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Effect of Breast Cancer Risk-Assessment Education on Breast Cancer Screening Practices among Women in Nigeria

Abstract

Breast cancer remains a major public health concern among women in Nigeria and is an important cause of cancer-related illness and mortality. Early detection through appropriate breast health assessment and timely diagnostic evaluation can improve treatment opportunities and health outcomes. However, many women may have limited knowledge of breast cancer risk factors, personal risk assessment, warning signs, appropriate screening options, and the importance of seeking professional evaluation when breast abnormalities are identified. Breast cancer risk-assessment education provides an opportunity to improve women's understanding of individual and population-level risk factors and to encourage appropriate breast cancer screening practices. Against this background, this study investigates the effect of breast cancer risk-assessment education on breast cancer screening practices among women in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Health Belief and Risk-Communication Framework. The Health Belief Model explains how perceived susceptibility to breast cancer, perceived severity, perceived benefits of screening, perceived barriers, and cues to action may influence women's screening practices. Social Cognitive Theory explains how women may acquire and maintain appropriate breast health behaviours through observational learning, modelling, reinforcement, social interaction, and self-efficacy. The risk-communication framework emphasizes the importance of providing individuals with accurate, understandable, personalized, and actionable information about health risks and appropriate preventive responses. Collectively, these theoretical perspectives provide a suitable framework for explaining how breast cancer risk-assessment education may influence breast cancer screening practices among women in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise women aged 18 years and above residing in selected communities across Nigeria, with screening practices assessed according to age, individual risk profile, and applicable clinical recommendations. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, households, and eligible women. Breast cancer risk-assessment education will be assessed using indicators such as knowledge of breast cancer risk factors, family history, age-related risk, reproductive and hormonal factors, lifestyle-related risks, previous breast conditions, recognition of warning signs, understanding of individual risk assessment, information on appropriate screening options, professional risk assessment, and referral information. Breast cancer screening practices will be assessed using indicators such as participation in recommended breast health assessment, clinical breast evaluation where appropriate, mammography where indicated, attendance at breast cancer screening services, response to breast symptoms, follow-up after abnormal findings, and timely referral for diagnostic evaluation. Data will be collected using structured questionnaires, breast cancer knowledge and risk-assessment tools, screening records where available, healthcare facility records, referral records, and relevant community health programme documents. Descriptive statistics will be used to summarize participants' characteristics, breast cancer risk profiles, exposure to risk-assessment education, and screening practices. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of breast cancer risk-assessment education on screening practices. Where a quasi-experimental design is adopted, screening-practice scores before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that breast cancer risk-assessment education has a significant positive effect on breast cancer screening practices among women in Nigeria. Women exposed to structured risk-assessment education are expected to demonstrate improved understanding of their breast cancer risk and greater adherence to appropriate screening and breast-health practices than women without comparable exposure. Education may help women recognize relevant risk factors, understand when professional risk assessment is appropriate, identify breast warning signs, and appreciate the importance of timely clinical evaluation. Personalized and culturally appropriate education may also reduce misconceptions, fear, embarrassment, and perceived barriers associated with breast cancer screening. However, limited availability and affordability of screening services, inadequate access to mammography and diagnostic facilities, fear of cancer diagnosis, low awareness, cultural beliefs, geographical barriers, and weak referral and follow-up systems may reduce the effectiveness of educational interventions. The study therefore expects accessible, accurate, culturally appropriate, and professionally supported breast cancer risk-assessment education to contribute significantly to improved breast cancer screening practices among women in Nigeria. The study is expected to contribute to the literature on breast cancer prevention, cancer risk assessment, breast cancer screening, women's health, health education, cancer awareness, early detection, health literacy, preventive healthcare, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, cancer-control programmes, primary healthcare centres, hospitals, healthcare professionals, women's organizations, development partners, and policymakers regarding strategies for improving breast cancer prevention and early detection. The study will also provide evidence-based recommendations for strengthening breast cancer risk-assessment education, integrating individualized risk communication into women's health services, improving access to appropriate screening and diagnostic facilities, strengthening referral and follow-up systems, addressing misconceptions about breast cancer screening, and promoting timely professional evaluation of breast abnormalities across Nigeria.

Keywords: Breast cancer risk assessment, risk-assessment education, breast cancer screening, breast cancer prevention, early detection, women's health, health education, health literacy, preventive healthcare, Nigeria, public health.