Description
ABSTRACT
In a developing and low- or middle-income countries like Nigeria, women present with advanced breast cancer at an earlier age. Given the limited resources, development of screening programs that parallel resource capabilities of low- and middle-income countries is imperative. The objective of this study was to evaluate the prevalence, practices, and knowledge regarding clinical breast examination (CBE) screening in five hospitals in Nigeria. A cross-sectional survey of women age 40 years or older in Ife, Nigeria, using multistaged sampling was performed. Information on sociodemographics, knowledge of breast cancer, screening practices, and willingness to participate in CBE screening was obtained using an interviewer-administered questionnaire. A total of 1,169 women whose ages ranged from 40 to 86 years (mean age, 47.7 years; standard deviation, 8.79 years) were interviewed. The majority of women (94%) knew about breast cancer, whereas 27.5% knew someone who had had breast cancer, the majority of whom (64.5%) had died of the disease. Of the 36% of women who had breast screening recommended to them, only 19.7% had an actual CBE. Of these, only 6% had it in the last year. The majority of women (65.4%) were willing to have regular CBEs and did not care about the sex of the examiner in most instances. Lack of perceived need was the reason cited by women unwilling to participate. The majority of women were aware of breast cancer and knew it as a fatal disease. With the relatively encouraging number of those willing to be examined, a carefully designed CBE program coupled with advocacy to correct uneducated beliefs seems promising.
TABLE OF CONTENTS
COVER PAGE
TITLE PAGE
APPROVAL PAGE
DEDICATION
ACKNOWLEDGEMENT
ABSTRACT
CHAPTER ONE
1.0 INTRODUCTION
1.1 BACKGROUND OF THE PROJECT
- PROBLEM STATEMENT
- AIM AND OBJECTIVE OF THE STUDY
- RESEARCH QUESTION
- SIGNIFICANCE OF THE STUDY
- LIMITATION / SCOPE OF THE STUDY
- DEFINITION OF TERMS
CHAPTER TWO
LITERATURE REVIEW
- REVIEW OF STUDY
- OVERVIEW OF CANCER
- CANCER IN WOMEN
CHAPTER THREE
3.0 METHODOLOGY
- STUDY AREA
- STUDY POPULATION
- INSTRUMENT
- STATISTICAL ANALYSIS
- ETHICAL APPROVAL
CHAPTER FOUR
4.1 RESULT AND DISCUSSION
CHAPTER FIVE
- CONCLUSION
- RECOMMENDATION
REFERENCES
CHAPTER ONE
1.0 INTRODUCTION
1.1 BACKGROUND OF THE STUDY
Top of Form
Bottom of Form
Breast cancer is a common cause of cancer-related deaths in most developing countries. With most patients presenting in advanced stages (Adesunkanmi et al., 2016), it is not surprising that it is one of the most common causes of cancer mortality (Akinde et al., 2016). Studies have shown a steady increase in the incidence of breast cancer in Nigeria from 15.3 per 100,000 in 1976 to 33.6 per 100,000 in 1992 to 52.1 per 100,000 in 2012 (Adebamowo et al., 2019).
In developed countries, however, mortality from breast cancer has been on the decline despite the higher incidence of breast cancer (Adebamowo et al., 2019). This is a result of early detection through organized screening programs and effective treatment modalities. In the United States, women with an average risk of breast cancer are recommended to undergo annual screening mammography starting at age 45 years and continuing up to age 54 years, after which they can transit to screening every 2 years or continue screening annually. It is also recommended that women between 40 and 44 years of age should have the opportunity to begin annual screening (Adebamowo et al., 2019). However, the applicability of mammography-based screening programs is limited in low- and middle-income countries because of the challenges of poor infrastructure, poverty, and inadequate manpower. Waiting until such capabilities are developed, however, will lead to continued loss of life as a result of late presentation.
Therefore, clinical breast examination (CBE) has been recommended as a screening modality that may find usefulness in resource-poor settings while efforts are underway to attain the status of international best practices. Studies of programs in Africa and India (Mittra et al., 2010) provide a strong rationale for this assertion. The successes of these programs demonstrate the acceptability and feasibility for resource-limited countries to develop formal programs at various levels of health care delivery that use CBE for screening either solely (where mammography is unavailable) or to complement mammography (where it is in short supply). However, this should be done cautiously, given previous experiences where most participants failed to comply with the screening recommendations after commencement of the program. (Mittra et al., 2010)As a first step in developing such a program, it is imperative to understand the peculiarities of the target community to conduct a successful, socially acceptable, and sustainable program. This study, conducted in a southwestern Nigerian community, set out to determine the perceptions, practices, and possible barriers of CBE-based screening program in a low-resource setting.
1.2 PROBLEM STATEMENT
According to World Health Organization (2021), in 2020, there were 2.3 million women diagnosed with breast cancer and 685 000 deaths globally. As of the end of 2020, there were 7.8 million women alive who were diagnosed with breast cancer in the past 5 years, making it the world’s most prevalent cancer. There are more lost disability-adjusted life years (DALYs) by women to breast cancer globally than any other type of cancer. Breast cancer occurs in every country of the world in women at any age after puberty but with increasing rates in later life.
Breast cancer mortality changed little from the 1930s through to the 1970s. Improvements in survival began in the 1980s in countries with early detection programmes combined with different modes of treatment to eradicate invasive disease.
1.3 AIM AND OBJECTIVES OF THE STUDY
The main aim of this study was to evaluate the prevalence, practices, and knowledge regarding clinical breast examination (CBE) screening in five hospitals in Nigeria. The objectives of the study are:
- To determine the main cause of cancer among women.
- To identify the percentage of women living with cancer
- To find out how to prevent cancer among mature women in nigeria.
- To understand breast cancer screening Modalities in the hospitals
1.4 RESEARCH QUESTION
- What percentage of the population has breast cancer?
- Is breast cancer more prevalent today?
iii. How common is breast cancer in the world?
- How common is breast cancer in Nigeria?
1.5 SIGNIFICANCE OF THE STUDY
The finding of this study will help the parents, the family, the individual health provide planners and government to understand the severity of cancer among women. The study will serve as a source of information to health workers thereby helping them to spread the knowledge on how to control and prevent cancer to the public.
1.7 LIMITATION / SCOPE OF THE STUDY
The study is limited to prevalence of breast cancer compare to screening modalities in 5 hospitals in Nigeria of mature females. It does not involve children and adolescent.
1.8 DEFINITION OF TERMS
Prevalent: is the widespread of cancer in a particular area or at a particular time.
Screening: is a strategy used to look for as-yet-unrecognised conditions or risk markers. This testing can be applied to individuals or to a whole population.
Cancer: is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body.
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