Breast self-examination practice and its determinants among women in Ethiopia: A systematic review and meta-analysis.

Yordanos Gizachew Yeshitila,Selamawit Gebeyehu,Melaku Desta,Getachew Mullu Kassa,Peter Memiah,Amir Radfar

doi:10.1371/journal.pone.0245252

Yordanos Gizachew Yeshitila, Selamawit Gebeyehu + Show 4 more

Open Access

https://doi.org/10.1371/journal.pone.0245252

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Abstract

The survival rate from breast cancer is lowest in African countries and the distribution of breast self-examination practice of and its determinants are not well investigated in Ethiopia. Therefore, this systematic review and meta-analysis was designed to determine the pooled prevalence of breast self-examination and its associated factors among women in Ethiopia. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for this systematic review and meta-analysis. The databases used were; PUBMED, Cochrane Library, Google Scholar, CINAHL, African Journals Online, Dimensions and Summon per country online databases. Search terms used were; breast self-examination, breast cancer screening, early detection of breast cancer and Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. The meta-analysis was conducted using STATA 15 software. The pooled meta-analysis was computed to present the pooled prevalence and relative risks (RRs) of the determinate factors with 95% confidence intervals (CIs). We identified 2,637 studies, of which, 40 articles (with 17,820 participants) were eligible for inclusion in the final meta-analysis. The pooled estimate of breast self-examination in Ethiopia was 36.72% (95% CI: 29.90, 43.53). The regional distribution breast self-examination ranged from 21.2% (95% CI: 4.49, 37.91) in Tigray to 61.5% (95% CI: 53.98, 69.02) in Gambela region. The lowest prevalence of breast self-examination was observed among the general population (20.43% (95% CI: 14.13, 26.72)). Women who had non-formal educational status (OR = 0.4 (95% CI: 0.21, 0.77)), family history of breast cancer (OR = 2.04 (95% CI: 1.23, 3.39)), good knowledge of breast self-examination (OR = 4.8 (95% CI: 3.03, 7.6)) and favorable attitude toward breast self-examination (OR = 2.75, (95% CI: 1.66, 4.55)) were significantly associated with practice of breast self-examination. Only a third of women in Ethiopia practiced breast examination despite WHO guidelines advocating for this practice among all women of reproductive age. Intervention programs should address the factors that are associated with breast self-examination. Population specific programs are needed to promote breast self-examination.

Highlights

In the 21st century, cancer is expected to rank as the leading cause of death and the single most important barrier to increasing life expectancy in every country of the world [1, 2]
The pooled estimate of breast self-examination in Ethiopia was 36.72%
A third of women in Ethiopia practiced breast examination despite World Health Organization (WHO) guidelines advocating for this practice among all women of reproductive age

Summary

Introduction

In the 21st century, cancer is expected to rank as the leading cause of death and the single most important barrier to increasing life expectancy in every country of the world [1, 2]. According to Global Cancer Incidence, Mortality and Prevalence (GLOBOCAN) 2018 estimates, there were about 2.1 million newly diagnosed female breast cancer cases in 2018, accounting for almost 1 in 4 cancer cases among women [2]. The survival rate from breast cancer is lowest in African countries and the distribution of breast self-examination practice of and its determinants are not well investigated in Ethiopia.

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