AWARENESS OF BREAST CANCER RISK FACTORS AMONG FINAL-YEAR
RADIOGRAPHY STUDENTS IN NORTHERN NIGERIA

doi:10.21203/rs.3.rs-4986850/v1

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AWARENESS OF BREAST CANCER RISK FACTORS AMONG FINAL-YEAR RADIOGRAPHY STUDENTS IN NORTHERN NIGERIA

https://doi.org/10.21203/rs.3.rs-4986850/v1

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Breast carcinoma is the leading cause of death among women aged 30 and above, significantly reducing life expectancy, particularly for those between 31 and 50 years old. The incidence of breast cancer is rapidly increasing in population groups that previously had low rates of the disease. A major concern is that most patients present late to the hospital, primarily due to inadequate knowledge of breast cancer among the general population. Therefore, it is crucial to assess the level of awareness and knowledge of breast cancer risk factors. This study aimed to evaluate the awareness of breast cancer risk factors among final-year Radiography students in Northern Nigeria. A cross-sectional survey was conducted among students from three universities in Northern Nigeria, using self-administered questionnaires. Of the respondents, 158 (96.3%) had heard of breast cancer, with 69 (42.1%) citing lectures as their primary source of information. However, overall knowledge of breast cancer risk factors was found to be low. In conclusion, while the majority of respondents were aware of breast cancer, their knowledge and understanding of the disease and its risk factors were notably deficient.

Nuclear Medicine & Medical Imaging

Oncology

breast cancer

risk factor

awareness

women

Northern Nigeria

Breast cancer remains one of the most significant global health challenges, affecting millions of women worldwide (WHO,2018; Heer et al,2020). In 2020 alone, 2.3 million women were diagnosed with breast cancer, resulting in 685,000 deaths globally (IAEA, 2022). This disease not only claims lives but also contributes substantially to the global burden of disease. By the end of 2020, an estimated 7.8 million women who had been diagnosed with breast cancer within the past five years were still alive, underscoring its status as the world’s most prevalent cancer (IAEA, 2022).

The impact of breast cancer extends far beyond mortality rates. It is responsible for the highest number of disability-adjusted life years (DALYs) lost among women worldwide when compared to other types of cancer (IAEA, 2022). DALYs reflect the total number of years lost due to ill-health, disability, or premature death, highlighting the profound and long-lasting effects of breast cancer on women’s health and quality of life(IAEA, 2022).. The incidence of breast cancer occurs universally, affecting women in every country and at any age after puberty, with the likelihood of developing the disease increasing significantly with age (IAEA, 2022).

In Nigeria, the burden of breast cancer is particularly severe. The disease is the most prevalent malignancy among women, accounting for 22.7% of all new cancer cases in the country (Omolara et al., 2022). Nigeria also bears the highest breast cancer mortality rate globally, with 12,000 deaths reported in 2018 alone (Eferakorho., 2024). This high mortality rate is indicative of significant challenges within the healthcare system, including issues related to early detection, accessibility to treatment, and overall awareness of the disease.

Early detection of breast cancer plays a crucial role in reducing its morbidity and mortality, particularly among young women, where the disease is associated with significantly higher mortality rates (Kalander et al., 2014). Studies have shown that young university females in 23 countries demonstrate poor knowledge of breast cancer risk factors compared to older women. This highlights the need to focus on young females (15-35 years), as this age group faces both a higher risk of mortality from aggressive breast cancer and stands to gain the most from early detection interventions, such as breast self-examination.

Given the increasing incidence and substantial mortality associated with breast cancer, particularly in low- and middle-income countries like Nigeria, this research aims to evaluate the awareness levels of final-year radiography students about breast cancer risk factors. The study also seeks to assess the perceptions of these students in Northern Nigeria regarding breast cancer risk factors and identify barriers to awareness. The findings are intended to inform strategies to reduce the impact of breast cancer on women’s health in the region.

The study was conducted at three universities in Northern Nigeria that offer Medical Radiography programs: the University of Maiduguri, Bayero University Kano, and Usman Danfodio University Sokoto. A prospective cross-sectional research design was employed for this study. A total of 175 respondents were recruited, with the sample size distributed proportionally across the three universities based on their respective student populations. Specifically, there were 140 students from the University of Maiduguri, 42 from Bayero University Kano, and 36 from Usman Danfodio University Sokoto, resulting in a rationalized distribution ratio of 3:1:1.

Data for the study was collected using self-administered questionnaires, which were divided into three sections: A, B, and C. Section A captured the demographic characteristics of the respondents, Section B assessed their awareness of breast cancer risk factors, and Section C explored the barriers to awareness. The questions were entirely close-ended, with multiple-choice options and checklists, and included a free-response option for answers not covered in the checklist.

