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Original Article
3 (
1
); 3-8
doi:
10.25259/ICAJ_26_2023

Breast Cancer Awareness and Practice of Self-Breast Examination among Biochemistry Students in Federal University Birnin Kebbi Nigeria

Department of Nursing Sciences, College of Health Sciences, Federal University, Birnin Kebbi, Kebbi, Nigeria.
Author image

*Corresponding author: Sulaiman Umar, Department of Nursing Science, College of Health Sciences, Federal University, Birnin Kebbi, Kebbi, Nigeria. rnumarsulaiman91@gmail.com

Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Umar S, Abdulkarim S. Breast Cancer Awareness and Practice of Self-Breast Examination among Biochemistry Students in Federal University Birnin Kebbi Nigeria. Indian Cancer Awareness J. 2024;3:3-8. doi: 10.25259/ICAJ_26_2023

Abstract

Objectives:

The objectives of the study were to assess the breast cancer awareness and practice of self-breast examination amongst female biochemistry students and to find out the statistically significant association between their level of practice regarding self-breast examination with their selected sociodemographic variables.

Materials and Methods:

The research design used for this study was a descriptive survey, purposive sampling technique was used to select 60 Biochemistry Students at Federal University Birnin Kebbi, Nigeria. This research was conducted within ten months (from January 2023 to October 2023). Data were collected using structures related to breast cancer awareness and the practice of self-breast examination. The collected data were tabulated in Excel and transported to IBM Statistical Package for the Social Sciences version 20.0.

Results:

The results showed that the majority of 38 (63.3%) had moderate, 17 (28.3%) had adequate and only 5 (8.3%) had an inadequate level of awareness regarding breast cancer. Therefore, the H0:1 hypothesis was rejected, whereas the H1:1 hypothesis was accepted. The results revealed that, out of 60 (100%) respondents, all of them had a positive attitude toward self-breast examination. Hence, the H0:2 hypothesis was rejected, whereas the H1:2 hypothesis was accepted. The results showed that there was a statistically significant association between their levels of awareness regarding breast cancer with their selected sociodemographic variables such as area of residence (urban) P < 0.001. Hence, the H0:3 hypothesis was rejected, whereas the H1:3 hypothesis was accepted.

Conclusion:

There was a statistically significant association between their levels of awareness regarding breast cancer with their selected sociodemographic variables such as area of residence (urban). The recommendation was given to conduct a similar study in a different setting using a large sample for generalisation of the findings.

Keywords

Breast cancer
Awareness
Practice
Self-breast examination
Students

INTRODUCTION

Breast cancer is the uncontrolled growth of abnormal cells in the milk-producing glands of the breast or in the ducts that deliver milk to the nipples. Breast cancer is the most common invasive cancer affecting women worldwide. It comprises 22.9% of invasive cancers in women and 16% of all female cancers. It affects about 12% of the women population worldwide. A report on the incidence of breast cancer reveals that one out of every eight women in the world stands a chance of having the disease in her lifetime.[1] It was reported that the Age-Standardised Incidence Rate of BC was 29.1/100,000 in Asia, 67.6/100,000 in the United States of America (USA) and 71.1/100,000 in Europe. The mortality-to-incidence ratio was much higher with about 0.35 in Asia in comparison to 0.21 in the USA and 0.23 in Europe.[2] In Africa, breast cancer was also the most commonly diagnosed cancer and the second leading cause of death amongst women in 2008; 92,600 cases and 50,000 deaths were reported that year. Cancer is a growing burden and continues to receive relatively low public health priority in Africa because of limited resources and more attention given to communicable diseases.[3]

However, breast cancer is already a well-known health problem in Nigeria, with about one death in every 25 reported cases. The continuous rise in the number of breast cancer cases and deaths in Nigeria is worrisome; this ugly situation confirms the Lakeshore Cancer Centre’s prediction that breast cancer cases may rise to 42 million by 2020 in the country.[4] The clinical stage of Breast cancer at the time of presentation is regarded as one of the most substantial prognostic factors of survival. The 5-year overall survival rates for patients with localised and regional diseases are very favourable and may reach up to 99% and 85%, respectively. Conversely, the 5-year overall survival rate for patients with metastatic disease is very dismal and may drop down significantly to as low as 27%.[5] Breast self-examination (BSE) is a non-invasive procedure performed by the individual monthly to determine a normal breast and recognise any change in the breast for early medical care to be sought. Evidence shows that nine out of ten breast lumps are detected by the women themselves.[6] BSE clinical breast examination and mammography are commonly recommended screening methods. Breast self examination is a screening technique for early breast cancer detection that women can perform at home.

