Egyptian Pharmaceutical Journal

: 2017  |  Volume : 16  |  Issue : 3  |  Page : 133--137

Knowledge, attitude, and practice regarding breast cancer among women of Kaduna Metropolis

Nanloh S Jimam, Dauda A Dangiwa, Elizabeth O Salami 
 Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, University of Jos, Jos, Nigeria

Correspondence Address:
Nanloh S Jimam
Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, University of Jos, PMB 2084 Jos


Context The incidence of breast cancer disease is on the rise in Nigeria. There is an urgent need for adequate knowledge regarding the disease among the risky populations for necessary self-care practices as an intervention measure. Aim The main purpose of this study was to assess the knowledge, attitudes, and practices of women concerning breast cancer in Kaduna Metropolis of Kaduna State. Settings and design It was a cross-sectional study conducted in Kaduna Metropolis. Materials and methods Semistructured questionnaires were administered to 300 respondents who consisted of women within the ages of 18 years and older and residing in Kaduna Metropolis. Statistical analysis The collected data were analyzed using the IBM statistical package for social sciences, version 20.0 software programmer. Results Although the results showed that most of the respondents (93%) were aware of breast cancer through different sources of information, their average knowledge scores on risk factors (30.36), signs, and symptoms (48.7%) were below average; however, their knowledge on the different screening methods was slightly above average (53.8%). Conclusion The result showed respondents’ high levels of awareness on breast cancer but poor knowledge on the risk factors, signs and symptoms, and screening practices despite their positive attitudes toward the disease.

How to cite this article:
Jimam NS, Dangiwa DA, Salami EO. Knowledge, attitude, and practice regarding breast cancer among women of Kaduna Metropolis.Egypt Pharmaceut J 2017;16:133-137

How to cite this URL:
Jimam NS, Dangiwa DA, Salami EO. Knowledge, attitude, and practice regarding breast cancer among women of Kaduna Metropolis. Egypt Pharmaceut J [serial online] 2017 [cited 2018 Feb 22 ];16:133-137
Available from:

Full Text


Epidemiologic studies have shown high burden of breast cancer in both the developed and developing countries, and the cases were seen to be on the rise [1],[2]. It had been reported to be associated with poor knowledge of the public regarding the disease and its risk factors, in addition to their attitudes and practices toward the screening and preventive practices [3],[4]. Some of the common predisposing risk factors that have been reported to influence the prevalence of the disease include diet and diet-related factors, alcohol and tobacco consumption, hormones and reproductive factors, exposure to ionizing radiation, family history of breast cancer, and presence of benign breast disease [5],[6],[7].

To reduce the incidence of the disease, there was a need for understanding the respondents’ skill and knowledge regarding the importance of paying close attention to lifestyles or related factors that might expose them to the disease, in addition to their screening practices toward ensuring prevention [8],[9],[10],[11].

Several studies had documented different levels of the knowledge, attitude, and practice of women regarding breast cancer from different parts of the world [12],[13],[14], with some from Nigeria [15],[16],[17]. In the course of our literature search, it was observed that not much information relating to patients’ knowledge and practices on breast cancer was available in the Kaduna State; hence, the purpose of the study was to assess women’s understanding and practices related to breast cancer. The outcome of the study will help in strengthening the preventive components of breast cancer control strategy in the state and by extension, Nigeria.

 Materials and methods

Study location

The study was carried out in three local government areas of Kaduna State (Kaduna South, Kaduna North, and Lere). Kaduna State is located in northwestern zone of Nigeria, sharing boundaries with Niger State to the west; Zamfara, Katsina, and Kano states to the north; Bauchi and Plateau states to the east; and Abuja and Nasarawa states to the south [18].

Study population and sample size

The study population consisted of all women within the age limits of 18 years and older residing within the study areas. The sample size was calculated using Slovin formula at confidence interval of 95%, with absolute precision of 0.05 [19].

Study design

The respondents were purposely selected based on strategic locations and population sizes, and at each of the selected location, simple random sampling was used in selecting the 300 respondents.

Ethical approval

The study was approved by the Ethics Committee of the Faculty of Pharmaceutical Sciences, University of Jos, Nigeria. The purpose of the study was explained to all the respondents, and their verbal consents were obtained. They were also assured of confidentiality of the collected information, in addition to informing them that participation in the study was voluntary.

Data collection

A semistructured questionnaire covering all the relevant information pertaining to the study variables such as sociodemographic information, knowledge, attitude, and practice of the respondent was included. It was developed based on questions used in previous peer-reviewed published studies, and the instrument was pretested on seven respondents within the study areas, and the results were excluded from the main report of the study.

