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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
Lay perceptions of breast cancer in Western Kenya
Violet Naanyu, Chite Fredrick Asirwa, Juddy Wachira, Naftali Busakhala, Job Kisuya, Grieven Otieno, Alfred Keter, Anne Mwangi, Orango Elkanah Omenge, Thomas Inui
Violet Naanyu, Chite Fredrick Asirwa, Juddy Wachira, Naftali Busakhala, Job Kisuya, Grieven Otieno, Alfred Keter, Anne Mwangi, Orango Elkanah Omenge, Academic Model Providing Access to Healthcare (AMPATH), Eldoret 30100, Kenya
Violet Naanyu, Anne Mwangi, Department of Behavioral Sciences, School of Medicine, College of Health Sciences, Moi University, Eldoret 30100, Kenya
Chite Fredrick Asirwa, Thomas Inui, Department of Medicine, School of Medicine, Indiana University, Indianapolis, IN 46202, United States
Naftali Busakhala, Department of Pharmacology, School of Medicine, College of Health Sciences, Moi University, Eldoret 30100, Kenya
Orango Elkanah Omenge, Department of Reproductive Health, School of Medicine, College of Health Sciences, Moi University, Eldoret, 30100, Kenya
Thomas Inui, Regenstrief Institute, Inc., Indianapolis, IN 46202, United States
Author contributions: All persons qualify for inclusion as authors; Naanyu V, Wachira J, Asirwa CF, Busakhala N, Keter A, Mwangi A and Inui T designed the research; Naanyu V, Wachira J, Busakhala N and Kisuya J performed the research; Naanyu V, Wachira J, Kisuya J, Otieno G, Keter A, Mwangi A and Inui T analyzed the data; Naanyu V, Kisuya J and Inui T wrote the paper; all authors reviewed the paper.
Supported by The Walther Cancer Foundation of Indianapolis, Indiana, United States.
Institutional review board statement: This study was reviewed and approved by two Institutional Review Boards, the Institutional Research and Ethics Committee of Moi University and the IRB of Indiana University.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: None of the study authors have conflicts of interest.
Data sharing statement: The study’s data, numerical and text after de-identification, would be available upon written request from the senior author.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Thomas Inui, ScM, MD, Regenstrief Institute, Inc., 1050 Wishard Blvd RG5, Indianapolis, IN 46202, United States.
tinui@iupui.edu
Telephone: +1-317-2749124 Fax: +1-317-2749304
Received: December 30, 2014
Peer-review started: December 31, 2014
First decision: February 7, 2015
Revised: June 3, 2015
Accepted: June 9, 2015
Article in press: June 12, 2015
Published online: October 10, 2015
Processing time: 287 Days and 8.4 Hours
AIM: To explore lay perceptions of causes, severity, presenting symptoms and treatment of breast cancer.
METHODS: In October-November 2012, we recruited men and women (18 years and older) from households and health facilities in three different parts of Western Kenya, chosen for variations in their documented burdens of breast cancer. A standardized and validated tool, the breast cancer awareness measure (BCAM), was administered in face-to-face interviews. Survey domains covered included socio-demographics, opinions about causes, symptoms, severity, and treatment of breast cancer. Descriptive analyses were done on quantitative data while open-ended answers were coded, and emerging themes were integrated into larger categories in a qualitative analysis. The open-ended questions had been added to the standard BCAM for the purposes of learning as much as the investigators could about underlying lay beliefs and perceptions.
RESULTS: Most respondents were female, middle-aged (mean age 36.9 years), married, and poorly educated. Misconceptions and lack of knowledge about causes of breast cancer were reported. The following (in order of higher to lower prevalence) were cited as potential causes of the condition: Genetic factors or heredity (n = 193, 12.3%); types of food consumed (n = 187, 11.9%); witchcraft and curses (n = 108, 6.9%); some family planning methods (n = 56, 3.6%); and use of alcohol and tobacco (n = 46, 2.9%). When asked what they thought of breast cancer’s severity, the most popular response was “it is a killer disease” (n = 266, 19.7%) a lethal condition about which little or nothing can be done. While opinions about presenting symptoms and signs of breast cancer were able to be elicited, such as an increase in breast size and painful breasts, early-stage symptoms and signs were not widely recognized. Some respondents (14%) were ignorant of available treatment altogether while others felt breast cancer treatment is both dangerous and expensive. A minority reported alternative medicine as providing relief to patients.
CONCLUSION: The impoverished knowledge in these surveys suggests that lay education as well as better screening and treatment should be part of breast cancer control in Kenya.
Core tip: A survey of women’s knowledge and beliefs about breast cancer causes, presentation, and treatment in Western Kenya uncovered significant ignorance and misperceptions. Effective approaches will be needed to remediate this situation if Kenyan national aspirations for breast cancer control are to succeed.
