. This study aimed to identify socioeconomic factors associated with knowledge and practice of breast self-examination (BSE) as well as assess the prevalence of breast disease symptoms among a mixed urban-rural population of women in the Southwest region of Cameroon. Methods We conducted a household-level community-based study in Southwest Cameroon between January and March 2017, using a three-stage cluster sampling framework. We surveyed 1287 households and collected self-reported data on 4208 female subjects, 790 of whom were household representatives. Each household representative provided information on behalf of all female household members about any ongoing breast disease symptoms. Moreover, female household representatives were questioned about their own knowledge and practice of BSE. Results Women demonstrated low frequency of knowledge of BSE, as 25% (n=201) of household representatives reported any knowledge of BSE; and among these only 15% (n=30) practiced BSE on a monthly basis. Age (aOR: 1.04), usage of Liquid Petroleum Gas fuel, a marker of higher socioeconomic status (aOR: 1.86), and speaking English as a primary language in the household (aOR: 1.59) were significant predictors of knowledge of BSE. Eleven women reported ongoing breast disease symptoms resulting in an overall prevalence of 2.3 cases of breast disease symptoms per 1000 women. Conclusions Socioeconomic disparities in access to health education may be a determinant of knowledge of BSE. Community-based strategies are needed to improve dissemination of breast cancer screening methods, particularly for women who face barriers to accessing care.
Highlights
Despite the rising trend in breast cancer incidence and mortality across Sub-Saharan Africa, there remains a critical knowledge gap about the burden and patterns of breast disease and breast cancer screening practices at the population level
In 2013, breast cancer accounted for 464,000 deaths and 13.1 million disability-adjusted life years (DALYs) globally, with 63% of DALYs occurring in developing countries [1]
As compared to the overall female population of Southwest Cameroon, subjects in this study belonged to households reporting a higher ownership of cellphones (95.4% vs. 70.2%) and more members with a secondary level of education or higher (77.5% vs. 38%) (Table 1)
Summary
Despite the rising trend in breast cancer incidence and mortality across Sub-Saharan Africa, there remains a critical knowledge gap about the burden and patterns of breast disease and breast cancer screening practices at the population level. The incidence and mortality of breast cancer have been continuously rising, primarily due to aging and population growth, increased urbanization, and a higher prevalence of risk factors associated with economic development (e.g., smoking, obesity, physical inactivity, and changing reproductive behaviors) [2]. This growing trend has been observed in the central African country of Cameroon, where breast cancer is the leading cancer among women in Yaounde, comprising 18.5% of all cancers and 32.5% of female cancers [3]. Currently available data may not accurately reflect the true burden and patterns of breast disease across all regions of Cameroon, especially since registries do not account for individuals who fail to present to formal care
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