Impact Of Breast Cancer Awareness Programmes On The Prevention Of Breast Cancer Amongst Nigerian Women

Project and Seminar Material for Public Health

Impact Of Breast Cancer Awareness Programmes On The Prevention Of Breast Cancer Amongst Nigerian Women


Abstract


This study was carried out on the impact of breast cancer awareness programmes on the prevention of breast cancer amongst Nigerian women in Minna metropolis. The study employed a descriptive method of data analysis. A total of 233 women from the study area were recruited. The study showed that the majority of participants had good knowledge about the burden of breast cancer, most women correctly identified breast cancer as one of the most common cancers in women and agreed that the disease was easier to cure when detected early. The results of the study showed that the participants who received the BCI program were significantly more likely to state that they practice BSE. Also, the effect of the BCI awareness program on obtaining high knowledge scores was also examined using unconditional logistic regression adjusting for age group and type of housing. Women who received the BCI awareness program were significantly more likely to obtain higher knowledge scores. The study recommended that the study indicates that the BCI breast awareness program improved KAP among women from rural Nigeria.


Chapter One


Introduction

1.1 Background to the Study

Breast cancer is the most common malignancy and first cause of cancer mortality in women worldwide with a world number of new cases estimated at 1,384,155 in 2008.[1] Its worldwide prevalence is still on the rise[2, 3] and nowadays breast cancer is considered to be an increasing public health problem among populations in low- and middle-income countries (LMICs). Moreover, a recent population-based study of cancer survival in Africa, Asia and Central America found unacceptably low breast cancer survival rates in African countries especially in Gambia where the 5-year age-standardized relative survival did not exceed 12%.[4]

Globally, breast cancer has been identified as a leading cause of death globally (1,2). There are more than a million new cases of breast cancer resulting in about 875,000 deaths each year, with high mortality rates in developing countries (3). In Nigeria, breast cancer has been reported to account for 56.6% of all cancer diagnosis between 1995&2002 (4). The burden of the disease has been on the increase and affected women often present late in hospitals when it has reached advance stage (5). Its cure at this stage becomes seriously compromised; the poor survival rate has been linked to late detection and diagnosis(6). Cancer is a disease process that begins when an abnormal cells is transformed by the genetic mutation of the cellular Deoxyribonuleic acids (DNA)(7). Breast cancer is neither painful nor cause any discomfort in its early stage. It usually present as a painless breast lump. There are diverse risk factors that may affect each woman’s susceptibility to the disease(3).

Besides poverty, low public awareness of breast cancer is a barrier to breast cancer control in LMICs where women seek medical help late and cancers are often diagnosed at advanced stages when very little can be done in terms of curative treatment. The Breast Health Global Initiative (BHGI) panel[5, 6] has recommended implementation strategies to optimize breast cancer management in LMICs concerning health-care systems, breast cancer diagnosis, treatment and early detection. For early detection, efforts must be devoted to improve community awareness. Civil society, represented by non-governmental organizations (NGOs), can play an important role in breast cancer control.[7]

In Ghana, 2,062 new breast cancer cases and 1,137 breast cancer deaths were estimated annually (16.5% of all women cancer deaths), with age-standardized incidence and mortality rates of 25.8 and 15.2 per 100,000 women, respectively (Globocan 2008).[1] Sixty percent of cases were detected at late stages (IIB, III and IV).[8] The available data on median age are limited and mainly hospital based. Clegg-Lamptey et al. reported a median age at diagnosis of 43 years on a sample of 66 women newly diagnosed with breast cancer. The age range was broad, from 20 to 84 years.[8] Surgery still represents the main form of treatment for breast cancer in the country[9] and as in other African countries some cultural beliefs and mysticisms surround the disease.[10].


1.2 Problem Statement

To date, little research has been done regarding the impact of awareness programs in breast cancer control in Nigeria and even less at the community level in rural areas. hence there is need to assess the impact of breast cancer awareness programmes on the prevention of breast cancer amongst Nigerian women.


1.3 Objectives of the study

The major objective of the study is the impact of breast cancer awareness programmes on the prevention of breast cancer amongst Nigerian women.


1.4 Research questions

  1. What is breast cancer
  2. How can it be prevented?
  3. What effect does breast cancer awareness programmes have on the prevalence of breast cancer?

1.5 Significance of the study

Our study aimed to assess the impact of breast cancer awareness programmes on the prevention of breast cancer amongst Nigerian women.


1.6 Scope of the study

The research focus on the impact of breast cancer awareness programmes on the prevention of breast cancer amongst Nigerian women.


