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Effect of Breast Cancer Education on Breast Self-Examination Practices among Women in Nigeria

Abstract

Breast cancer is an important public health concern among women in Nigeria and remains a significant cause of cancer-related morbidity and mortality. Delayed presentation and diagnosis may contribute to poorer treatment outcomes, making awareness of breast health and timely healthcare-seeking important components of breast cancer control. Breast cancer education provides women with information about breast cancer, risk factors, warning signs, the importance of breast awareness, available diagnostic services, and appropriate healthcare-seeking when breast abnormalities are identified. Breast self-examination practices refer to women's regular awareness and examination of their breasts for unusual changes such as lumps, swelling, changes in breast shape or size, nipple abnormalities, skin changes, or other unusual findings, followed by appropriate medical evaluation when necessary. In Nigeria, inadequate breast cancer knowledge, misconceptions, fear of cancer diagnosis, cultural beliefs, limited access to healthcare information, and poor awareness of appropriate breast health practices may contribute to delayed recognition and presentation of breast abnormalities. Effective breast cancer education may improve women's knowledge and confidence regarding breast health and encourage appropriate breast self-examination and prompt healthcare-seeking when abnormalities are detected. Against this background, this study investigates the effect of breast cancer education on breast self-examination practices among women in Nigeria. The study is anchored on the Health Belief Model (HBM), Social Cognitive Theory (SCT), and Knowledge-Attitude-Practice (KAP) framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding women's decisions to engage in breast health practices. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, behavioural capabilities, and environmental conditions in shaping health behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how improved breast cancer knowledge and attitudes resulting from health education may influence breast self-examination practices. Collectively, these theoretical perspectives provide a comprehensive framework for explaining how breast cancer education may influence breast self-examination practices among women in Nigeria. The study adopts a quantitative quasi-experimental research design. Primary data will be collected from women in selected communities, workplaces, healthcare facilities, and women's organizations in Nigeria using a structured interviewer-administered questionnaire. A multistage sampling technique will be employed to select states, local government areas, communities, institutions, healthcare facilities, and eligible participants. Where feasible, selected communities or participant groups will be assigned to intervention and comparison groups. Women in the intervention group will receive structured breast cancer education covering breast cancer risk factors, warning signs, breast health awareness, appropriate breast self-awareness and self-examination practices, common misconceptions, the importance of prompt clinical assessment of breast abnormalities, and available healthcare services. Breast self-examination practices will be assessed using indicators such as awareness of breast changes, frequency of breast examination, knowledge of appropriate examination procedures, ability to recognize unusual breast findings, and willingness to seek professional medical evaluation when abnormalities are detected. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, breast cancer knowledge, exposure to breast cancer education, and breast self-examination practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple regression analysis, will be employed to determine the effect of breast cancer education on breast self-examination practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study anticipates that breast cancer education will have a significant positive effect on breast self-examination practices among women in Nigeria. Women exposed to structured breast cancer education are expected to demonstrate improved knowledge of breast cancer risk factors and warning signs and greater confidence in monitoring their breast health. Education may improve women's ability to recognize unusual breast changes, encourage appropriate breast self-awareness and examination practices, and promote timely consultation with qualified healthcare professionals when abnormalities are identified. However, education alone may not guarantee sustained breast health practices because women may continue to experience barriers such as fear of cancer diagnosis, stigma, cultural beliefs, limited access to healthcare facilities, financial constraints, and inadequate availability of trained healthcare professionals. Consequently, breast cancer education is expected to be most effective when supported by accessible clinical breast assessment and diagnostic services, appropriate referral systems, affordable healthcare, and sustained community-based cancer awareness programmes. This study is expected to contribute to the literature on breast cancer prevention, women's health, cancer education, early detection, health promotion, and public health in Nigeria by providing empirical evidence on the effect of breast cancer education on breast self-examination practices among women. The findings will provide useful information for the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency (NPHCDA), state ministries of health, hospitals, primary healthcare facilities, cancer-control programmes, women's health organizations, community health workers, nurses, public health practitioners, development partners, and policymakers regarding strategies for improving breast cancer awareness and early detection. The study will also provide evidence-based recommendations for strengthening breast cancer education, promoting breast health awareness, improving access to appropriate clinical breast assessment and diagnostic services, addressing misconceptions and stigma, strengthening referral systems, and encouraging timely healthcare-seeking among women with breast abnormalities across Nigeria.

Keywords: Breast cancer education, breast self-examination, breast cancer awareness, women, breast health, cancer prevention, early detection, health education, women's health, health promotion, public health, Nigeria.