An assessment of women’s knowledge, attitude and health seeking behaviour towards breast cancer and it’s screening in Kakamega county of Kenya

Abstract

Background: Seventy to eighty percent of the cancer cases are diagnosed in late stages in Kenya. Breast cancer is among the most common cause of mortality in women and late diagnosis is the major ubiquitous concern. Existing literature has substantially focused on unraveling epidemiological and health system profile, but has largely neglected the assessment of factors shaping people’s decisions on health care use. The study sought to evaluate the knowledge, attitude and health seeking behavior towards breast cancer and its screening in a quest to explain why women present for prognosis and treatment when symptomatic pointers are in advanced stages, impeding primary prevention strategies. Methods: Focus group discussions (FGDs) were conducted with women and key informant interviews (KII) in the rural and urban settings of Kakamega County in western Kenya. Results: Women perceived breast cancer as a deadly disease and conveyed fear of having early screening. Rural women preferred to seek self-prescribed medications and the use of traditional herbal remedies for long period before presenting for professional care on suspicion that the lamp is cancerous. Long distance to health facilities, lack of information to establish effective follow-up treatment and low-income status were underscored as their major health seeking behavior barriers for rural women; whereas, urban women identified marital status as their main barrier. Key informant interviews revealed that health communication programs emphasized more on communicable diseases. Conclusions: Creating breast cancer awareness alongside clear guidelines on accessing screening and treatment infrastructure is critical. It was evident, a diagnosis of breast cancer/lump brings unexpected confrontation with mortality; the fear, pain, cultural barriers, emotional and financial distress are very real. Without clear referral channels to enable those with suspicious lumps or early stage disease get prompt diagnosis and treatment, then well-meaning awareness will not necessarily contribute to reducing morbidity and mortality.