ASSESSING WOMEN’S KNOWLEDGE OF BREAST CANCER AND PRACTICE ON BREAST SELF-EXAMINATION IN BUEA TOWN COMMUNITY, SOUTH WEST REGION, CAMEROON.

ABSTRACT

Breast cancer is the most common female malignancy and commonly associated with high levels of morbidity and mortality in developing countries due to late presentation. Statistic indicates that 15000 new cases of cancer are diagnosed annually and a prevalence of about 25000 cases throughout the country, cancer is being recognized as a public health problem in Cameroon. Breast self‑examination (BSE) can help in early detection of the disease. The objective of this study was to Assess women’s knowledge of breast cancer and practice on breast self-examination in Buea town community. In order, to achieved the objectives of the study, a non-probability sampling technique called simple random sampling was employed to sampled 40 participants of age 18-40years in Bokwango locality in Buea. Data was analysed using SPSS (21.0), descriptive statics and hypothesis was done. Findings of the study revealed, the mean age of the women was 25±1.1years. majority of the females were married (42.5%), and most have attended a secondary level of education (45.0%). With regards to the obstetric characteristics of the females, 47.4% of them have been pregnant once in their life time while 47.4% have 3-4 children. This study therefore reveals that most participants have heard of breast cancer as a disease entity; however, adequate knowledge and understanding of the disease is still lacking. Furthermore, the awareness of cancer and knowledge of BSE was high, but however, the practice of BSE and other methods of early detection of breast cancer among women in Buea is very much on the low side. Thus it was recommended that, Improvement in the knowledge and practice rates of BSE would allow the detection of breast cancer at an early stage which could consequently lower mortality rates.

Keywords: Breast self-examination, cancer, knowledge, women

CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

Breast cancer is one of the leading causes of cancer mobility and mortality worldwide (Forman, 2010). It is a worldwide problem linked with high level of mobility and mortality especially in developing countries due to delayed presentation. Breast cancer affects more than one million females annually; the incidence increases the adaptation of western lifestyle (int j cancer, 2012). Breast cancer is the most common form of cancer affecting women in Africa. About one in every 19 women of these African countries is at risk, compared to one in eight in Europe and the United States (MOS, 2012). It accounts for 30.4% of newly diagnosed cancer and it is second most common cancer in Africa. Women of about 20years and above of aged are often at risk of breast lump and Rates of breast cancer are low under 40 and the rates begin to increase after 40years and the highest age at risk is from 50-60 years and above so therefore there is need for monthly Breast Self-examination (BSE) (Kocic et al., 2011). Lack of public awareness of breast cancer and screening in the environment and the absence of organized screening programs and also lack of accessible and affective treatments options and most importantly cultural believes predispose women in Africa to late detection and presentation of breast cancer. Early detection involves two major components which are: Education to encourage early diagnosis and screening. A wide range of modern procedures include mammography, sonography, and magnetic resonance imaging of the breast. Breast self-examination and clinical examination are other methods that can be used to detect any changes in the breast. Breast self-examination involves the woman self-looking at and feeling the breast for lumps, texture, shape, size and contours. (Marcia Boraas et al, 2019) The purpose of this is for any women to be taught the topography of her breast, know how her normal breast feel like and be able to identify changes in them should they occur in the future. It has been reported that the sensitivity and specificity of breast self-examination are low but it has positive effects on the early detection of breast cancer.

In Cameroon breast cancer causes as many as 10.7 deaths per 100,000 women making it the second cause of cancer mortality. (Asoh, 2012) Better documentation of women’s knowledge and practice on breast cancer and breast self-examination would be useful in the design of interventions aimed at preventing breast cancer. The study sought to describe the knowledge of women in Buea Town on breast self-examination to access the impression on the practice of breast self-examination and the awareness of breast cancer and to describe their perception on the causes risk factors and prevention of breast cancer. Moreover, women’s knowledge and proficiency in the area of BSE are limited in developed countries and particularly in developing ones Bray, 2008. Barriers to women’s regular BSE are their fear, anxiety, as well as lack of knowledge about the importance of regular BSE and the accurate method for doing it (Ferly, 2008). several researchers have identified factors that interfere with breast cancer screening practices. These studies have shown that the factors that interfere with breast cancer screening practices are: fear, perceived susceptibility, perceived barriers, forgetfulness, lack of knowledge, forgetfulness and lack of confidence by women to carry out their own breast self-examination (Banegas, 2001). Previous studies on breast self-examination have shown that improving public knowledge and attitude about cancer can positively affect “individuals” screening behaviors (Cochrane, 2003). One way for improving women’s BSE knowledge, attitude, and practice is education. Education not only enhances people’s knowledge, but also can play a vital role in improving their attitude and practice.

Nurses have a unique opportunity to increase knowledge, correct misperceptions, and reduce fears related to breast cancer (Powe, 2005). Investigations have shown that nursing textbooks focus little attention on these psychological aspects and they are not included in nursing educational programs (Powe, 2005). According to (Powe, 2005), nurses do not teach detection of breast cancer, perhaps because the breast promotion content is not part of the educational program or perhaps due to the lack of emphasis on the breast health promotion content.