The pretested questionnaires were then self-administered to the respondents within the study areas, with special guidance given to those who were not sufficiently literate. Thereafter, the filled questionnaires were retrieved on the spot by the researcher and coded for analysis.

Data analysis

The collected data were then encoded and analyzed using IBM statistical package for social sciences, version 20, to statistically describe the frequencies of occurrences of the study variables among respondents (SPSS; SPSS Inc., Chicago, Illinois, USA).


Respondents’ demographic characteristics

Of the 300 (100%) respondents who participated in the study, 55.30% of them were within the age brackets of 18 and 27 years, with 26.7% being in the age bracket of 28 and 37 years; most of them (58.3%) were single, whereas 34.7% were married. Most of them (30.3%) had degree as their highest academic qualification followed by diploma/NCE/CHEW (28%) and secondary certificates (27.7%) ([Table 1]).{Table 1}

Respondents’ awareness and sources of information on breast cancer

Most of the respondents (93%) had heard of breast cancer through different sources of information, with most of them identifying health workers and the media as their main sources of information ([Figure 1] and [Figure 2]).{Figure 1}{Figure 2}

Respondents’ knowledge on breast cancer

[Table 2] shows that the respondents’ knowledge on some of the predisposing risk factors of the disease such as positive family history (60.7%), tobacco consumption (53.7%) and smoking (52.7%) was fair, but their average knowledge score on all the selected risk factors was poor (30.36%).{Table 2}

Their knowledge regarding the signs and symptoms of breast cancer was below average (48.71%), though the details of the results ([Table 2]) showed their good recognitions of some of the symptoms such as presence of lumps in the breast (81.30%), pain or soreness in the breast (71%), swelling or enlargement of the breast (65%), discharge from the breast (57%), and changes in the shape of the breast (50%).

Approximately half of the respondents (53.80%) were able to identify the different screening methods for the disease, with most of them (72.7%) recognizing self-breast examination as the best screening method ([Table 2]).

Respondents’ attitudes toward breast cancer

Most of the respondents admitted that breast cancer was more prevalent in Nigeria, with more than 70% of them agreeing that any woman could be at risk of getting the disease. Similarly, most of them recognized screening practices as the best approach toward helping in the prevention or early diagnosis and treatment (65.3%) of the disease, with majority of them agreeing with surgical operation as the best treatment option ([Table 3]).{Table 3}

Respondents’ breast cancer screening practice

Despite the fact that most of the respondents had good attitudes toward the disease ([Table 3]) and knew the right age for initiating self-breast examination ([Table 4]), their practice of self-breast examination was averagely poor ([Table 4]); more than 60% of them also confessed not visiting a medical practitioner for breast cancer examination and care ([Table 4]).{Table 4}


Although the result of the study showed high levels of awareness about breast cancer among the respondents, their mean score knowledge regarding the risk factors for the disease was poor (30.94%) compared with the results of similar studies conducted by Akhigbe and Omuemu [5] who found the respondents’ knowledge on breast cancer risk factors to be approximately 55%. On the contrary, the findings of the present study showed better knowledge of the study population on risk factors compare with a similar study conducted among women in Northern Nigeria [3].

Regarding the signs and symptoms of the disease, their understandings were averagely fair compared with the risk factors. The observed high knowledge of the respondents on some of the specific symptoms of the disease could be associated with the advancing stages of the disease, which are obvious. For instance, many of them knew that presence of lumps in the breast, pain or soreness in the breast, swelling or enlargement of the breast, discharge from the breast, and changes in the shape of the breast were symptoms of the disease, and these had been reported as indications of later stage of the disease [6],[20],[21].

The observation of poor breast cancer screening practices among respondents was similar to that found in a study conducted by Okobia et al. [16] but was contrary to similar studies conducted in developed countries, which showed the presence of regular self-breast screening practices among women and regular visitations to health personnel for checkup [22],[23],[24],[25]. This may be helpful in early detection and prompt attention to any incidence of the disease, thereby arresting the situation at an earlier stage of the disease [23].Although there was a high level of awareness about the disease among respondents through health personnel, news media, and family members ([Figure 1] and [Figure 2]), their effect on the respondents’ knowledge of the cause and prevention of the disease was minimal. It implies a need for more public teachings about the disease, using the identified common means of information dissemination (e.g., media), as most of the households have televisions or radio. In addition, community health talk on the disease could be organized, during which the disease-related information and its preventive measures could be passed on to the society [26].