Data analysis was performed using Microsoft Excel 2013, and descriptive statistics were generated to summarize the findings. Ethical clearance for the study was obtained from the Research and Ethics Committee of the Department of Medical Radiography at the University of Maiduguri.

The age of the respondents ranged from 18 years to 39 years with the mean age group of 25-31 years and the modal age group was 25-31 years. Fifty respondents range between 18-24 (30.5%), eighty nine respondents range between 25-31 (54.3%), twenty four respondents range between 3238 (16.6%) and one respondent ranges between 39 and above (0.6%). One hundred and nine (66.5%) respondents were male and fifty five (33.5%) were female. Ninety one (55.5%) respondents were single, fifty nine respondents were married (36%), ten (6.1%) respondents were divorced and four (2.4%) respondents were widow. One hundred and two (62.2%) responded from University of Maiduguri, thirty four (20.7%) responded from Bayero University Kano and twenty eight (17.1%) responded from Usmanu DanFodio University Sokoto. (See Table 1)

Table 1: Demographic Characteristics of The Respondents

AGE
Age Groups (Years)	Frequency	Percentage
18 - 24	50	30.5
25 – 31	89	54.3
32 – 38	24	14.6
39 – above	1	0.6
TOTAL	164	100

SEX
Sex	Frequency	Percentage
Male	109	66.5
Female	55	33.5
TOTAL	164	100
MARITAL STATUS
Marital Status	Frequency	Percentage
Single	91	55.5
Married	59	36
Divorced	10	6.1
widow	4	2.4
TOTAL	164	100

INSTITUTION
Institution	Frequency	Percentage
Bayero University Kano	34	20.7
University of Maiduguri	102	62.2
Usmanu Danfodio University, Sokoto	28	17.1
TOTAL	164	100

Table 2.0: Respondents’ knowledge of breast cancer

Have you ever heard of breast cancer?
Institution	Frequency	Percentage
Yes	158	96.3
No	6	3.7
TOTAL	164	100

Table 2.0: The above show that 96.3% of the respondents heard about breast cancer while 3.7% of the respondents don’t know.

What was your source of information about breast cancer?
Institution	Frequency	Percentage
During lectures	69	42.1
Through electronic media/ awareness campaign	58	35.4
Has seen a victim during clinical postings	31	18.9
I was a victim	6	3.7
TOTAL	164	100

Table 2.1: The above table shows that 42.1% of the respondents heard about breast cancer during lectures, 35.4% through the electronic media/awareness campaign, 18.9% have seen a victim while 3.7% were victims.

Did your institution ever organized a breast cancer awareness campaign?
Institution	Frequency	Percentage
Yes	72	43.9
No	92	561
TOTAL	164	100

Table 2.2: The above show that 43.9% of the respondents’ Institutions had breast cancer awareness campaign while 56.1% of the respondents’ institutions did not.

Did you ever participate in awareness of breast cancer risk factor?
Institution	Frequency	Percentage
Yes	59	36
No	105	64
TOTAL	164	100

Table 2.3: The above show that only 36%% of the respondents Institutions participated in awareness of breast cancer risk factor while 64% of the respondents did not.

Table 3.0: Respondents’ knowledge of breast cancer risk factors

Being a female could increase the risk of breast cancer?
Institution	Frequency	Percentage
Strongly agreed	54	32.9
Agreed	76	46.3
Neutral	16	9.8
Disagree	15	9.1
Strongly disagreed	3	1.8
TOTAL	164	100

The above show 32.9% for Strongly agreed, 46.3% for agreed, 9.8% for Neutral, 9.1% for disagree and 64% for strongly disagreed.

Table 3.1: Respondents’ knowledge of breast cancer risk factors

The risk of breast cancer increases with age.
Institution	Frequency	Percentage
Strongly agreed	55	33.5
Agreed	81	49.4
Neutral	14	8.5
Disagree	10	6.1
Strongly disagreed	4	2.4
TOTAL	164	100

The above table shows 33.5% for Strongly agreed, 49.4% for agreed, 8.5% for Neutral, 6.1% for disagree and 2.4% for strongly disagreed.

Table 3.2: Respondents’ knowledge of breast cancer risk factors

Family history of breast cancer is a strong risk factor?
Institution	Frequency	Percentage
Strongly agreed	68	41.5
Agreed	79	48.2
Neutral	12	7.3
Disagree	4	2.4
Strongly disagreed	1	0.6
TOTAL	164	100

The above table shows 41.5% for Strongly agreed, 48.2% for agreed, 7.3% for Neutral, 2.4% for disagree and 0.6% for strongly disagreed.

Table 3.3: Respondents’ knowledge of breast cancer risk factors

Nulli parous women have higher chances of developing breast cancer.
Institution	Frequency	Percentage
Strongly agreed	44	26.8
Agreed	74	45.1
Neutral	34	20.7
Disagree	12	7.3
Strongly disagreed	0	0
TOTAL	164	100

The above table shows 26.8% for Strongly agreed, 45.1% for agreed, 20.7% for Neutral, 7.3% for disagree and 0% for strongly disagreed.

