Level of Awareness and Knowledge of Breast Cancer in Nigeria. A Systematic Review

Abstract

BACKGROUND: Despite reports of improved awareness of breastcancer entity and seemingly upbeat levels of other awarenesssubthemes in Nigeria, patients continue to present late whentreatment is least rewarding. This paradoxical trend of both risingawareness and late presentation coupled with reports suggestingother competing drivers of late presentation question the “theory ofpoor awareness” as the foremost driver of late presentations. Byaggregating available data, we aimed to assess what still constitutespoor breast cancer awareness in Nigeria in order to suggest how toallocate resources to reverse the paradoxMETHOD: Studies conducted on Nigerian populace from 2000 todate were reviewed systematically. Search was made inPROSPERO, PubMed/MEDLINE, AJOL, Cochrane library,GOOGLE, ResearchGate and ACADEMIA. Primary outcome waslevel of awareness about breast cancer entity.RESULT: Fifty-one eligible (48 descriptive surveys, 3interventional ones) studies were reviewed. They included 19,598respondents (98.5% females; 43% rural dwellers). 17,086(87.2%)were laypersons in various walks of life; 2,512(12.8%) werehealthcare professionals. There were high levels of awareness ofbreast cancer entity, BSE, knowledge of fatality and benefit of earlydetection (weighted percentages 80.6%, 60.1%, 73.2% and 73.9%respectively).Weightedpercentagesofknowledgeofsymptoms/signs was 45.1%. Weighted percentages of sense ofsusceptibility and performance of BSE were low-26.8% and 22.9%respectively. Generally, rate of performance of screening did notvary with changes in the level of awareness/knowledge of concepts.CONCLUSION: In general, low awareness of breast cancer maynot be the direct and foremost driver of persistent late presentationin Nigeria.