CAUSES, MANAGEMENT AND PERCEPTION OF BREAST CANCER AMONG FEMALE STUDENT IN TERTIARY INSTITUTION

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CAUSES, MANAGEMENT AND PERCEPTION OF BREAST CANCER AMONG FEMALE STUDENT IN TERTIARY INSTITUTION

CHAPTER ONE

INTRODUCTION

Breast cancer is a leading cause of death and disability among young women in re- source constrained countries. The incidence of breast cancer in low income country continues to be lower than in most high-income countries. However, the mortality rate from breast cancer is very high. This high mortality rate is likely due to a lack of awareness about breast cancer detection and treatment, inadequate facilities for de- tection and diagnosis, as well as poor access to treatment. In many developing coun- tries, the incidence of breast cancer is now rising sharply due to changes in reproduc- tive factors, increase urbanization, adoption of western lifestyle, and increased life expectancy. (Lawrence et al, 2010.)

There are 2.1 million new cases every year, and the mortality rate from breast cancer is 627,000 deaths among women which is approximately 15% of all cancer deaths. Breast cancers were more common in developed countries previously, however it is estimated that breast cancer rates are inflating in nearly every area worldwide. The negative outcomes of breast cancer can be reduced by using preventative measures. They can also, be reduced if it is detected at an early stage. However, in developing countries, due to the incidence of breast cancer that is diagnosed at late stage; these strategies cannot eliminate the majority of breast cancers or improve the outcome. Therefore, early detection of breast cancer is the cornerstone of breast cancer control in order to improve breast cancer outcomes and survival chances. By participating in awareness programmes that teach women how to recognize the early signs and symptoms, breast cancer diagnosis can be made at earlier stages; which can result in faster treatment. (WHO, 2018.)

 

According to WHO 2017, deaths due to breast Cancer in Nigeria remained 1,054 which is 0.65% of all deaths. The age adjusted Death Rate is 9.21 per 100,000 popu- lation. Nigeria ranks 163th position in the world in breast cancer mortality rate inci- dence. Statistical data collected from Globocan 2018, shows there were 2068 new breastcancercasesdiagnosed

The purpose of this thesis was to find out the Causes, management and perception of breast cancer among  student in tertiary institution among college students in Nigeria. Knowledge of breast cancer and awareness regarding practices is common in developing countries.

There are limited research done and are published in Nigeria that are focused on this topic. Hence, research on this topic would be preeminent and possibly very beneficial for Nigerian population. Students are focused in this study because they are the integral part of community who plays vital roles in providing further knowledge in their family and society. Hence educating the students about breast cancer and the practice of breast self-examination assists them to detect breast cancer in early phase. This thesis also evaluates the knowledge of participants after the awareness programme.

Statement of the  Problem

Prognosis and survival rates for breast cancer vary greatly depending on the cancer type, stage, treatment and geographical location of the patient (Fasoranti, 2010). Survival rates of breast cancer in the western world are high as eight out of ten women in England diagnosed with breast cancer survive for at least five years. In developing countries, survival rates of breast cancer are much poorer. Lack of awareness of early detection measures and screening for breast cancer is common in developing countries (Hanna & Kangolie, (2010)

Salaudeen, et al (2009) asserted that the black woman usually presents late for treatment of breast cancer with a bigger mass and seems afflicted with a biologically more aggressive tumour. Jebbin and Adotey (2009) reported that many cases of carcinoma of the breast they found in the clinic were advanced, with large tumours and multiple nodal involvements and have poorer clinical and pathological prognostic outcome. Jebbin and Adotey, 2009, believe that if women in Port-Harcourt are knowledgeable about BSE and practice it, this scenario may not be so. Similarly, at the surgical unit of Imo State Teaching Hospital, women with breast cancer are presenting with advanced stages of the disease. As a result of late detection of breast cancer, five women of Umuowa died of breast cancer between March and June, 2010.

 

Otunne (2008) acknowledged that following hospital records in Nigeria breast cancer is truly an epidemic among women, as it was estimated that 211,000 new cases of invasive breast cancer was diagnosed in 2007 and 43, 3000 patients died of this disease in Nigeria. Tara, et al (2008) noted that the earlier a woman is diagnosed of breast cancer, the better her chances of survival.  Since there is increased mortality in Nigeria due to late detection and late presentation, one begins to wonder if women are aware of breast cancer and if they practice BSE. This study is therefore set to empirically ascertain Causes management and perception of breast cancer among female student in tertiary institution.

