Barriers to uptake of breast cancer screening in Kenya

Abstract

Objectives: To conduct clinical breast cancer screening in three sites in Western Kenya and explore community barriers to screening uptake. Design: Cross-sectional study. Setting: Western Kenya specifically, Mosoriot, Turbo, and Kapsokwony. Subjects: Community members (18 years and older) who did not attend the screening events. Outcome Measure: The outcome measure was having heard about the breast cancer screening events. Both structured and open-ended questions were used for data collection. Item frequency, correlations, and content analyses were performed. Results: A total of 733 community members were surveyed (63% women, median age 33 years, IQR=26-43). More than half (55%) of respondents had heard about the screening but did not attend. The majority of those who had heard about this particular screening had knowledge of screening availability in general (45% vs. 25%, p<0.001). Only 8.0% of those who heard and 6.0% of those who had not heard of the screening event had previously undergone clinical breast exam (p=0.20). Reasons for not attending the screening event were personal factors, including busy schedule (41.0%), perceived low personal risk (12.7%), lack of transport (4.2%), as well as health facility factors such as poor publicity (14.4%) and long queues (8.7%). Conclusion: Barriers to breast cancer screening uptake were associated with inadequate publicity, perceived long waits at event and busy lives among community women.