The 'fear factor' : Nigerian women and practitioners' views on the factors affecting attendance in mammography screening

Breast cancer is one of the leading causes of death amongst women. According to the World Health Organisation (WHO), a significant increase in the incidence of breast cancer is expected in developing countries (such as Nigeria) by 2030. Mammography screening can significantly reduce the mortality and morbidity resulting from breast cancer. In Nigeria, however, 70% of the breast cancer cases are reported at its later stages, and evidence concludes that the participation level of eligible women in the mammography-screening programme is low. This study is the first to explore the factors affecting women’s attendance in mammography screening in the Lagos state via a qualitative approach. A qualitative descriptive approach is used to explore the views of susceptible women living in Lagos state. Seven focus group discussions (n= 65) and face-to-face interviews with five mammography practitioners in Lagos state were conducted. The study was guided by the theory of care seeking behaviour, and participants were questioned through semi-structured interviews and focus group guides. A conventional content analysis method was used to analyse the information gathered from the participants. Results have shown that lack of awareness among women influences their knowledge of benefits and risks, thus exposing them to several forms of fear and cultural issues (such as, trust in wonder drugs, believe in God, and the culture of non-disclosure of problems) which may directly affect their participation in mammography screenings. In addition, professionalism of mammography staff and government’s role in providing an effective mammography screening service were external factors found to influence women’s attendance. To conclude, the need for targeted education within the society is essential, as the participants identified that education might improve awareness, reduce fear and improve women’s attendance.