Abstract
BackgroundBreast cancer (BC) is a non-communicable disease with increased morbidity and mortality. Early detection of BC contributes to prompt linkage to care and reduction of complications associated with BC. Breast self-examination (BSE) is useful for detecting breast abnormalities particularly in settings with poor access to healthcare for clinical breast examination and mammography. Therefore, we mapped evidence on women’s knowledge, attitude, and practice of BSE in sub-Sahara Africa (SSA).MethodsWe conducted a systematic scoping review using Arskey and O’Malleys’ framework as a guide. We searched PubMed, Google Scholar, CINAHL, and Science Direct databases for relevant studies on women’s knowledge, attitude and practice on BSE. Studies included in the review were from SSA countries as defined by the World Health Organization published from 2008 to May 2019. Two reviewers independently screened the articles at the abstract and full-text screening guided by inclusion and exclusion criteria. All relevant data were extracted, and a thematic analysis conducted. The themes were collated, and a narrative summary of the findings reported.ResultsOf the 264 potentially eligible articles identified from 595,144, only 21 met the inclusion criteria and were included for data extraction. These included studies were conducted in 7 countries of which 11 were conducted in Nigeria; two each in Ethiopia, Ghana, Cameroon, and Uganda; and one each in Kenya and Sudan. Of the 21 included studies, 18 studies reported evidence on BSE knowledge and practice; two on only knowledge; one on only practice only; and six presented evidence on women’s attitude towards BSE. The study findings suggest varying knowledge levels on BSE among women in SSA countries. The study findings also suggest that BSE practice is still a challenge in SSA.ConclusionThere is a paucity of published literature on women’s knowledge, practice, and attitude of BSE in SSA. Hence, this study recommends further studies on knowledge, practice, and attitude of BSE, to identify contextual challenges and provide evidence-based solutions to improve women’s knowledge, practice, and attitude of BSE in SSA.
Highlights
Breast cancer (BC) is a non-communicable disease with increased morbidity and mortality
It is projected that 43.1% of women will die due to BC worldwide and 36.8% will occur in low-andmiddle-income countries (LMICs) by the end of 2020 [2]
Of the 26 fulltext articles excluded, eleven did not report on any of this study outcome of interest [22–32]; five studies were conducted outside this study setting [8, 33–36]; three reported on Clinical breastexamination (CBE) and mammography [37–39]; three were review articles [40–42]; two studies reported on cost-effective of Breast self-examination (BSE) [5, 7]; one study reported evidence on male [43] and one full text could be accessed [44] despite several emails to the authors requesting for it
Summary
Breast cancer (BC) is a non-communicable disease with increased morbidity and mortality. It is estimated that 1 in 8 women will develop BC over a lifetime and in the decade 19.7 million new cases are expected globally by 2020, and 10.6 million will occur in low-andmiddle-income countries (LMICs) [2, 3]. It is projected that 43.1% of women will die due to BC worldwide and 36.8% will occur in LMICs by the end of 2020 [2] These regional projections of BC incidence and mortality are worrying. Clinical breast examination and mammography are ideal for BC diagnosis, access to healthcare in most SSA countries may be a major challenge. Economic constraints in most SSA countries may impede the availability of mammography in the majority of the health facilities [5–7] Both clinical breast examination and mammography require expertise, specialized equipment, and a visit to the health facility [7]. Evidence shows that nine out of the ten breast lumps are detected by the women themselves [9]
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