Moreover, this is a simple, inexpensive, easy and effective technique that allows women to examine their breast tissue for any physical or visual changes. BSE increases women’s chances for treatment, thereby increasing the survival rate in women.[7] Adult women of all ages are encouraged to perform BSE at least once a month. Johns Hopkins Medical Centre states that, fourty percent of diagnosed breast cancers are detected by women who feel a lump, so establishing a regular BSE is very important.[8] Besides women, breast cancer is also common in men, though little attention is shown to the latter sex.[9] Another study result revealed that a total of 400 students participated from two private and two public universities (100 from each university). Out of all, 60.5% had the presence of knowledge (i.e., heard) about BSE. The average knowledge score was 7.41 ± 3.27 (on a scale of 0–15). Amongst those who knew BSE, only 10.7% of participants practiced it monthly. Being in a public university (adjusted odds ratio [aOR]: 3.42, 95% confidence interval [CI] 1.73–6.74) and years of education (aOR: 1.42, 95% CI: 1.02–1.97) were significant determinants of the presence of knowledge regarding BSE. Moreover, studying in public universities (β: 0.99; 95% CI 0.16–1.82) and education years passed (β: 0.51; 95% CI: 0.18–0.85) were associated with a higher knowledge score. The practice of BSE was negatively associated with students’ rural living before admission (aOR: 0.26, 95% CI: 0.08–0.79) and positively associated with the level of knowledge regarding BSE (aOR: 1.48; 95% CI 0.08–0.79).[10]

In addition, in recent times, studies have shown that there has been an increase in the death rate amongst women and adolescent children, most of which has been attributed to late detection of breast cancer and negligence in BSE.[11] Hence, the investigator felt the need and desire to carry out a study to assess the breast cancer awareness and practice of self-breast examination amongst female Biochemistry Students at Federal University Birnin Kebbi, Northwest, Nigeria.

Aim

The study aimed to assess the breast cancer awareness and practice of self-breast examination amongst female biochemistry students; and to find out the statistically significant association between their level of practice regarding self-breast examination with their selected sociodemographic variables.

Research hypotheses

  • H1:1. There was a significant awareness regarding breast cancer

  • H1:2. There was a positive practice regarding the self-breast examination

  • H1:3 There was a statistically significant association between their levels of awareness regarding breast cancer with their selected sociodemographic variables.

MATERIALS AND METHODS

Study design and population for the study

The research design used for the study was a descriptive survey design to assess the breast cancer awareness and practice of self-breast examination amongst female Biochemistry Students at Federal University Birnin Kebbi, Nigeria.

Sample size and sampling technique

A purposive sampling technique was used to select female Biochemistry Students at Federal University Birnin Kebbi, Nigeria. The sample size of this study was 60 respondents who were selected from the target population, which are female Biochemistry Students at Federal University Birnin Kebbi, Northwest Nigeria.

Inclusion criteria

Only female Biochemistry Students at Federal University Birnin Kebbi, Northwest Nigeria; those who were willing to participate and were available during data collection were included in this study.

Exclusion criteria

Female Biochemistry Students who were not willing to participate in the study and those who were not available during data collection were excluded from the study.

Development and description of the tool

The researcher prepared a questionnaire to collect data from Female Biochemistry Students. The tool used for the research study was a self-structured questionnaire which was prepared to assess breast cancer awareness and practice of self-breast examination. The tool was formulated based on the clinical experience of the investigator, consultation of experts, extensive library search and review of literature. The instrument for data collection was a self-structured, closed-ended questionnaire to suit the research objectives. The questionnaire consisted of three sections: sections A, B and C.

Section A

It consisted of demographic variables of students including six items such as age, marital status, religion, level of study, area of residence, source of information and previous knowledge regarding breast cancer.

Section B

It consisted of a self-structured questionnaire on breast cancer awareness. There were 20 awareness questions; each question had multiple choice with four responses (a, b, c and d). Each correct answer was given a score of one mark, whereas the wrong answer and unanswered score were zero. The maximum score was 20. The level of awareness score was interpreted as adequate, moderate and inadequate [Table 1].