Chapter Five


Conclusion And Recommendation

Conclusion

Our study is one of the first community-based studies on the impact of breast cancer awareness programmes on the prevention of breast cancer amongst Nigerian women in Minna metropolis. A recent study by Abuidris et al. (2016) has shown that a breast cancer awareness program in rural Sudan could increase breast cancer early detection. The study in Sudan is ongoing and the results regarding the effect of the program on KAP toward breast cancer among the participants have not been published yet. We used previously validated questionnaires and pilot tested locally our own questionnaire, which was conducted by trained community workers. The study had sufficient power but faced some methodological limitations. The lack of detailed census data before starting the survey and the unfeasibility of randomly sampling the communities and the study participants within the communities led to significant sociodemographic differences between the two groups. Multivariate logistic regression analyses were performed to account for them and evidence that the BCI program was the responsible of the improved knowledge and BSE practice after adjusting for those differences. The unit of the study was at community level but, because of time constraint, the survey was conducted only in one intervention and one referent community each. This and the unfeasibility to randomly sample might lead to an overestimation of the effect of the program. The validity of the answers was not checked by triangulating the information with other data sources. A future qualitative study will assess the relationship between knowledge and behavior change. The data were collected by five interviewers, including for one (MM) the need of a translator.

The ability of the field workers to translate and interpret the survey instrument from English to Twi and vice versa was not accurately evaluated. The participants who refused to participate in the study were not monitored and the causes not ascertained. Because of the cross-sectional nature of the study and the limited time available to conduct it, it was not possible to realize an analysis of the Peace and Love hospital records to ascertain the effect of the program on differences in number and stage at presentation of breast cancer cases since the inception of BCI and the beginning of its breast awareness programs in 2002. Finally, with only one round of evaluation, it was impossible to evaluate the effect of time.

The study indicates that the BCI breast awareness program improved KAP among women from rural Nigeria. Following the program, the knowledge on breast cancer was better in particular for points improving early detection such as recognition of breast lumps. Some misunderstanding on risk factors may be considered less important as long as women know that finding a persistent breast lump on BSE requires medical evaluation. A common misconception is that women who lack a family history of breast cancer are not at risk for the disease. In fact, the majority of women diagnosed with breast cancer do not have a family history or strong risk profile, which is why screening needs to be directed at the general population of women above a specified age cutoff. The program did not have impact on changing some beliefs that may delay presentation but on attitudes and practices toward breast cancer, especially in motivating women to practice BSE. Even if BSE has not been shown to reduce breast cancer mortality,27 this simple and cheap technique jointly with CBE have never been tested in LMICs where mammography procedures have limited application28,29 and mean tumor sizes at presentation are above 5 cm, and might yet prove to be valuable, as recently stated by Panieri.30 Our findings are similar to results from other studies on breast cancer education programs in LMICs and show the benefit of community-based interventions.


Recommendation

One suggestion for improvement of the BCI program is to devote more efforts to change beliefs related to breast cancer, which can encourage women to seek early treatment. Involving men in the program could help on that and reduce the women’s fear of being rejected by their husbands if they get breast cancer. Training and involving of community health workers in the BCI awareness program will reinforce the sustainability of the improved KAP and the necessary link between the knowledge gained and the seeking early medical help. Education is clearly critical. As this can be out of the scope of BCI, Nigeria Health Service, Ministry of Health and other policy makers should focus on such interventions. In addition, collaborations between all existing oncology services and civil society organizations must be enhanced. Funding is needed to link this increased awareness to appropriate diagnosis, care and follow-up.


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Frequently Asked Questions


How does breast cancer awareness affect individual’s knowledge of risk factors?

The results showed that breast cancer awareness significantly affect individual’s knowledge of the symptoms and risk factors of breast cancer, as well as their practice of breast self-examination. Most importantly the result showed that Health Education has a positive significant role in the reduction of breast cancer.

How can I reduce my risk of breast cancer?

Women who breastfed have a lower risk of breast cancer than women who have had children but did not breastfeed. Hormone therapy with estrogen only may be given to women who have had a hysterectomy. In these women, estrogen-only therapy after menopause may decrease the risk of breast cancer.

Which genes increase the risk of breast cancer in women?

Women who have inherited changes in the BRCA1 and BRCA2 genes or in certain other genes have a higher risk of breast cancer. The risk of breast cancer caused by inherited gene changes depends on the type of gene mutation, family history of cancer, and other factors.

What is the abbreviation for breast cancer prevention?

Breast Cancer Prevention (PDQ®)–Patient Version 1 Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. 2 Breast cancer is the second most common type of cancer in American women. 3 Avoiding risk factors and increasing protective factors may help prevent cancer.  

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