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

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.

MATERIALS AND METHODS

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.

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.

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

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.

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 H_0:1 hypothesis was rejected, while the H_1:1 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 H_0:2 hypothesis was rejected, whereas the H_1:2 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 H_1:3 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).