Breast self-examination is a simple, very low cost, noninvasive with no special material/tool requirements; and it is an effective diagnostic method for breast cancer which takes only five minutes to apply (Yurugen, 2010). Its purpose is twofold: to make women familiar with both the appearance and the feel of their breasts and to help women detects any changes in their breast as early as possible. There is evidence that women who correctly practice BSE monthly are more likely to detect a lump in the early stage of its development, and early diagnosis has been reported to influence early treatment and to yield a better survival rate (American cancer society, 2002). Unfortunately, despite the benefits of regular BSE, few women actually examine themselves; in fact, a majority does not even know how to do a BSE (Al-Abadi, 2001). It is important to adequately motivate women to regularly carry out BSE so as to curtail the increasing mortality rate from breast cancer (Hacshaw, 2003). In fact, regular BSE has been suggested as part of overall health promotion concept. The practice of BSE can help women to know the structure and composition of their normal breast thereby enhancing their sensitivity to detect any abnormality at the earliest time (Larkin, 2001). Thus this study was conducted to assess the knowledge of women of Buea town community on breast cancer, the practice of breast self-examination and to describe the perception, risk factors and the signs and symptoms of breast cancer.

 

1.2 STATEMENT OF PROBLEM

Due to the hazardous effects of breast cancer which has impact on health, economic and social aspect of life, breast cancer is a call for concern worldwide. Studies have shown that, one of the ways to avoid this problem is through breast self-examination where early diagnosis can lead to proper management therefore the earlier cancer is detected, the better the chances for treatment and survival. Statistic indicates that 15000 new cases of cancer are diagnosed annually and a prevalence of about 25000 cases throughout the country, cancer is being recognized as a public health problem in Cameroon (Orock et al., 2012). It seems there is under sensitization as to the benefits of BSE. The cause of breast cancer remains unknown and thus the disease cannot be prevented. Approximately 90% of breast cancer is curable if treated in its early stages. Detection of breast cancer at an early stage improves treatment options, specific opportunities for treatment, and survival. Considering the eminent danger and possibilities of lack of knowledge especially in remote communities, this study deems it necessary to investigate the knowledge and practice of BSE by female aged 18-40 in Buea town community.

 

1.3 JUSTIFICATION

As a student nurse and a member of Buea Town community, during my community health practice, I noticed that most women lack adequate knowledge of breast self-examination due to the frequent incidence of women with breast lump who visited the hospital. So this prompted me to carry out research on breast self-examination so as to know if they are aware of disease condition that affect the breast especially breast cancer and to also assess their knowledge as far as breast self-examination is concern.

 

1.4 RESEARCH GOAL

The aim or goal of this study is to improve early diagnosis and management of breast cancer

 

1.5 RESEARCH OBJECTIVES

1.5.1 GENERAL OBJECTIVE

To assess women’s knowledge and practices of breast self-examination in Buea town community

 

1.5.2 SPECIFIC OBJECTIVES

• To assess the knowledge of females in Buea town community on breast cancer.
• To access the knowledge on breast self-examination
• To examine the practice of breast self-examination

 

1.6 RESEARCH QUESTION

• Do females in Buea town community have knowledge on breast cancer? ­­­­­­
• What do females in Buea town community know about BSE?
• What are the practices of females in Buea town community with respect to breast self-examination?

 

1.7 RESEARCH HYPOTHESIS

• There is a significant level of knowledge and practice of self-examination by females in Buea town community

1.8 RESEARCH SCOPE

The scope of this study would be limited in assessing women’s knowledge and practices of breast self-examination in Buea town community from age 18years.

 

1.9 DEFINITIONS OF TERMS

For the purpose of this study, the key terms have been defined as follows:

• Nursing; nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recovery optimal health and quality of life (weber, janet,2014)
• Female: a female according to this study is a woman 18-40 years of age.
• Breast cancer: a malignant disease characterized by uncontrolled growth and spread of abnormal cells of the breast tissue (Phipps, Monahan et al., 2011).
• Breast cancer screening procedures: these include breast self-examination clinical breast examination, and mammography (ACS, 2011).
• Breast self-examination (BSE): performed by the woman herself doing inspection and palpation of her own breast tissue (ACS, 2011).
• Clinical breast examination (CBE): breast exam performed by a health care provider (doctor or nurse) using the inspection and palpation techniques (ACS, 2011).
• Environment: defined as all external conditions to the individual that affect behavior (Bandura, 1997). In this study, environment is identified as the breast cancer and breast-self-examination content provided by the associate degree nursing program.
• Knowledge in breast cancer: information obtained through education or experience on breast anatomy and physiology, pathology of common breast tumors, breast cancer risks, symptoms of breast cancer, and benefits of breast cancer screening in breast cancer early detection (Phipps et al., 2011). Student breast cancer knowledge was measured using a questionnaire
• Practice: commitment to regular procedures or breast cancer screening. Procedural knowledge: knowledge of how to do something, methods of inquiry, and criteria using skills, algorithms, techniques, and methods (Duan, 2006).
• Self-confidence: a significant predictor of individual performance developed and supported by the self-efficacy sources (mastery experiences, role modeling, and verbal persuasion (Bandura, 1997).