Breast cancer is said to be the commonest cancer and the most lethal malignancy in women across the world. Most of the cases are brought late to the hospital when the conditions are severe with multiple nodal involvements and poorer clinical pathological prognostic outcome. If braest changes are detected early and treatment commenced early enough, the survival rate of breast cancer wii be increased. The purpose of this study was to investigate the breast cancer awareness and practice of Breast Self-Examination (BSE) among women in Umuowa Orlu L.G.A. of Imo State. The research design for the study was descriptive survey. Umuowa was purposively selected for the study. Proportionate sampling method was used to draw three hundred and forty nine (349) women in the ten villages in Umuowa. Systematic sampling technique was used to the reach the respondents in the villages. A validated questionnaire which served as an interview schedule was used for data collection. Data derived from the questionnaire were analyzed descriptively using frequencies and percentages. Chi Square and Spearman’s Rank analysis were used to test for relationships between demographic data, breast cancer awareness and practice of BSE. The study revealed that the awareness of breast cancer and BSE among the women were low. The major source of information was healthcare providers. Majority of the women had inadequate practice of BSE despite the fact that a little above half (51.95) practiced BSE. Age, educational attainment and parity were associated with the practice of BSE. This implied that with increase in age and parity, the practice of BSE reduced while it increased with educational attainment. There were negative relationships between age, parity and awareness of BSE. This implied that BSE awareness increased as age and parity reduced. A positive relationship was established between BSE awareness and educational attainment. Findings further revealed that there is a positive relationship between breast cancer awareness and practice of BSE. Based on these findings, it was recommended that healthcare providers should embark on directed and focused health education awareness campaign to enhance the awareness of breast cancer. The importance of BSE as a key factor in the early detection of breast cancer should be stressed with special emphasis on regular practice of BSE and the proper steps of BSE.
Background to the study
Breast cancer is the commonest cancer as it continues to remain the most lethal malignancy in women across the world (Doshi, Reddy, Karunakar & Kulkarani, 2012). It constitutes a major public health issue globally with over one million new cases diagnosed annually, resulting in over 400,000 annual deaths and about 4.4 million women living with the disease (Globocan, 2008; Ganiy and Ganiyu, 2012). Breast cancer is the leading cancer among women but it can also appear in men (Tara, Agrawal & Agrawal, 2008). Although breast cancer is 100 times more common in women than in men, although men tend to have poorer outcomes due to delay in diagnosis (Fasoranti, 2010).
Although breast cancer incidence rates are higher in industrialized countries, recent trends show that the largest increase in risk is occurring in developing countries. There is thus a geographical variation in the incidence of breast cancer with higher incidence in Europe and America compared to Asia and Africa (Otunne, 2008). According to Beiki, Hall, Ekbom and Moradi (2012), the incidence ranks highest in high income countries, with the exception of Japan. In Canada, for example, 19,000 new cases are diagnosed each year and 5, 300 Canadian women die from the diseases annually.
Breast cancer is now the commonest cancer affecting women in Nigeria. In Nigeria, the number of women at risk of breast cancer increased steadily from approximately 24.5 million in 1990 to approximately 40 million in 2010 and is projected to rise to over 50 million by 2020 (Akarolo- Anthony, Ogundiran & Adebamowo, 2010). Statistics from the Ministry of Health Nigeria showed that breast cancer had risen at least four times over the decade and accounted for 40 percent of women cancers (Onyebuchi, 2012). In the present scenario, roughly 1 in 26 women are expected to be diagnosed with breast cancer in their life time, majority of cases occurring in pre-menopausal women (Dosh et al, 2010).
According to Salaudeen, Akande and Musa (2009) studies from various ethnic populations have reported the demographic profile of breast cancer especially from the Western and Northern parts of the country. A review of breast biopsies in the Lagos University Teaching Hospital showed 34 percent of all breast biopsies done over a 10-year period to be malignant. They also asserted that a report from Zaria described the mean age of presentation of breast cancer as 42 years with 30 percent occurring in women less than 25 years of age. Furthermore, at University College Hospital, Ibadan, 74 percent of breast cancer patients were pre-menopausal. A ten year review of breast cancer in Eastern Nigeria revealed that patients with breast cancer constituted 30 percent of all patients with breast disease and that 69 percent of these patients were pre-menopausal (Oluwatosin, 2010).
More so, majority of women present with advanced stages of the disease at which time little or no benefits is derived from any form of therapy. The 5- year survival rate of breast cancer is over 85% with early detection whereas later detection decreased the survival rate to 56% (Dosh et al, 2010; Fasoranti, 2010). The low survival rates of breast cancer in less developed countries can be attributed to lack of early detection as well as inadequate diagnosis and treatment facilities. Oluwatosin (2012) asserted that late presentation of breast cancer patients suggests that women in Nigeria have poor knowledge of the disease. Chiejina (2011) also noted that what is more worrisome in a country like Nigeria with over 140 million people is that the detection of the disease is usually late. For women to present early, they need to be “Breast aware” and must be able to recognize symptoms of breast cancer through routine practice. Late presentation of patients at advanced stages is thus the cause of breast cancer death in Nigerian women, as 80 percent of breast cancer patients in Nigeria are said to die because of late detection (Otunne, 2008)