Koech J Maureen, Magutah Karani, Mogere Dominic M, Kariuki John, Willy Kipyegon, Muriira Mutua Alex, Chege Harrison
Department of Epidemiology and Biostatistics, School of Public Health, Mount Kenya University, Kenya.
Department of Medical Physiology, Moi University, Eldoret, Kenya.
Heliyon. 2024 May 20;10(11):e31597. doi: 10.1016/j.heliyon.2024.e31597. eCollection 2024 Jun 15.
Only 12% of Kenyan women use breast cancer (BC)screening programs. Early identification is critical for reducing the condition's associated morbidity and mortality. Unfortunately, few studies have been conducted on the screening program's implementation and the causes for the low usage rates in Turbo Sub-County, Kenya. The purpose of this study was to learn about women of reproductive age's (WRA) practices, attitudes, and knowledge regarding BC screening programs, as well as to investigate the potential association between lifestyle factors and BC screening service utilization.
Mixed-method approaches were used in an analytical cross-sectional study design. The study included 317 participants selected randomly. An interviewer-administered questionnaire was used to collect quantitative data while focus group discussion (FGD) and key informant interview (KII) guides were used for collecting qualitative data. The Statistical Package for Social Sciences (SPSS) version 26 was used to manage quantitative data, whereas NVivo version 12 was used to analyze qualitative data. Chi-square, Fisher's exact test, and multiple logistic regression were used to assess the degree of relationship between BC screening service uptake and independent variables. The qualitative data was transcribed verbatim, and the transcripts were automatically coded to generate themes.
The participants' mean age was 30.14 (9.64). Breast cancer screening services were used by 10.21% of the population. Women who were aware of the signs and symptoms of BC were 71.5 times more likely to undergo screening than their counterparts. Similarly, those with positive attitudes toward BC and screening programs were 84 times more likely to get screened than those with negative attitudes. Breastfeeding increased the likelihood of BC screening by OR = 37 (95% CI: 0.00-0.32), physical activity by OR = 37 (95% CI: 0.00-0.25), and chronic illnesses by OR = 37 (95% CI: 0.00-0.17).
Knowledge of signs and symptoms of BC and a positive attitude towards perceived barriers enhanced the probabilities of BC screening. Being physically active, breastfeeding, and having a chronic disease all increased the odds of BC screening uptake. To improve screening rates, it is necessary to provide sufficient information to those who are least likely to be screened.
肯尼亚只有12%的女性使用乳腺癌筛查项目。早期识别对于降低该病相关的发病率和死亡率至关重要。不幸的是，在肯尼亚图尔博次县，很少有关于筛查项目实施情况以及使用率低的原因的研究。本研究的目的是了解育龄妇女对乳腺癌筛查项目的做法、态度和知识，并调查生活方式因素与乳腺癌筛查服务利用之间的潜在关联。
在一项分析性横断面研究设计中采用了混合方法。该研究随机选取了317名参与者。通过访谈员管理的问卷收集定量数据，同时使用焦点小组讨论（FGD）和关键 informant 访谈（KII）指南收集定性数据。使用社会科学统计软件包（SPSS）26版管理定量数据，而使用NVivo 12版分析定性数据。采用卡方检验、费舍尔精确检验和多元逻辑回归来评估乳腺癌筛查服务接受情况与自变量之间的关联程度。定性数据逐字转录，并对转录本自动编码以生成主题。
参与者的平均年龄为30.14岁（9.64岁）。10.21%的人群使用了乳腺癌筛查服务。了解乳腺癌体征和症状的女性接受筛查的可能性是其同龄人71.5倍。同样，对乳腺癌和筛查项目持积极态度的女性接受筛查的可能性是持消极态度女性的84倍。母乳喂养使乳腺癌筛查的可能性增加，比值比（OR）=37（95%置信区间：0.00 - 0.32）；体育锻炼使OR = 37（95%置信区间：0.00 - 0.25）；慢性病使OR = 37（95%置信区间：0.00 - 0.17）。
对乳腺癌体征和症状的了解以及对感知到的障碍持积极态度提高了乳腺癌筛查的概率。进行体育锻炼、母乳喂养和患有慢性病都增加了接受乳腺癌筛查的几率。为了提高筛查率，有必要向最不可能接受筛查的人群提供充分信息。