Table 3.4: Respondents’ knowledge of breast cancer risk factors

Obesity increases the chances of developing breast cancer.
Institution	Frequency	Percentage
Strongly agreed	40	24.4
Agreed	72	43.9
Neutral	37	22.6
Disagree	14	8.5
Strongly disagreed	1	0.6
TOTAL	164	100

The above show 24.4% for Strongly agreed, 43.9% for agreed, 22.26% for Neutral, 8.5% for disagree and 0.6% for strongly disagreed.

Table 3.5: Respondents’ knowledge of breast cancer risk factors

Life style affects the chances of developing breast cancer.
Institution	Frequency	Percentage
Strongly agreed	53	24.4
Agreed	83	43.9
Neutral	17	22.6
Disagree	9	8.5
Strongly disagreed	2	1.2
TOTAL	164	100

The above table shows 24.2% for Strongly agreed, 43.9% for agreed, 22.6% for Neutral, 8.5% for disagree and 1.2% for strongly disagreed.

Table 3.6: Respondents’ knowledge of breast cancer risk factors

Faith and religious belief affects the chances of developing breast cancer.
Institution	Frequency	Percentage
Strongly agreed	34	20.7
Agreed	69	42.1
Neutral	16	9.8
Disagree	29	17.7
Strongly disagreed	16	9.8
TOTAL	164	100

The above table shows 20.7% for Strongly agreed, 42.1% for agreed, 9.8% for Neutral, 17.7% for disagree and 9.8% for strongly disagreed.

Table 3.7: Respondents’ knowledge of breast cancer risk factors

Economic status affects the chances of developing breast cancer.
Institution	Frequency	Percentage
Strongly agreed	46	28
Agreed	73	44.5
Neutral	14	8.5
Disagree	24	14.6
Strongly disagreed	46	28
TOTAL	164	100

The above show 28% for Strongly agreed, 44.5% for agreed, 8.5% for Neutral, 14.6% for disagree and 28% for strongly disagreed.

The age of the respondents ranged from 16 to 28 years, with the mean and modal age group being 25 to 31 years. This age distribution is consistent with the findings of Garba et al. (2022).

Most of the respondents (96.3%) in this survey were aware of breast cancer. Similar findings have been reported in studies conducted in other regions of Nigeria, where a high level of awareness of breast cancer as a disease entity was observed (Nnebue et al., 2018; Zaher et al., 2024).

The high level of breast cancer awareness among the respondents can be attributed to several factors. Firstly, the majority of the respondents are students in tertiary institutions, where they have access to educational resources and exposure to health-related information. Additionally, the proliferation of social media and digital platforms has made it easier for young people to access and share information about health issues, including breast cancer. Public health campaigns, both within educational institutions and in the wider community, may also have played a significant role in raising awareness. Furthermore, the increasing focus on women's health and cancer prevention in public discourse may have contributed to the heightened awareness observed in this study.

Based on the results of this study, it is recommended that culturally specific and sensitive health education programs be developed to address the risk factors associated with breast cancer. These programs should aim to enlighten women about these risks and emphasize the importance of breast self-examination as a crucial tool for the early detection of breast cancer. By tailoring the educational content to resonate with the cultural beliefs and practices of the target population, these initiatives can more effectively promote awareness and encourage proactive health behaviors among women.

Early presentation of breast cancer to a hospital not only increases the chances of survival and improves prognosis (Obajim et al., 2015), but it can also lead to a potential cure of the disease. However, many patients hold the belief that as long as pain is absent during the course of an illness, there is no cause for concern. This misconception can delay seeking medical attention.

Knowledge of breast cancer risk factors is crucial in ensuring that women present early at healthcare facilities for diagnosis and treatment. The findings of this study, in which more than half of the respondents demonstrated good knowledge scores regarding breast cancer risk factors, underscore the importance of educating women about these risks. By enhancing awareness and understanding, it is possible to encourage early medical intervention, thereby improving outcomes for those at risk of breast cancer.

In conclusion, the majority of final-year undergraduate radiography students at BUK, UNIMAID, and UDUS, ABU, are aware of breast cancer as a disease and its associated risk factors. However, to further enhance their understanding and preparedness, it is recommended that the curricula for medical radiography training be updated to include a dedicated course on cancer. This addition would ensure that radiographers are better informed about cancer risk factors, enabling them to play a more proactive role in early detection and patient education.

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The authors declare no competing interests.

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AWARENESS OF BREAST CANCER RISK FACTORS AMONG FINAL-YEAR RADIOGRAPHY STUDENTS IN NORTHERN NIGERIA

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