Kinteh Bakary, Jitteh Fatoumatta, Badjie Mansour, Barrow Amadou, Jaiteh Lamin
School of Public Health, Gambia College, Brikama, The Gambia.
Solace Foundation, Banjul, The Gambia.
PLoS One. 2025 May 12;20(5):e0307785. doi: 10.1371/journal.pone.0307785. eCollection 2025.
Breast cancer is a significant public health challenge in The Gambia, where it ranks as the second most commonly diagnosed cancer among women. Rural women face unique challenges in accessing screening services; however, evidence about their breast cancer awareness and screening uptake remains limited. This study aimed to assess breast cancer awareness and identify associated factors influencing screening uptake among rural women in The Gambia.
A community-based cross-sectional study was conducted among rural women in The Gambia. Using multistage sampling, we recruited 985 women from two local government authorities (response rate: 90.2%). Data were collected using a structured questionnaire administered in Kobo Toolbox. Descriptive statistics were used to summarize participant characteristics, while associations between predictors and breast cancer screening uptake were assessed using Chi-squared or Fisher's exact test. Multivariable logistic regression was used to identify factors associated with screening uptake. Statistical significance was set at p<0.05 and adjusted odds ratios (aOR) with 95% confidence intervals were reported.
The mean age of the study population was 32 years (standard deviation [SD]: ±12.6), with 34% aged 18-24 years. Although breast cancer awareness was high (87.7%), screening uptake was low (12.6%), primarily due to limited knowledge (58.7%), service unavailability (13.5%) and financial constraints (13.1%). Clinical breast examination was the most common screening method used (62.6%). Multivariable analysis revealed that Students (aOR=3.111, 95% CI: 1.453-6.663) and civil servants (aOR=2.778, 95% CI: 1.174-6.573) were more likely to undergo screening compared to unemployed women. Conversely, women with two (aOR=0.061, 95% CI: 0.005-0.791), three (aOR=0.075, 95% CI: 0.006-0.967), and five children (aOR=0.065, 95% CI: 0.005-0.877) were less likely to participate in screening compared to nulliparous women.
Despite the high awareness of breast cancer, screening uptake among rural women in The Gambia was notably low, primarily due to limited knowledge, service unavailability and financial constraints. There is an urgent need for targeted interventions to improve screening uptake, particularly among multiparous women in rural communities.
乳腺癌是冈比亚一项重大的公共卫生挑战，在该国女性中，乳腺癌是第二大最常确诊的癌症。农村女性在获得筛查服务方面面临独特挑战；然而，关于她们对乳腺癌的认识以及筛查接受情况的证据仍然有限。本研究旨在评估冈比亚农村女性对乳腺癌的认识，并确定影响筛查接受情况的相关因素。
在冈比亚农村女性中开展了一项基于社区的横断面研究。采用多阶段抽样，我们从两个地方政府部门招募了985名女性（应答率：90.2%）。数据通过在Kobo Toolbox中管理的结构化问卷收集。描述性统计用于总结参与者特征，而预测因素与乳腺癌筛查接受情况之间的关联则使用卡方检验或费舍尔精确检验进行评估。多变量逻辑回归用于确定与筛查接受情况相关的因素。统计学显著性设定为p<0.05，并报告调整后的比值比（aOR）及其95%置信区间。
研究人群的平均年龄为32岁（标准差[SD]：±12.6），其中34%的年龄在18 - 24岁之间。尽管对乳腺癌的认识较高（87.7%），但筛查接受率较低（12.6%），主要原因是知识有限（58.7%）、服务不可得（13.5%）和经济限制（13.1%）。临床乳腺检查是最常用的筛查方法（62.6%）。多变量分析显示，与失业女性相比，学生（aOR = 3.111，95% CI：1.453 - 6.663）和公务员（aOR = 2.778，95% CI：1.174 - 6.573）接受筛查的可能性更大。相反，与未生育女性相比，有两个孩子（aOR = 0.061，95% CI：0.005 - 0.791）、三个孩子（aOR = 0.075，95% CI：0.006 - 0.967）和五个孩子的女性（aOR = 0.065，95% CI：0.005 - 0.877）接受筛查的可能性较小。
尽管对乳腺癌的认识较高，但冈比亚农村女性的筛查接受率显著较低，主要原因是知识有限、服务不可得和经济限制。迫切需要有针对性的干预措施来提高筛查接受率，特别是在农村社区的多子女女性中。
