Willingness to screen for breast cancer among adult females attending Mulago National Referal Hospital

Abstract

Background Breast cancer incidence has increased worldwide, with exceptionally high mortality in Sub-Saharan African women, mostly due to late disease diagnosis. Breast cancer screening is crucial to identifying cancer in its early stages, when the disease is more amenable to treatment or cure. Early detection has been promoted as a key strategy for reducing breast cancer-related mortality and improving survival. Knowledge of women’s willingness to screen and factors related to willingness to screen for breast cancer is important for increased uptake of breast cancer screening services, which can potentially increase early disease detection and treatment. However both are not well understood among Ugandan women. Objectives: The general objective was to determine willingness to screen for breast cancer and identify factors related to likelihood to screen among women attending the general out patients department of Mulago National Referral Hospital in Kampala, Uganda. Methods In this cross sectional study, participants were randomly selected from adult female patients reporting to the Assessment Centre, a general out-patients department of Mulago National Referral Hospital. Data from consented adults was collected using interviewer-administered questionnaires and FGDs. Level of willingness, bivariate analysis and logistic regressions were done to determine factors associated with willingness to screen for breast cancer using stata version 12.0. Odds ratios (OR), 95% confidence intervals and p values are reported. Results A total of 404 participants were interviewed, with mean age of 31 years. 83.7% were willing to screen for breast cancer. Almost 50% were fairly knowledgeable about breast cancer disease and screening however a big discrepancy between awareness and the practice of breast cancer screening was noted. More women are willing to screen by CBE or mammogram than SBE. Non performance has been shown to be attributed to lack of adequate knowledge, fear of knowing the result of the test, misperceptions (such as screening is only necessary when one has breast problems, mammograms cause cancer), and system related factors especially poor access and expensive services, Contrary to expectation, being young, 35 and younger, is associated to willingness. Also some constructs from the HB model i.e. perceived benefit (breast cancer screening improved survival) and perceived susceptibility (having a relative who died of breast cancer and the fear that one could get breast cancer) were highly associated with willingness to screen for breast cancer Conclusion There appears to be a high level of willingness to screen for Breast cancer among women in Kampala and multiple perception barriers to screening. However extending access closer through community outreach and availing free breast cancer services would increase uptake