Table 1: Level of awareness score.
Level of awareness Score Percentage
Adequate 15–20 ≥75
Moderate 10–14 ≥50 <75
Inadequate 0–9 ≤45

Section C

It consisted of a self-structured questionnaire on self-breast examination. There were ten practice questions, each question had multiple choice with four responses (a, b, c and d). Each correct answer was given a score of one mark, whereas the wrong answer and unanswered score were zero. The maximum score was 10. The level of practice score was interpreted as positive and negative [Table 2].

Table 2: Level of practice score.
Level of knowledge Score Percentage
Positive 5–10 ≥50
Negative 0–4 ≤40

Method of data collection

The data were collected from the respondents and were analysed using descriptive and inferential statistics with the aid of IBM Statistical Package for the Social Sciences version 20.0. Sample criteria were analysed by frequency and percentage distribution tables. The Chi-square test was used to find out the association between their level of awareness regarding breast cancer with their selected sociodemographic variable.

RESULTS

As shown in Table 3, the age range of participants is between 18 and 20 years, 21–23 years ≥24 years, which accounted for 18 (30.0%), 37 (61.7%) and 5 (8.3%), respectively. The majority, 56 (93.3%), are unmarried, 3 (5.0%) are married, whereas 1 (1.7%) is a widow. Fourteen (23.3%) are practising Christianity. Similarly, 46 (76.7%) are practising Islam. In terms of level of study, 100, 200, 300 and 400 all represent 15 (25%). According to the area of residence, 22 (36.7%) of the respondents are residing in rural areas, and the majority 38 (63.3%) are from urban areas. Fourty (66.7%) of the participants got their source of information through social media, 10 (16.7%) from family and friends, and 10 (16.7%) from health workers. Fourty-five (75%) of the respondents had previous awareness of breast cancer, whereas 15 (25.0%) had no previous awareness.

Table 3: Respondents sociodemographic variables (n=60).
S. No. Variable Frequency Percentage
1. Age
  18–20 18 30.0
  21–23 37 61.7
  24 and above 5 8.3
2. Marital status
  Unmarried 56 93.3
  Married 3 5.0
  Widow 1 1.7
3. Religion
  Christianity 14 23.3
  Islam 46 76.7
4. Level of study
  100 15 25.0
  200 15 25.0
  300 15 25.0
  400 15 25.0
5. Area of residence
  Rural 22 36.7
  Urban 38 63.3
6. Source of information
  Social media 40 66.7
  Family and friends 10 16.7
  Health workers 10 16.7
7. Previous awareness
  Yes 45 75.0
  No 15 25.0

As shown in Table 4, the majority, 38 (63.3%) had moderate, 17 (28.3%) had adequate and only 5 (8.3%) had an inadequate level of awareness regarding breast cancer.

Table 4: Respondents levels of awareness of breast cancer (n=60).
S. No. Level of awareness Score range Frequency Percentage
1. Inadequate 0–4 5 8.3
2. Moderate 50–60% 38 63.3
3. Adequate 70–100% 17 28.3

As revealed in Table 5, out of 60, (100%) respondents had a positive attitude toward self-breast examination.

Table 5: Respondents practice of self-breast examination (n=60).
S. No. Level of practice Score range (%) Frequency Percentage
1. Positive 50–100 60 100.0
2. Negative 0–40 0 0.0

As shown in Table 6, there was a statistically significant association between their levels of awareness regarding breast cancer with their selected sociodemographic variables, such as area of residence (urban) P = 0.001.

Table 6: Association between the levels of awareness of the respondents with their selected sociodemographic variables (n=60).
Sociodemographic variables Level of awareness Chi-square P-value
Adequate Moderate Inadequate
F % F % F %
Age
  18–20 years 4 6.7 12 20 2 3.3 2.34 0.670
  21–23 years 11 1.8 24 40 2 3.3
  ≥24 years 2 3.3 2 3.3 1 1.7
Marital status
  Unmarried 16 26.7 35 58 5 8.3 0.89 0.930
  Married 1 1.7 2 3.3 0 0.0
  Widow 0 0 1 1.7 0 0.0
Religion
  Christianity 4 6.7 8 13 2 3.3 0.89 0.640
  Islam 13 21.7 30 50 3 5
Area of residence
  Rural 12 20.0 12 20.0 2 3.3 13.1 0.001s
  Urban 4 6.7 28 46.7 2 3.3
Level of study
  100l 6 1.0 9 1.5 0 0.0 10.8 0.090
  200l 2 3.3 9 15 4 6.7
  300l 5 8.3 10 16.7 0 0.0
  400l 4 6.7 10 16.7 1 1.7
Previous knowledge
  Yes 12 2.0 29 48.0 4 6.7 0.28 0.870
  No 5 8.3 9 15 1 1.7

s: Statistically significant

DISCUSSION

Alsareii et al. conducted a study on Awareness of breast cancer among female students and faculty from Najran University, Najran, Saudi Arabia the study found a total of 232 students participated in the study. The study found that the majority (75.3%) of the students had good general awareness about breast cancer.[5]

