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Knowledge of Breast Cancer and Preference of Early Detection Screening Measures Among Female Undergraduate Students of Ekiti State University, Ado Ekiti, Nigeria

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Knowledge of Breast Cancer and Preference of Early Detection Screening Measures Among Female Undergraduate Students of Ekiti State University, Ado Ekiti, Nigeria KNOWLEDGE OF BREAST CANCER AND PREFERENCE OF EARLY DETECTION SCREENING MEASURES AMONG FEMALE UNDERGRADUATE STUDENTS OF EKITI STATE UNIVERSITY, ADO EKITI, NIGERIA BY OLAJUMOKE PRECIOUS ADAKO MATRIC NO: 173403 B.Sc. Zoology (Parasitology and Entomology) University of Ado-Ekiti, Ekiti State, Nigeria A Dissertation in the department of Health Promotion and Education Submitted to the Faculty of Public Health College of Medicine In partial fulfillment of the award of Master of Public Health (Health Promotion and Education) University of Ibadan UNIVERISTY OF IBADAN LIBRARY NOVEMBER, 2014 AFRICA DIGITAL HEALTH REPOSITORY PROJECT DEDICATION To the Almighty and the All-knowing God (The Omnipotence and Omniscience God), The giver of life, The sustainer, For His love, mercy and grace UNIVERISTY OF IBADAN LIBRARY AFRICA DIGITAL HEALTH REPOSITORY PROJECT ABSTRACT Breast cancer (BC) is the leading cause of cancer deaths among women and observed to be rising among younger women. Early detection is the best defense against morbidity and mortality from BC. Low disease knowledge, wrong perception and poor utilization of screening services have been shown to increase its morbidity and mortality. This study was designed to assess knowledge and perception of BC and preference of early detection measures (EDM) among female undergraduate students of Ekiti State University, Nigeria. This is a descriptive and cross-sectional study. Using multi-stage random sampling technique, pre-tested semi-structured questionnaires were administered on 427 respondents to assess their socio-demographic characteristics, opinion about BC, knowledge of BC, perception of vulnerability, preference of early detection screening methods and what they would like to know about screening methods. Data collected was analyzed using SPSS version 20. One way ANOVA was used to assess relationship between dependent and independent variables. Results showed that the respondents’ mean age was 21.9±1.88 years. Majority was single (90.3%). The highest education attained by the bulk of respondents was SSCE (91.3%). Most were Yoruba (91.4%) and Christians (90.3%). Majority (94.5%) was aware of BC and (92.3%) stated that it is a serious disease. Most (76.0%) did not perceive themselves vulnerable to BC and (81.1%) utilized divine protection through prayer to avoid it. Knowledge of pre-disposing factors for BC was low. The mean knowledge score of the respondents was 11.3±5.1 out of 24-points BC knowledge score. Age-group, marital status, parents’ occupation and level of education were statistically significant with knowledge of BC. Majority (87.1%) agreed that early detection increases the chances of survival of BC. The most preferred early detection screening method was Breast Self- Examination (BSE) (32.6%), followed by Clinical Breast Examination (CBE) (12.6%). Only (30.6) and (23.3%) of the respondents have ever performed BSE and CBE respectively. Motivation for BSE utilization was fear of disease (31.3%) and school health registration, (66.3%) for CBE. Although awareness of BC was high among the students, knowledge, perception of self- vulnerability and utilization of screening service were very poor. It is therefore recommended that educative programs on BC and early detection screening methods using preferred sources of information and training on how to perform BSE should be carried out among the study population. Key words: Female undergraduate students, Breast cancer, knowledge, Early Detection and BSE and CBE. UNIVERISTYWord Count: 375 OF IBADAN LIBRARY AFRICA DIGITAL HEALTH REPOSITORY PROJECT ACKNOWLEDGEMENTS I am particularly indebted to my supervisor Prof. Oladimeji Oladepo who also doubles as the Head of Department. I really appreciate his invaluable time, contribution, mentorship and continuous support despite busy schedule. I am very grateful to all my brilliant lecturers Prof. Adeniyi, Prof. Oladimeji Oladepo, Prof. A J Ajuwon who is also the Dean of the Faculty, Dr F O Oshiname, Dr O S Arulogun, Dr O E Oyewole, Mr M A Titiloye, Mr I O Dipeolu, Mrs T A Desmennu and Mrs M M Oluwasaanu, for their love, advice, encouragement and intellectual support. I am grateful to the Matron of Olufunmilayo Adunni Breast Wellness and Diagnostic Centre Mrs Adetoye, Mrs Olofinbiyi of Breast Clinic, Ekiti State University Teaching Hospital, Ado Ekiti and all study participants for their cooperation and willingness to participate in the study. I appreciate my friends Aderenle Yetunde, Fawole omobayonle and Agogo Winnifred for their love, advice and encouragement. I