Prevalence and determinants of breast cancer screening in four sub-Saharan African countries: a population-based study

Djibril M. Ba*, Paddy Ssentongo, Edeanya Agbese, Yanxu Yang, Ramata Cisse, Brehima Diakite, Cheick Bougadari Traore, Bakarou Kamate, Yaya Kassogue, Guimogo Dolo, Etienne Dembele, Hama Diallo, Mamoudou Maiga

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives Breast cancer is the most prevalent cancer and the second leading cause of cancer-related deaths among women after cervical cancer in much of sub-Saharan Africa. This study aims to examine the prevalence and sociodemographic-socioeconomic factors associated with breast cancer screening among women of reproductive age in sub-Saharan Africa. Design A weighted population-based cross-sectional study using Demographic and Health Surveys (DHS) data. We used all available data on breast cancer screening from the DHS for four sub-Saharan African countries (Burkina Faso, Ivory Coast, Kenya and Namibia). Breast cancer screening was the outcome of interest for this study. Multivariable Poisson regression was used to identify independent factors associated with breast cancer screening. Setting Four countries participating in the DHS from 2010 to 2014 with data on breast cancer screening. Participants Women of reproductive age 15-49 years (N=39 646). Results The overall prevalence of breast cancer screening was only 12.9% during the study period, ranging from 5.2% in Ivory Coast to 23.1% in Namibia. Factors associated with breast cancer screening were secondary/higher education with adjusted prevalence ratio (adjusted PR)=2.33 (95% CI: 2.05 to 2.66) compared with no education; older participants, 35-49 years (adjusted PR=1.73, 95% CI: 1.56 to 1.91) compared with younger participants 15-24 years; health insurance coverage (adjusted PR=1.57, 95% CI: 1.47 to 1.68) compared with those with no health insurance and highest socioeconomic status (adjusted PR=1.33, 95% CI: 1.19 to 1.49) compared with lowest socioeconomic status. Conclusion Despite high breast cancer mortality rates in sub-Saharan Africa, the prevalence of breast cancer screening is substantially low and varies gradually across countries and in relation to factors such as education, age, health insurance coverage and household wealth index level. These results highlight the need for increased efforts to improve the uptake of breast cancer screening in sub-Saharan Africa.

Original languageEnglish (US)
Article number039464
JournalBMJ open
Volume10
Issue number10
DOIs
StatePublished - Oct 12 2020

Keywords

  • breast tumours
  • epidemiology
  • preventive medicine

ASJC Scopus subject areas

  • Medicine(all)

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