Breast Cancer: Knowledge, Attitudes, and Perceptions among Female Soldiers of the Ghana Armed Forces in the Greater Accra Region

Abstract

Introduction: Breast cancer continues to represent a major public health problem despite recent falls in deaths due to improved survival from a combination of early diagnosis, breast screening and improvement in treatment methods. This study aimed to determine the knowledge about and attitudes towards breast cancer among female soldiers and officers of the Ghana Armed Forces and to document some of the perceptions they have about breast cancer. Methods: A cross-sectional study was conducted among uniformed female personnel within all units of the Ghana Armed Forces (GAF) in the Greater Accra Region. Interviewer-administered questionnaires consisting of closed ended questions were employed. The study adapted the standardized and widely used breast cancer knowledge and perception survey developed in the 1980s. Results: A total of 300 female soldier and officers participated in the study. The mean age of respondents was 28.7 years (sd=6.78) and only 33% were married. Eight-one percent were in the Junior Rank category, 9.0% were Senior Non-commissioned Officers (SNCOs), 6.0% were Junior Officers and 4.0% were Senior Officers. Seventy-eight percent of respondents had poor knowledge about the risk factors for breast cancer. Only 30.7% of respondents knew that a woman‟s risk of developing breast cancer increased with age and only 36.3% knew that a positive family history is a strong risk factor for breast cancer. Respondent‟s knowledge about warning signs and symptoms of breast cancer was generally good as 67% had satisfactory knowledge about the warning signs and symptoms of breast cancer. Most respondents (73.0%) know that an unusual painless breast lump is a warning sign of the disease and 75.3% knew that an unusual nipple discharge is also another sign. Nipple retraction or inversion was the least known symptom; only 41.7% mentioned it as a warning sign. Although a third (33.7%) of respondents were able to tell the correct sequence of steps in breast self-examination only 20.3% actually performed BSE monthly as recommended by health authorities. Majority of respondents (93.7%) had a healthy attitude to breast cancer. Seventy-one percent indicated they would see a doctor within a month on discovering any unusual breast lump. With regards to breast cancer perceptions, 21.7% indicated that changes found in the breast during BSE are usually cancer and 40% also thought a blow to the breast can cause breast cancer. One‟s level of education (x 2 =12.417, df=4, p=0.015) and unit (x 2 =13.143, df=1, p<0.001) showed significant association with knowledge about the signs and symptoms of breast cancer. One‟s rank was also significantly associated with knowledge about the risk factors of breast cancer (x 2 =23.195, df=1, p<0.001). Conclusion: Majority of female soldiers had poor knowledge about the risk factors for breast cancer. Nevertheless, their attitude to breast cancer was generally good. To the extent that these results reflect the current knowledge and perceptions of female soldiers of the GAF in general about breast cancer, they call for renewed and innovative efforts directed at enhancing breast caner knowledge and early detection practices.