Factors associated with the uptake of clinical breast examination among women of reproductive age in Lesotho: analysis of a national survey

Abstract

Background In low-resource settings with weak health systems, the WHO recommends clinical breast examination (CBE) as the most cost-effective breast screening modality for women. Evidence shows that biennial CBE leads to significant downstaging of breast cancer in all women. Breast cancer is the second most common cancer among women in Lesotho with a weaker healthcare system and a low breast cancer screening rate. This study investigated the prevalence and factors associated with the uptake of CBE among women of reproductive age in Lesotho. Methods This study used cross-sectional data from the 2014 Lesotho Demographic and Health Survey. A sample of 6584 reproductive-age women was included in this study. We conducted both descriptive and multivariable logistic regression analyses. The study results were presented in frequencies, percentages, and adjusted odds ratios (aOR) with their corresponding confidence intervals (CIs). Results The prevalence of CBE uptake was 9.73% (95% CI: 8.91, 10.61). Women who were covered by health insurance (aOR = 2.31, 95% CI [1.37, 3.88]), those who were pregnant (aOR = 2.34, 95% CI [1.64, 3.35]), those who had one to three children (aOR = 1.81, 95% CI [1.29,2.52]), and women who frequently read newspapers or magazines (aOR = 1.33, 95% CI [1.02,1.72]) were more likely to undergo CBE than their counterparts. Women who were aware of breast cancer (aOR = 2.54, 95% CI [1.63,3.97]), those who have ever had breast self-examination (BSE) within the last 12 months prior to the study (aOR = 5.30, 95% CI [4.35,6.46]), and those who visited the health facility in the last 12 months prior to the study (aOR = 1.57, 95% CI [1.27,1.95]) were also more likely to undergo CBE than their counterparts. Women residing in the Qacha’s-nek region (aOR = 0.42, 95% CI [0.26,0.67]) were less likely to undergo CBE than those in the Botha-bothe region. Conclusion The study found a low prevalence of CBE uptake among reproductive-age women in Lesotho. Factors associated with CBE uptake include health insurance coverage, being pregnant, those who had one to three children, exposure to media, breast cancer awareness, ever had BSE, and those who visited a health facility. To increase CBE uptake, these factors should be considered when designing cancer screening interventions and policies in order to help reduce the burden of breast cancer in Lesotho.

Factors associated with awareness of breast cancer among women of reproductive age in Lesotho: a national population-based cross-sectional survey

“…Higher educational attainment has been known all over the world to be significantly related to women’s awareness of breast cancer [ 33 , 36 – 38 ]. In all these studies, it was shown that women’s educational status increased their awareness and the chance of using screening services [ 13 , 33 , 36 – 38 ]. Women of higher educational status can read and comprehend health-related information compared to the non-educated women.…”

Breast Cancer Awareness and Associated Factors among Students of Allied Health Sciences in Indonesia and Pakistan: A cross-sectional study

“…Healthcare providers are often more accessible in urban areas in Indonesia and Pakistan. Women between the ages of 45 and 49 years, married women, women with a higher educational level, women who listened to the radio at least once a week, those who read newspapers or magazines, and women in the wealthiest group were all more likely to be aware of breast cancer, according to a recent Lesotho study [41]. These results also compare to the results of our study with women in rural areas being less likely than those in urban areas to be aware of breast cancer.…”