appreciate my loving parents Mr Toluwase Joshua Adako and Mrs Florence Oluremi Adako and my wonderful siblings, aunty Bunmi, Tosin and Tope, for their love, encouragement, financial, moral and spiritual support. Above all, I return all the glory to God for seeing me through this study. Thank you Lord! UNIVERISTY OF IBADAN LIBRARY AFRICA DIGITAL HEALTH REPOSITORY PROJECT CERTIFICATION I certify that the study was carried out by Olajumoke Precious Adako in the Department of Health Promotion and Education, Faculty of Public Health, College of medicine, University of Ibadan, Ibadan, Nigeria. ………………………………………. Supervisor Oladimeji Oladepo B.Sc., MPH, PhD (Ibadan) FRSPH (UK) Professor Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Nigeria. UNIVERISTY OF IBADAN LIBRARY AFRICA DIGITAL HEALTH REPOSITORY PROJECT TABLE OF CONTENTS Pages Title Page………………………………………………………………………………………….i Dedication………………………………………………………………………………………....ii Abstract…………………………………………………………………………………………...iii Acknowledgement………………………………………………………………………………..iv Certification………………………………………………………………………………………vi Table of Contents………………………………………………………………………………...vii List of Tables……………………………………………………………………………………...x List of Figures…………………………………………………………………………………....xii List of Appendices………………………………………………………………………………xiii List of Abbreviations……………………………………………………………………………xiv Operational Definition…………………………………………………………………………...xv CHAPTER ONE: INTRODUCTION The study background……………………………………………………………………………..1 The statement of problem…………………………………………………………………………3 Justification for the study……………………………………………………………………….....5 Research questions………………………………………………………………………………...6 Broad objective of the study………………………………………………………………………7 Specific objectives of the study…………………………………………………………………...7 CHAPTER TWO: LITERATURE REVIEW Overview of the structure of the breast……………………………………………………………8 The lymph (lymphatic) system of breast………………………………………………………….9 UNIVERISTYTypes of breast growth…………………………………………………………………………….9 OF IBADAN LIBRARY Causes/aetiology of breast cancer………………………………………………………………..10 AFRICA DIGITAL HEALTH REPOSITORY PROJECT Breast cancer risk factors………………………………………………………………………...10 Signs and symptoms of breast cancer……………………………………………………………15 Stages of breast cancer…………………………………………………………………………...16 Screening and diagnostic methods for detecting breast cancer………………………………….19 Incidence and prevalence of breast cancer……………………………………………………….25 Breast cancer in African women and problems of late presentation…………………………….30 Female undergraduate students’ knowledge of breast cancer from previous studies…………...33 Conceptual frame work…………………………………………………………………………..35 Health Belief Model……………………………………..............................................................36 CHAPTER THREE: METHODOLOGY Study design……………………………………………………………………………………...38 Description of study area………………………………………………………………………...38 Description of study site…………………………………………………………………………39 Study population…………………………………………………………………………………41 Study variables…………………………………………………………………………………...41 Recruitment of study participants……………………………………………………………......41 Sampling procedure……………………………………………………………………………...42 Instrument for data collection……………………………………………………………………43 Instrument validity……………………………………………………………………………….44 Instrument reliability……………………………………………………………………………..44 Pre-testing of instrument…………………………………………………………………………44 Data collection procedure………………………………………………………………………..44 Data management and analysis…………………………………………………………………..45 UNIVERISTYEthical consideration……………………………………………………………………………..45 OF IBADAN LIBRARY Limitation to the study…………………………………………………………………………...46 AFRICA DIGITAL HEALTH REPOSITORY PROJECT CHAPTER FOUR: RESULT Socio-demographic characteristics……………………………………………………………....47 Awareness and knowledge about breast cancer………………………………………………….50 Comparison of breast cancer knowledge by socio-demographic characteristics………………...56 Perception of vulnerability to breast cancer……………………………………………………...59 Comparison of vulnerability to breast cancer by socio-demographic characteristics……………64 Preferred breast cancer early detection screening measures………………..................................67 Comparison of breast self-examination preference by socio-demographic characteristics….......78 Comparison of clinical breast examination preference by socio-demographic characteristics….80 Comparison of breast ultra-sound preference by socio-demographic characteristics…………...84 Comparison of mammography preference by socio-demographic characteristics……………....86 CHAPTER FIVE: DISCUSSION Socio-demographic characteristics………………………………………………………………87 Awareness and knowledge about breast cancer………………………………………………….87 Perception of vulnerability to breast cancer……………………………………………………...91 Early breast cancer detection screening preference and utilization……………………………...94 Implication for health promotion and education…………………………………………………94 Conclusion……………………………………………………………………………………….95
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