Breast Cancer: Early Detection and Screening in South African Women from the Bonteheuwel Township in the Western Cape: Knowledge; Attitudes and Practices

ABSTRACT

Background: Breast cancer is one of the most common cancers; rating among the most frequent causes of mortality in women worldwide; including in South Africa. Although curative treatment is increasingly successful; early detection and intervention are critical in reducing mortality rates. Early diagnosis is facilitated via breast self-examination (BSE); clinical breast examination (CBE); and mammography. Breast cancer presentation shows an apparent racial variation; with black; coloured and Indian patients presenting at a younger age than whites. In addition; whites tend to present at earlier stages of disease severity; coloureds and Indians at more intermediate stages and blacks at later stages. Socio-economic variables impact on screening practices. One American/Canadian study showed women with higher education and incomes were more likely to receive screening. In South Africa; there is scant research on breast cancer screening. In 2001; Prof. Karl Peltzer of the University of the North did a small telephonic comparative study between black and white women that identified low frequencies of BSE in both groups. Further research is necessary. While several international studies exist; little research is available on the screening behaviour of South African women. The aim of this study; therefore; was to evaluate the knowledge; attitudes; and actual screening practices regarding breast cancer among women in the Bonteheuwel township in the Western Cape.Methods: A random sample of 100 women completed a questionnaire administered by a research assistant. A separate; selected group of nine women participated in a focus group discussion.Results: The results indicate that the majority of the participants were aware of the dangers of breast cancer; perceived as a common (87; 95 CI 80) and serious (88; 95 CI 82-94) disease; which; if treated early; could be cured in most cases (82; 95 CI 74-90). Most had previously examined their breasts (65; 95 CI 56-74) and/or had been examined by their doctors (62; 95CI 52-72). Only a minority; however; practised regular BSE (24; 95 CI 16) or had received a CBE in the last year (29-32 ; 95 CI 20-38). Fear of diagnosis was identified as the main barrier to screening (87; 95 CI 80-94). Despite their fears; the participants were keen to improve their knowledge and participate in the further education of their community. However; only 40 (95 CI 30-50) had ever been taught BSE by a healthcare professional. Moreover; only 34 (95 CI 25-43) of women who had consulted a GP in the preceding year had received a CBE during this period. A total of 38 (95 CI 28-48) had never had a CBE in their lives.Conclusion: The participants were better informed and more engaged in screening than had been anticipated. Still; healthcare professionals need to play a more proactive role in breast cancer screening and education