Purpose
To assess factors contributing to the late-stage breast cancer presentation in Uganda.
Methods
A survey with open and close-ended questions was conducted on a community sample of
Ugandan women to assess 1. Breast cancer downstaging practices and breast health messaging
preferences to present early for a CBE in the theoretical scenario of self-detecting a palpable
lump (breast health messaging preferences) and 2. Their beliefs (culturally-perceived risks,
scientifically-established risks, perceived benefits of early detection) about breast cancer.
Results
The 401 Ugandan women who participated in this survey were mostly poor with less than a
primary school education. Of these women, 27% had engaged in BSE and 15% had undergone a
CBE. Greater breast cancer downstaging practices were associated with an urban location,
higher education, having a health center for their regular source of care and receiving breast
cancer education (P<0.05). Women indicated a greater breast health messaging preference from their provider (66%). This preference was associated with a rural location, having a health
center for their regular source of care, and receiving breast cancer education (P<0.05).
Culturally-perceived risks of breast cancer were common (58.5-97.7%) and were described by
the majority as the most important causes of breast cancer (69.2%), compared to scientificallyestablished
risks (45.6-64.5%; 16.2%, respectively). Perceived benefits of early detection varied
widely (12.3-70.3%) while many women held fatalistic attitudes towards their own detection
efforts, including the common belief that cure is impossible once they could self-detect a lump
(56.3%). Only having a lower income was associated with all breast cancer belief categories.