Abo Al-Shiekh et al. conducted a study on breast cancer knowledge and the practice of BSE amongst female University students in Gaza. The findings showed that the majority (69.8%) of the students had a positive level of practice.[2]

In another study conducted by Idowu et al. conducted a study on Breast cancer awareness, knowledge and screening practices amongst women residents in an urban local government area of Oyo State, Nigeria. The findings showed that there was a significant association between their levels of awareness regarding breast cancer and with level of education, having tertiary education (P < 0.001), ever using family planning methods (P = 0.018), ever heard of breast cancer (P < 0.001), ever heard of breast examination (P < 0.001) and having relatives who had died with breast cancer (P = 0.018).[12]

The key findings of this study showed that the sociodemographic variables showed that the age range of participants is between 18 and 20 years, 21–23 years and ≥24 years, which accounted for 18 (30.0%), 37 (61.7%) and 5 (8.3%), respectively. The majority, 56 (93.3%), are unmarried, 3 (5.0%) are married, whereas 1 (1.7%) is a widow. Fourteen (23.3%) are practising Christianity. Similarly, 46 (76.7%) are practising Islam. In terms of the level of study, 100, 200, 300 and 400 all represent 15 (25%). According to the area of residence, 22 (36.7%) of the respondents are residing in rural areas, and the majority 38 (63.3%) are from urban areas. Fourty (66.7%) of the participants got their source of information through social media, 10 (16.7%) from family and friends, and 10 (16.7%) from health workers. Fourty-five (75%) of the respondents had previous awareness of breast cancer, whereas 15 (25.0%) had no previous awareness.

The results showed that, out of 60 (100%) respondents, the majority, 38 (63.3%), had moderate, 17 (28.3%) had adequate and only 5 (8.3%) had an inadequate level of awareness regarding breast cancer. Therefore, the H0:1 hypothesis was rejected, while the H1:1 hypothesis was accepted. This conforms with a study conducted by Lee et al. on Breast Cancer Awareness and Knowledge Assessment amongst Men and Women in Malaysia using a cross-sectional descriptive study. The study results revealed that the majority (76.5%) of the respondents have moderate awareness of breast cancer.[13]

The results revealed that, out of 60 (100%) respondents, all of them had positive practices towards the self-breast examination. Hence, the H0:2 hypothesis was rejected, whereas the H1:2 hypothesis was accepted. This conforms with a study conducted by Parle and Gupta, on breast cancer knowledge, attitude, and self-examination practices practices of physiotherapy students in India: A cross-sectional study. The study results revealed that the majority (62.6%) of the students had positive practice toward the self-breast examination.[14]

The results showed that there was a statistically significant association between their levels of awareness regarding breast cancer with their selected sociodemographic variables such as area of residence (urban) P < 0.001. Hence, the H0:3 hypothesis was rejected, whereas the H1:3 hypothesis was accepted. This conforms with a study conducted by Mohamed on Awareness and Knowledge towards Breast Cancer and BSE: A Cross-Sectional Descriptive Study amongst Undergraduate Female Students at Cairo University, Egypt; the study results showed that there was a statistically significant association between their place of residence with their levels of awareness regarding breast cancer (P = 0.001).[15]

CONCLUSION

The results revealed that the majority of the respondents had moderate awareness regarding breast cancer, and all had positive practices toward the self-breast examination. There was a statistically significant association between their levels of awareness regarding breast cancer with their selected sociodemographic variables such as area of residence (urban).

Recommendations

Based on the study findings, the researcher recommends that a similar study be conducted on awareness of breast cancer and self-breast examination using different settings and a large sample for generalisation of the findings.

Ethical approval

Approval has been obtained from Institutional Ethical Committee, Faculty of Sciences, Federal University, Birnin Kebbi, Kebbi, Nigeria. With Ref. No.: FS/FUBK/003, which was dated on 6th, Feb. 2023.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Conflicts of interest

There are no conflicts of interest.

Use of artificial intelligence (AI)-assisted technology for manuscript preparation

The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.

Financial support and sponsorship

Nil.

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