The result of this study showed a high level of awareness about the existence of breast cancer disease among the respondents, who also had positive attitudes toward the disease, but their knowledge regarding the disease and the screening practices was poor, which may affect the preventive practices of the disease.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


1Europe PMC Funders Group. The global burden of cancer. JAMA Oncol 2015; 1:505–527.
2John RB, Ismail J. The global breast cancer burden-review. Future Oncol 2012; 8:697–702.
3Azubuike SO, Celestina UO. Breast cancer. The perspective of Northern Nigerian women. Int J Prev Med 2015; 6:130.
4Garg P, Bansal M, Garg M. Creating awareness about the painless nature of early breast cancer lump is important in low income countries. Breast J 2009; 16:101–102.
5Akhigbe AO, Omuemu VO. Knowledge, attitudes and practice of breast cancer screening among female health workers in a Nigerian urban city. BMC Cancer 2009; 9:203.
6American Cancer Society. Cancer facts & figures of 2016. Atlanta: American Cancer Society; 2016.
7World Health Organization. World Cancer Report, Inter. Geneva: Agency for Research on Cancer (IARC); 2014.
8Odusanya OO, Tayo OO. Breast cancer knowledge, attitudes and practice among nurses in Lagos, Nigeria. Acta Oncol 2001; 40:844–848.
9Maxwell CJ, Bancej CM, Snider J. Predictors of mammography use among Canadian women aged 50-69: findings from the 1996/97 National Population Health Survey. CMAJ 2001; 164:329–334.
10English J. Importance of breast awareness in identification of breast cancer. Nurs Times 2003; 99:18–19.
11Georgia R, Sadler L. Breast cancer knowledge, attitudes, and screening behaviours among African American women: the Black cosmetologists promoting health program. BMC Public Health 2007; 7:57.
12Ahmed F, Mahmud S, Hatcher Juanita H, Khan S. Breast cancer risk factors knowledge among nurses in teaching hospitals of Karachi, Pakistan: a cross-sectional study. BMC Nurs 2006; 5:6.
13Chongi PN, Krishan M, Hong CY, Swah TS. Knowledge and practice of breast cancer screening among public health nurses in Singapore. Singapore Med J 2002; 43:509–516.
14Johan. S, Al-Saiqul AM, Abdelgadir MH. Breast cancer knowledge, attitude and practices of breast self-examination among women in Qassim region of Saudi Arabia. Saudi Med J 2006; 27:272–277.
15Jebbin NJ, Adotey JM. Attitude to knowledge and practice of breast self-examination (BSE) in Port Harcourt. Niger J Med. 2004; 13:166–170.
16Okobia MN, Bunker CH, Okonofua FE, Osime U. Knowledge, attitude and practice of Nigerian women towards breast cancer: a cross-sectional study. World J Surg Oncol 2006; 4:11.
17Aderounmu AO, Egbewale BE, Ojofemi EO, Fadora SO, Oguntola AS, Asekun-Olarinmoye EO et al. Knowledge, attitude and practice of educated and non-educated women to cancer of the breast in semi-urban and rural area of SouthWest, Nigeria. Niger Postgrad Med J 2006; 13:182–188.
18National Population Commission (NPC). Nigeria Malaria Indicator Survey 2010. Abuja: National Malaria Control Programme (NMCP) and ICF International; 2012.
19Pangestuti ASD, Armanu S, Noermijati A. The role of work commitment and work motivation in mediate the influence of transformational leadership on the performance (Study on PT. Terminal Peti Kemas Surabaya). Eur J Bus Manag 2014; l6:21.
20Curado MP. Breast cancer in the world: incidence and mortality. Salud Publica Mex 2011; 53:372–384.
21Garg P. Awareness that early cancer lump is painless could decrease breast cancer mortality in developing countries. World J Clin Oncol 2016; 7:321–323.
22Dundar EP. The knowledge and attitude of breast self-examination and mammography in a group of women in rural area in western Turkey. BMC Cancer 2006; 6:43.
23Kosters JP, Gotszsche PC. Regular self-examination or clinical examination for early detection of breast cancer. Cochrane Database of Systematic Reviews. Copenhagen (Denmark): John Wiley & Sons Ltd; 2008. p. 16.
24Popoola AO, Omodele FO, Oludara MA, Ibrahim NA, Igwilo AI, Makanjuola SBL. Prevalence and pattern of cancers among adults attending a Tertiary Health Institution in Lagos, Nigeria. IOSR J Dent Med Sci 2013; 6:68–73.
25Smith S, Dumant M. The state of consumer health information: an overview. Health Info Libr J 2009; 26:260–278.
26Gupta A, Sridhar K, Dhillon PK. A review of breast cancer awareness among women in India: cancer literate or awareness deficit? Eur J Cancer 2015; 51:2058–2066.