Research Questions 

  1. What is the knowledge level regarding breast cancer among female students?
  2. What are the attitudes towards breast cancer among students?
  3. What are the screening practices of breast cancer among students in Nigeria?
  4. What are the health seeking behaviors of students regarding breast cancer?
  5. Are there differences in knowledge level, attitudes and practices of students re- garding breast cancer before and after awareness programme?
  6. What are the knowledge level and attitudes regarding breast cancer among male students?

Objectives of the Study

The main objective of the study is on Causes,management and perception of breast cancer among female student in tertiary institution.

The following are the specific objectives;

  1. To examine the knowledge level regarding breast cancer among female students
  2. To understand the attitudes towards breast cancer among students
  3. To ascertain the screening practices of breast cancer among students in Nigeria
  4. To investigate the health seeking behaviors of students regarding breast cancer
  5. To examine the differences in knowledge level, attitudes and practices of students re- garding breast cancer before and after awareness programme?
  6. To empirically ascertain the knowledge level and attitudes regarding breast cancer among male students?

 Scope and Limitations of the Study

The study, however, is subject to several limitations. The sample size for the data collection was not sufficient as stated by sample size calculator. Only one tertiart institution student was involved. The results could have altered if the study has increased number of participants. It could have been better if other secondary and university student were also included to provide the generalized result of the population. The result of this study might be biased as the sample size was limited and they were not selected randomly. The level of knowledge of students after awareness programme was assessed soon after providing the education; hence, it was not assured if the participants are applying the education to their daily habit and behaviors. It is recommended that studies should be carried out for time intervals for evaluating the effectiveness of the educative programme. Due to time limitation, the concentration level of the students regarding Causes, management and perception of breast cancer was relatively less. A less interest and rapidity was also observed when filling up the questionnaires. This might be because the pre data and post data along with the awareness programme was conducted on the same day, making the students lethargic after their lectures. This limitation needs to be measured when interpreting the findings of this study.

Significance of the Study

The findings of this study will help to provide information on breast cancer awareness and practice of BSE among students. If the information obtained indicate that the women have poor awareness of breast cancer and do not practice BSE or do not do so adequately, it will sensitize health workers to the needs of the women and health-educate them accordingly. This will help in the delivering of focused and directed health talks to the women in the rural areas on the meaning of BSE, meaning of breast cancer and the proper steps used in BSE. This will in turn increase attention to and practice of BSE among rural women.

When the findings of this study come to the awareness of other Government Health Agencies, it will assist them in devicing the means through other sources of information such as television, radio etc to ensure increased awareness on breast cancer and BSE in rural communities. Through these media, the women will be made to know the importance of early reporting of breast changes to their healthcare providers thereby creating room for early diagnosis of breast cancer for better clinical and prognostic outcomes.

It is expected that when the above measures are adequately implemented, the breast cancer and BSE awareness will be increased among these women. This in effect will ensure regular and accurate performance of BSE and consequently early detection of abnormalities. Decrease in late detection and presentation will lead to reduction of maternal morbidity and mortality rate due to breast cancer which will in turn contribute to the achievement of millennium development goal four.

 

The information obtained from this study may be of help to other researchers interested in working in this field as it will serve as a reference material for further research.

Operational definition of terms

  • Breast Self Examination: An individual examining her breasts to look and feel for abnormal changes such as lump, discharge, swelling, pain.
  • Breast cancer Awareness: In this study means if the women have heard of breast cancer, seen cases of breast cancer, how it is detected and how it presents. It will also mean awareness of those risk factors that could predispose one to breast cancer such as
  1. a) Behavior or actions of a person e.g. smoking, alcohol, high fat diet, nulliparity, late first pregnancy.
  2. b) Factors within the person; e.g. Presence of previous cancer, age, breast biopsies, breast cancer among first-degree relatives.
  3. c) Environmental factors e.g. radiation and environmental pollutants.
  • Awareness of BSE: awareness will denote if the women have heard of breast self examination, its purpose, timing and things to watch out for.
  • Sources of Information on Breast cancer and BSE: For this study, sources of information include health workers, friends, religious leaders, traditional leaders, newspaper, radio, televisions, poster, magazine, library and journals.
  • Practice of Breast Self Examination: for this study means whether it is done, its frequency, accuracy of procedure. It will also include the reasons for not practicing
  • Demographic Factors: The demographic factors referred to in this study are parity, age and educational level.
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