Knowledge, Attitude and Practice of Breast Self-examination Among Female University Students from 24 Low, Middle Income and Emerging Economy Countries

  • Pengpid, Supa (ASEAN Institute for Health Development, Mahidol University) ;
  • Peltzer, Karl (ASEAN Institute for Health Development, Mahidol University)
  • Published : 2014.11.06


The aim of this study was to investigate the knowledge, attitude and practice of Breast Self-Examination (BSE) among female university students from 24 low, middle income and emerging economy countries. Using anonymous questionnaires, data were collected from 10,810 female undergraduate university students aged 16-30 (mean age 20.7, SD=2.9) from 25 universities in 24 countries across Asia, Africa and the Americas. Overall, 50.4% of the female students indicated that they knew how to conduct BSE. Among all women, 59.3% had never practiced BSE in the past 12 months, 21.3% 1-2 times, 10.3% 3-10 times, and 9.1% monthly. The proportion of monthly BSE was above 20% in Nigeria and Laos and below 2% in Bangladesh, India, Singapore, Russia, and South Africa. Logistic regression found that BSE importance or positive attitude was highly associated with BSE practice. BSE practices were found to be inadequate and efforts should be made to develop programmes that can increase knowledge related to breast cancer as well as the practice of breast self-examination.


  1. Ahmed BA (2010). Awareness and practice of breast cancer and breast-self examination among university students in Yemen. Asian Pac J Cancer Prev, 11, 101-5.
  2. Akhtari-Zavare M, Juni MH, Said SM, Ismail IZ (2013). Beliefs and behavior of Malaysia undergraduate female students in a public university toward breast self-examination practice. Asian Pac J Cancer Prev, 14, 57-61.
  3. Al-Sharbatti SS, Shaikh RB, Mathew E, Salman Al-Biate MA (2013). Breast self examination practice and breast cancer risk perception among female university students in Ajman. Asian Pac J Cancer Prev, 14, 4919-23.
  4. Al-Naggar RA, Al-Naggar DH, Bobryshev YV, Chen R, Assabri A (2011). Practice and barriers toward breast selfexamination among young Malaysian women. Asian Pac J Cancer Prev, 12, 1173-8.
  5. American Cancer Society (2014). American Cancer Society recommendations for early breast cancer detection in women without breast symptoms. Retrieved at; accessed 12 May 2014.
  6. Boulos DN, Ghali RR (2013). Awareness of breast cancer among female students at Ain Shams University, Egypt. Glob J Health Sci, 6, 154-61.
  7. Gwarzo UM, Sabitu K, Idris SH (2009). Knowledge and practice of breast-self examination among female undergraduate students of Ahmadu Bello University Zaria, northwestern Nigeria. Ann Afr Med, 8, 55-8.
  8. Shin KR, Park HJ, Kim M (2012). Practice of breast selfexamination and knowledge of breast cancer among female university students in Korea. Nurs Health Sci, 14, 292-7.
  9. Wardle J, Steptoe A (1991). The european health and behaviour survey: rationale, methods and initial results from the United Kingdom. Soc Sci Med, 33, 925-36.
  10. Wardle J, Steptoe A, Smith H, et al. (1995). Breast selfexamination: attitudes and practices among young women in Europe. Eur J Cancer Prev, 4, 61-8.
  11. WHO (2014). Breast cancer: prevention and control. Retrieved at; accessed12 May 2014.

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