A groundbreaking community-based study recently published in Health Science Reports has shed light on the ongoing challenges surrounding breast cancer screening in southeastern Bangladesh. The research, conducted by Mohammad Injamul Hoq and colleagues, has revealed alarming gaps in awareness and participation in breast cancer screening practices.
Breast cancer remains one of the most common cancers among women worldwide, and early detection is crucial for reducing mortality rates. While the disease is widely recognised in Bangladesh, the study highlights the significant barriers preventing many women from accessing essential screening services.
Overview of the study
The study surveyed 869 women aged 18 and above from both urban and rural areas in Chattogram, Bangladesh. It sought to evaluate their awareness of breast cancer, screening practices, and the barriers they faced in seeking early detection methods, such as Breast Self Examination (BSE) and Clinical Breast Examination (CBE). With 47.3% of respondents residing in urban areas and 52.7% from rural regions, the study offered a comprehensive look at the disparities between these two populations in terms of breast cancer awareness and practice.
Key findings
Limited awareness of screening methods: Despite 77% of participants having heard of breast cancer, awareness of specific screening methods was notably low. Only 32.68% of women were aware of BSE, a simple yet effective method for early detection. Even fewer – a mere 52.47% -- had ever heard of CBE, which is performed by healthcare professionals. Urban women showed higher awareness levels compared to their rural counterparts. In urban areas, 44.28% of women were aware of BSE, while in the rural regions, this figure dropped significantly to just 22.27%. Similarly, 63.75% of urban women had heard of CBE, compared to only 42.36% of rural women.
Low participation in screening: Participation in screening activities was even lower than awareness levels. Just 27.73% of respondents reported ever performing a BSE, with a stark divide between urban (40.15%) and rural (16.59%) areas. Even more concerning, only 14.61% of participants had ever visited a health facility for CBE, with rural women (8.08%) being far less likely than urban women (21.90%) to undergo this potentially life-saving examination.
Education and economic status: The study found a strong correlation between education levels and participation in breast cancer screening. Women with secondary or higher education were much more likely to perform BSE and CBE compared to those with only primary education. Specifically, women with higher secondary education were seven times more likely to perform BSE than those with lower education levels. Family income also played a role, as women from households earning between 20,001 and 40,000 (BDT) per month were twice as likely to perform BSE compared to those earning less than 20,000 (BDT).
Barriers to screening: The study identified a range of perceived barriers to breast cancer screening. A striking 92.86% of respondents believed that having no symptoms meant they were not at risk, discouraging them from seeking early detection. This misconception was widespread in both urban and rural areas, though more prevalent in the rural areas.
In addition, 84.34% of participants cited the lack of awareness programmes as a major reason for not participating in screening. The absence of accessible healthcare facilities and organised campaigns, particularly in rural areas, further exacerbates the issue. While fear of clinical examinations and social stigma were less frequently cited, they still contributed to the hesitancy
among many women regarding screening.
The urban-rural divide
One of the study’s most significant findings was the stark contrast between urban and rural women when it comes to breast cancer screening. Women in urban areas not only had higher levels of awareness but were also far more likely to perform BSE and CBE. This disparity underscores the need for targeted health interventions that address the specific challenges faced by rural women.
perform self-examinations or seek clinical screenings. This is a clear indication that we need to intensify our efforts in rural health education and ensure that women in these regions have access to the same resources as their urban counterparts,” said the study’s lead author.
Public health implications
The findings of this study emphasise the urgent need for government and healthcare organisations to enhance breast cancer awareness and promote screening, particularly in rural areas where access to healthcare services remains limited. While Bangladesh’s Ministry of Health has established several
screening facilities and campaigns, their reach is not yet sufficient to cover the entire population. The study calls for a more robust and widespread approach, particularly in underserved areas where breast cancer screening awareness remains low. The earlier breast cancer is detected, the better the chance of successful treatment. This means we need to make self-examinations and clinical screenings a regular part of women’s healthcare.
The way forward
The study underscores the urgent need for widespread public health campaigns to promote breast cancer screening,
particularly in the rural areas. The researchers recommend enhancing educational programmes and expanding the availability of screening services to reduce the mortality and morbidity associated with late-stage breast cancer.
“The findings of our study show that increasing awareness and access to screening in communities can make a significant difference in early detection and treatment outcomes. This is a call for health authorities to prioritise breast cancer awareness
and ensure that women everywhere have access to lifesaving screening services.”
Breast cancer remains the leading cause of cancer-related deaths among women in Bangladesh, but with proper screening and early detection, many of these deaths could be prevented.______________________________________The writer is an Assistant Professor,School of Public Health, Universityof Creative Technology Chittagong.
“In the rural areas, women are about three times less likely to
