Awareness of breast cancer risk factors and screening practices among female community health workers in Kigali, Rwanda: a cross sectional study

Abstract

Background: Each year, breast cancer is newly diagnosed in more than 1 million women worldwide and more than 400,000 women die from it [102,103]. Breast cancer is a growing public health throughout the world, but especially in developing regions where the incidence has increased as much as 5% per year. [102,104]. In Rwanda, breast cancer is the most occurring cancer among women (28.7%) followed by Cervix uteri cancer (21.3%). Early diagnosis is especially important for breast cancer because the disease responds best to treatment before it has spread. Female community health workers are in good position to encourage and influence women to be breast aware. Objectives: The study assessed the awareness of the breast cancer risk factor and early detection measures among female community health workers residing in Kigali city. Methodology: The study used across-sectional design which was carried out in Kigali City from June to November 2016. A total of 405 female community health workers were interviewed using simple random sampling with proportional allocation to size of Districts. Data were collected, entered and analyzed with SPSS 21. Ethical clearance was obtained from College of Medicine and Health Sciences IRB (131/CMHS IRB/2016) to ensure the study adheres to principles of protecting the rights of participants. Thereafter, data were collected, entered and analyzed using SPSS version 21.The awareness of breast cancer risk factors and early detection measures were categorized into poor and good. Results: The awareness of breast cancer risk factors among female community health workers in Kigali was low was (7.7%). Breast cancer risk awareness was increasingly associated with personal history of breast problem χ2=10.928, p<0.005. The awareness of breast cancer early detection measures among community health workers relatively moderate (19.9%). Awareness was associated with education and occupation of the respondents respectively χ2=7.277, p<0.05 and χ2=9.204, P<0.05. The practice of self breast examination was relatively averaged (44.3%) and it increasing associated with residence (OR=2.569, 95% CI=1.121-5.886) education level (OR=2.133, 95% CI=1.269-3.585), having received breast cancer information from health professional (OR=2.115, 95% CI=1.132-3.951) and having first degree family member with breast cancer history (OR=0.263, 95% CI=0.070-0.986) respectively. Conclusion: The awareness of breast cancer risk factors and early detection measures was generally low in female community health workers living and residing in Kigali. Demographics characteristics like residence, xii

education level, having a first degree relative with breast cancer history and receiving breast cancer information from health profession were statistically associated with the awareness and practice of self breast examination practice. These results provide important baseline information and may be used to develop tailored breast cancer education programs, increase primary and secondary prevention efforts and evaluate the effectiveness of prevention programs.