CHAPTER ONE

GENERAL INTRODUCTION

1.1 Background of the study

Non-communicable diseases, including breast cancer (BC), in Africa have been in a rise. Breast cancer is a life threatening disease affecting woman across the globe (Sehrawatet al., 2017; Azubuikeet al., 2013).Breast cancer has a very long history as it was first reported by the Egyptians more than 3500 years ago in about 1500 BC (Ebeid N.I et al., 1999). Cancer of the breast was diagnosed globally in 2020, 2.3 million women were diagnosed with breast cancer and 685000 deaths, and before the year ended, it was reported that 7.8 million women were diagnosed with breast cancer in the past 5 years, making it the world’s most prevalent cancer. A study in the United States has showed that women are 100 times more likely to develop breast cancer more than men are. This is because their breast cells are constantly expose to the female hormones estrogen and progesterone, which promote cell growth. Breast cancer occurs in every country of the world in women at any age after puberty but with increasing rates in later life (WHO, 2021). Breast cancer is the second most common cancer among females in the United States.

Researchers across the globe are working to find new and improved ways to prevent, detect, and treat breast cancer in the world. Each year in the United States, about 255000 cases of breast cancer are diagnosed in women and about 2300 in men. About 42000 women die each year from breast cancer). In addition, patients, healthcare providers, and system mediated barriers have also been reported the reasons for late medical care among cancer patients (Morse et al., 2014). For instance, there are very few places with specialized capacities for diagnosing cancer and its diagnostic centers are only available only in tertiary hospitals making the services less accessible and expensive for patients in remote areas in the world. To prevent and control breast cancer, several measures have been taken by the WHO, government, health ministries, and non-Government Mental Organizations (NGOs).

In Africa, breast cancer caused 74072 deaths and 168690 cases were estimated to have occurred in 2018. According to the 2020 data in Africa,186598 cases were reported with 85,787 related deaths. According to the International Agency for Research on Cancer, there were 2,625 new cases of breast cancer per 100,000 women in Cameroon during 2012. This estimate, however, was based on data extrapolated from a regional hospital-based cancer registry covering part of the country. Thus, currently available data may not accurately reflect the true burden and patterns of breast disease across all regions of Cameroon, especially since registries do not account for individuals who fail to present to formal care. Evidence has shown that black women have a higher rate of death from cancer than white women (CDC, 2021). The high mortality rate attributed to breast cancer in sub-Saharan Africa is partly due to lack of knowledge pertaining to risk factors, signs and symptoms such as breast lump, increase in size of the breast and an ulcer on the breast, and early detection methods among women as well as effects such as breast amputation and death are causing these women to seek medical treatment at late stages of the disease when it can no longer be reversed (Sehrawat et al., 2017; Dandash and Al-Mohamed, 2007).

In Cameroon, the present study is important, as it will bring to light the current level of knowledge on breast cancer among women. It will also help in promoting early detection and management of breast cancer in these communities by helping the central and local government authorities and also NGOs in understanding where exactly how to allocate resources in matters pertaining to breast cancer and it’s awareness, practices among women especially in these communities(Olam group, 2022). Since mammography is the only screening modality proven to reduce breast cancer mortality, mammography is neither affordable nor feasible in many low and middle-income countries (LMICs). Consequently, alternative screening methods, such as breast self-examination (BSE), has been recommended in remote settings to promote breast health awareness and early detection of breast abnormalities (Hussain SA et al., 2013). Breast Self-examination BSE is a simple screening method that can be performed at no cost. Previous studies have indicated that a majority of early-stage breast tumors are self-detected. Studies have proven that the main factor that interferes with breast cancer prevention is the perceive barrier to forgetfulness and lack of confidence by the woman to carry out their own self-breast examination, lack of the knowledge of self-breast examination (Banegas, 2001).

This study aimed at assessing the knowledge and perceived practice on the prevention of breast cancer among women of childbearing age in the Molyko Community of Buea, South West Region of Cameroon.

1.2 Problem Statement

Breast cancer is increasingly recognized as a public health problem whereby majority of its problems affects women of childbearing age.

However, timely access to diagnosis remains a challenge due to the lack of specialized facilities. Most patients present with advanced stages of the disease making management impossible. This leads to an increase in breast cancer-related mortality. Like many other women in the developing world, the practice of breast cancer screening among Cameroonian women is unsatisfactory (Nsagha et al., 2012).These studies show that many women are not aware of the danger of breast cancer such as breast amputation, breast deformation, and even death because of their little knowledge about breast cancer. That is why the need for new studies especially in Cameroon (Buea) is necessary to ascertain levels of improvement. From observation, lifestyle practices affect some women of childbearing age. Some of these practices include; smoking, alcohol consumption, breast enlargement, not breastfeeding the baby can also lead to breast cancer. Some preventive methods being exercise minimizing radiation exposure from screening tests, limiting hormone therapy, breastfeeding the baby, eating the right food. This would be necessary for designing appropriate awareness creation of intervention strategies and educating the masses bout breast cancer. This study was then to access women’s knowledge and practice in the prevention of breast cancer.

1.3 Rational of study

The aim of this study is to assess women’s knowledge and practice in the prevention of breast cancer in the Molyko community to help reduce morbidity and mortality related to breast cancer and by improving the knowledge and prevention of breast cancer in women.

1.4 Research Objectives

1.4.1 General Objective

To assess the knowledge and perceived practices on the prevention of breast cancer among women of childbearing age at the Molyko community.

1.4.2 SpecificObjectives

1. To assess the knowledge on the prevention of breast cancer among women of childbearing age at the Molyko community.
2. To examine the perceived practices on the prevention of breast cancer among women of childbearing age at the Molyko community.
3. To identify the challenges faced in the prevention of breast cancer among women of childbearing age.

1.5 Research Questions

1. What knowledge do women of childbearing age have on the prevention of breast cancer at the Molyko community?
2. What are the perceived practices carried out by women of childbearing age on the prevention of breast cancer at the Molyko community?
3. What are the challenges faced in the prevention of breast cancer amongst women of child beating age at the Molyko community?