Relating self-perceived with objective risk for breast cancer among women in rural and urban communities in southwestern Nigeria

Abstract

Background: In an effort to enhance the value of early detection of breast cancer, attempts are now being made to relate a woman’s perceived risk of developing breast cancer with her actual risk. Women at increased risk but who underestimate this risk may unnecessarily defer the benefits of screening. Objective: To compare the self-perceived risk for developing breast cancer with their objective risk, as determined by the objective breast cancer risk (OBCR) and the Gail’s risk score. Materials and Methods: Quantitative methods utilized a cross-sectional comparative study design. Six hundred and eighty women aged 20 years or older were interviewed using a semi-structured, interviewer-administered questionnaire and selected using a multistage sampling technique from two predominantly rural and urban local government areas. A study set criteria on the OBCR was determined and classified into average or high risk for developing breast cancer (AOBCR and HOBCR, respectively), based on whether or not the respondent showed any of the two of four strong risk factors for breast cancer. Objective risk was also determined using an Internet-based Gail’s breast cancer assessment tool. Quantitative data were analyzed using SPSS software, version 16.0. Qualitative methods comprised focus group discussion sessions for women in both rural and urban areas, which were analyzed using detailed content analysis, and the results were presented in Z–Y tables. Result: The result of this study suggested that majority of women did not accurately assess their risk of developing breast cancer as nine in 10 women at high risk underestimated their true risk of developing breast cancer. Using the study set criteria, about one in 20 respondents were assessed to have HOBCR. Among women in rural communities, about 95% and 4% revealed AOBCR and HOBCR, compared with 93% and 11% of women in urban communities showing AOBCR and HOBCR, respectively. The Gail’s risk assessment tool was able to classify just two (5.6%) respondents as being at a high risk of developing breast cancer. The sensitivity of the Gail’s model when applied to the respondents was 5.56%. Conclusion: The study showed that OBCR has a potential of being used as a high-risk screening tool for breast cancer in middle- or low-resource setting. Therefore, clients who screen positively as HOBCR can subsequently be offered targeted screening, intensive health education, and counseling on various risk-reducing options.