Knowledge, attitude, and practice among non-breast cancer women towards breast cancer screening with a focus on economic factors

Abstract

Although breast cancer incidence and mortality are rising globally and China has a screening programme, participation remains low due to poor awareness and financial barriers. This cross-sectional study aimed to assess the knowledge, attitude, and practice (KAP) of breast cancer screening among 964 non-breast cancer women, averaging 29.79 years old, through web-based questionnaires and face-to-face interviews. The knowledge, attitude and practice scores were 7.04 ± 4.19 (possible range: 0-20), 25.37 ± 6.09 (possible range: 10-50), and 15.07 ± 2.84 (possible range: 0-20), respectively. Key barriers included embarrassment (65.45%), fear of radiation (49.48%), and treatment costs (70.34%). Structural equation modeling indicated that income had a direct effect on both knowledge (β = 0.36, P = 0.010) and attitude (β = 1.34, P < 0.001). The logistic regression analysis found that identifying as "housewife" (OR = 2.87, 95%CI: 1.11-7.37, P = 0.029) and having no medical insurance (OR = 3.19, 95%CI: 1.13-9.04, P = 0.028) were significantly associated with unwillingness to undergo breast cancer screening. In conclusion, this study shows that there is a significant gap in KAP regarding breast cancer screening among women in China, particularly among low-income groups. To improve screening rates, it is crucial to address these barriers, enhance knowledge, and provide better risk assessment resources.

Keywords: Breast cancer; Cross-Sectional study; Knowledge, attitude, practice; Screening.

Fig. 1

Structural equation modeling of responses in the study population (non-breast cancer women). The solid line in the figure indicates that the path coefficient is statistically significant, and the dashed line indicates that the path coefficient is not statistically significant.

Fig. 2

Structural equation modeling of responses in the particimants aged over 40 years old. The CA71 codes the question regarding the worry about treatment cost.