Perception towards breast cancer and the acceptance of breast cancer screening
It is pertinent to study women's perception of breast cancer and its early-detection
measures because their perception would influence their use of early-detection measures
of breast cancer. In Nigeria, a cross-sectional study conducted to evaluate the level of
awareness, perception, specific knowledge, and screening behavior towards Breast
Cancer among rural women in Ipokia local government area of Ogun state showed that
level of awareness about breast cancer among women in this study was low while their
level of perception was just above average and screening behavior was very low. Again,
perception variables positively and significantly correlated with screening behavior
among the participants. The study recommended a serious awareness drive, education
and communication strategies packaged towards these women, to reinforce their positive
trends as well as aggressive health promotion intervention to encourage regular screening
for breast cancer among women in the rural communities. (Ademola, Adenike, Adebo
and Abraham, 2011).
A descriptive cross-sectional study conducted to describe perceived breast cancer risk,
identify the percentage of women with inaccurate risk perceptions, and examine the
influence of perceived and objective risk on screening behavior in a Community settings
in a metropolitan area on the western coast of the United States using a multicultural
sample of 184 English-speaking women who have never been diagnosed with cancer.
From the study Participants reported that they “probably will not” get breast cancer and
that their risk was “somewhat lower” than average. Family history of breast cancer was a
significant predictor of perceived risk. Demographic characteristics and objective risk
factors were not associated with perceived risk. Most women at high risk for breast
cancer (89%) underestimated their actual risk; fewer women with low to average risk for
breast cancer (9%) overestimated their risk. According to the study, inaccurate
perceptions of risk do not promote optimal breast cancer screening. (Katapodi, Dodd,
Kathryn and Facione, 2009)
Karen (2011), assessing breast cancer perceptions in Northern Uganda for the purpose of
informing necessary cancer initiatives found out that the concept of cancer was relatively
new in Northern Uganda, in conjunction with a lack of understanding and competing
priorities, many women are often diagnosed in late and advanced stages. Most women go
to the hospital when they feel distinctive pain in the body instead of getting regular
check-ups. Breast cancer patients and the Gulu District community development officer
participated in semi-structured interviews that were analyzed using qualitative data
analysis. The study concluded that educating people on needs for more proactive health-
seeking behavior could have a significant impact on cancer control in this community.
A Study on factors influencing breast cancer screening among Iranian women showed
that Perceived self-efficacy and perceived barriers to breast self-examination (BSE) were
significant predictors for BSE performance. For having mammography, health motivation
was the main predictor. The aim of the study was to identify the rates of breast self-
examination (BSE) performance and mammography use in Iranian women, and to
characterize the demographic and cognitive factors associated with their breast cancer
screening behavior. In the study, data was collected from a convenience sample of 388
females, using an adapted version of Champion’s revised Health Belief Model Scale. The
study concluded that eliminating barriers and increasing perceived self-efficacy with an
emphasis to make the women acquainted with BSE performance; as well as increasing
health motivation of women and persuading of physicians for clinical breast examination
(CBE) performance with low cost and free access to mammography, are important to
promote BSE and mammography. (Naroozi and Tahmasabi, 2011).
Ukwenya, Yusufu, Nmadu, Garba and Ahmed (2008) carried out a cross-sectional study
at a teaching hospital in Kaduna, Nigeria, to investigate the extent and reasons for the
delay between onset of symptoms and admission for treatment of symptomatic breast
cancer. The patients had histological proven breast cancer and had been admitted for
treatment. Data were obtained from interviews and patients’ clinical and referral records.
The study showed that delayed treatment of symptomatic breast cancer at this center in
Nigeria is as much related to the quality of medical care as it is to local beliefs, ignorance
of the disease, and lack of acceptance of orthodox treatment.
Barbara, Elvan and Ramona (2005) compared perception of cancer fatalism among
African American patient and their providers, who were recruited at federally funded
community primary care centres where the majority of patients were African American
women and the majority of providers were physicians and nurses. Patients indicated low
perceptions of cancer fatalism, but providers believed patients were highly fatalistic. As
the patients’ educational level increased, perceptions of cancer fatalism decreased. The
providers’ belief that patients are fatalistic about cancer may influence patient–provider
communication. They may be less likely to recommend screening, and patients may be
less likely to initiate a discussion about cancer. Strategies are needed that target providers
and their patients to address actual and/or perceived perceptions and their influence on
cancer screening.
In Kenya, a cross-sectional questionnaire survey involving a consecutive sample of 219
consenting non-pregnant women attending MCH-FP clinic at Moi Teaching and Referral
Hospital, Eldoret, to determine perceptions on cervical cancer risk, barriers to screening
and previous screening. Perception of being at risk was significantly associated with a felt
need for screening (p=0.002), an association that persisted only for women reporting
multiple lifetime sex partners (p=0.005). Fear of abnormal results and lack of finances
were the commonest barriers to screening reported by 22.4% and 11.4% of respondents,
respectively. (Were et al 2011).
A descriptive study that assessed rural women's perception of breast cancer using data
from two rural health districts in Ibadan, Oyo state of Nigeria, showed that 66.2% of the
respondents considered that breast cancer is more severe than other forms of cancer.
Respondents' perception of risk of developing breast cancer was low, as 64.8% rated
themselves 1, on a scale of 1 to 9 (where 1 = does not perceive herself to have cancer; 9 =
very much perceives herself to have cancer). Respondents' perceived cause of breast
cancer included "putting money in brassiere" and attack from the enemy, among others.
None of the respondents identified early detection as an advantage of breast self-
examination. Swelling was the most acknowledged early-warning sign
(Oluwalosin, 2006).
Muchiri M. (2006) in his cross sectional study on factors influencing the decision
for breast cancer screening in ol-kalou division Nyandarua district Kenya with a
sample size of 384 women and using a questionnaire with items as knowledge
level of the respondents as pertain to prevention methods, treatment and
knowledge of the available services for breast cancer screening, parity, perception
of cancer and individual risk perception. Of 384 subjects, 34.4% did not know
about the disease, 16.4% had knowledge as pertains to cancer and had been
screened. The Reason for not taking the screening included lack of knowledge,
poor access to the health facility, perception not at risk and cultural definition of
the disease. The most common reason was that they do not associate it to any
direct benefit (66%). Education and Economic activity was found to significantly
affect the decision to take a screening (P=0.00).
Muthoni and Miller, (2010) explored rural and urban Kenyan women's knowledge
and attitudes regarding breast cancer and breast cancer early detection measures.
The study employed eight focus groups with low- and middle-income rural and
urban Kenyan women to explore their knowledge, attitudes, and behaviors
concerning breast cancer and its early detection measures. Findings revealed a
huge divide between urban middle- income women and all other groups with
respect to knowledge of breast cancer and early detection measures.
From the review, women viewed breast cancer as a highly severe disease and
Perceived benefits of early detection measures centered on preparing themselves
for what was assumed to be inevitable death. Local belief, ignorance of the disease
and lack of orthodox treatment was associated to delayed treatment of breast
cancer and Perception of being at risk was significantly associated with a felt need
for screening. One study showed a decrease in perception of cancer fatalism
associated to increased patients educational level.
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