SELF-PERCEIVED RISK OF BREAST CANCER AND ACCEPTABILITY OF SCREENING AMONG WOMEN ATTENDING PERIPHERAL HEALTH CENTRES IN KOLAR – A CROSS-SECTIONAL STUDY

Abstract

Introduction: Among all cancers affecting women, breast cancer continues to be a leading cause of mortality on a global scale. Despite advancements in early detection and treatment, breast cancer continues to pose a significant public health challenge. Beyond the physical and emotional toll on patients, breast cancer contributes to substantial economic loss at both the household and national levels. Families often face financial strain, reduced productivity, and long-term psychological distress. The lack of awareness of disease per se, its risk factors and warning signs, stigma and embarrassment around it contribute to incorrect estimation of the risk of getting the disease and cause a delay in timely presentation to healthcare centres. Self-breast examination (SBE) is the most cost-effective screening tool for early detection and diagnosis of breast cancer, especially in low-resource settings. Awareness of breast health is essential for recognising significant changes in one’s breasts and seeking timely medical attention for the same. Objectives: Among women attending peripheral health centres in Kolar, i. To assess the self-perceived risk of breast cancer and its association with sociodemographic factors. ii. To assess the knowledge and perception of risk factors and warning signs of breast cancer and its association with sociodemographic factors. iii. To assess the knowledge and practice of self-breast examination (SBE) as a screening test for the early detection and diagnosis of breast cancer and its association with sociodemographic factors. 2 Materials and methods: A Cross-Sectional Survey was conducted from July 2023 to December 2024 in the Outpatient departments of the Rural Health Training Centre (RHTC), Devarayasamudra, Mulbagal, and the Urban Health Training Centre (UHTC), Gandhinagar, Kolar, of the field practice area of the Department of Community Medicine, Sri Devaraj Urs Medical College, Tamaka, Kolar. All women aged 18 years and above who availed themselves of the OPD services at RHTC/UHTC in the field practice area of the Department of Community Medicine, SDUMC, Kolar, were invited to participate in the study. The study excluded women presenting to the outpatient department (OPD) under emergency conditions (road traffic accidents or altered consciousness), as well as those with a pre-existing diagnosis of breast cancer and women who were pregnant or lactating. A minimum sample size of 350 participants was determined based on calculations derived from a prior study conducted by Pooja et al.1 Expecting 400 women in each health centre per month, a sample of 175 women above 18 years satisfying inclusive and exclusive criteria in each centre was selected using systematic random sampling with a sampling interval of 3 (800/350=2.28). Results: 64% of the total participants have heard about breast cancer, and 50 % of the participants said social media was the source of information. Self-perceived risk of breast cancer is 54%, and is significantly associated with age, residence, education, occupation, and socio-economic status of the participants. Overall perception of risk factors and warning signs of breast cancer is 45% and 23% respectively, and is significantly associated with residence, education and socio-economic status of the participants. Out of the total participants, only 42% were aware of the national program for breast cancer (NP-NCD). Among 350 participants, 22.5% 3 performed SBE, out of which 16% accepted it as a screening method for the early detection and diagnosis of breast cancer, practised it regularly, and it was significantly associated with the participants' residence, education, occupation, and socio-economic status. Conclusion: The study highlights the alarming prevalence of limited awareness regarding breast cancer, including its predisposing factors and warning signs, and the significantly low practice of breast self-examination (SBE) among women. Contributing factors include low literacy levels, poor economic conditions, lack of motivation, and the stigma surrounding the disease. Implementing routine breast health programs monitored by healthcare professionals in schools, colleges, workplaces, and health centres could greatly benefit women and improve timely detection efforts