Screening by Clinical Breast Examination in Western Kenya: Who Comes?

Purpose: More than 80% of women with breast cancer in Kenya present to medical care with established late-stage disease. We sought to understand why women might not participate in breast cancer screening when it is offered by comparing the views of a cohort of those who attended a screening special event with those of community controls who did not attend.
Methods: All residents living close to three health centers in western Kenya were invited to participate in screening. Participants (attendees) underwent clinical breast examination by trained physician oncologists. In addition, women who consented were interviewed by using a modified Breast Cancer Awareness Module questionnaire. Nonattendees were interviewed in their homes the following day.
Results: A total of 1,511 attendees (1,238 women and 273 men) and 467 nonattendee women participated in the study. Compared with nonattendees, the women attendees were older, more often employed, knew that breast cancer presented as a lump, and were more likely to have previously felt a lump in a breast. In addition, they were more likely to report previously participating in screening activities, were more likely to have performed breast self-examination, and were less concerned about wasting a doctor's time. Almost all those surveyed (attendees and nonattendees) expressed interest in future breast cancer screening opportunities.
Conclusion: The women who volunteer for breast cancer screening in western Kenya are more aware of breast cancer than those who do not volunteer. Screening recruitment should seek to close these knowledge gaps to increase participation.
Competing Interests: Authors’ disclosures of potential conflicts of interest and contributions are found at the end of this article.The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or jco.ascopubs.org/site/ifc. Naftali Wisindi BusakhalaNo relationship to discloseFredrick Asirwa ChiteNo relationship to discloseJuddy WachiraNo relationship to discloseViolet NaanyuNo relationship to discloseJob Wapangana KisuyaNo relationship to discloseAlfred KeterNo relationship to discloseAnn MwangiNo relationship to discloseEvanjeline NjiruNo relationship to discloseDavid ChumbaNo relationship to discloseLugaria LumaraiNo relationship to disclosePenina BiwottNo relationship to discloseIvan KiplimoNo relationship to discloseGrieven OtienoNo relationship to discloseGabriel KigenNo relationship to disclosePatrick Loehrer SrNo relationship to discloseThomus InuiNo relationship to disclose