Women's Knowledge, Attitudes, and Practices about Breast Cancer in a Rural District of Central India

  • Gangane, Nitin (Department of Pathology, Mahatma Gandhi Institute of Medical Sciences) ;
  • Ng, Nawi (Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umea University) ;
  • Sebastian, Miguel San (Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umea University)
  • Published : 2015.11.04


Background: Breast cancer accounted for almost 25% of all cancers in women globally in 2012. Although breast cancer is the most prevalent cancer in India, there is no organised national breast cancer screening programme. Local studies on the burden of breast cancer are essential to develop effective context-specific strategies for an early detection breast cancer programme, considering the cultural and ethnic heterogeneity in India. This study examined the knowledge, attitudes, and practices about breast cancer in rural women in Central India. Materials and Methods: This community-based cross sectional study was conducted in Wardha district, located in Maharashtra state in Central India in 2013. The sample included 1000 women (609 rural, 391 urban) aged 13-50 years, selected as representative from each of the eight development blocks in the district, using stratified cluster sampling. Trained social workers interviewed women and collected demographic and socio-economic data. The instrument also assessed respondents' knowledge about breast cancer and its symptoms, risks, methods of screening, diagnosis and treatment, as well as their attitudes towards breast cancer and selfreported practices of breast cancer screening. Chi-square and t-test were applied to assess differences in the levels of knowledge, attitude, and practice (the outcome variables) between urban and rural respondents. Multivariable linear regression was conducted to analyse the relationship between socio-demographic factors and the outcome variables. Results: While about two-thirds of rural and urban women were aware of breast cancer, less than 7% in rural and urban areas had heard about breast self-examination. Knowledge about breast cancer, its symptoms, risk factors, diagnostic modalities, and treatment was similarly poor in both rural and urban women. Urban women demonstrated more positive attitudes towards breast cancer screening practices than their rural counterparts. Better knowledge of breast cancer symptoms, risk factors, diagnosis, and treatment correlated significantly with older age, higher levels of education, and being office workers or in business. Conclusions: Women in rural Central India have poor knowledge about breast cancer, its symptoms and risk factors. Breast self-examination is hardly practiced, though the willingness to learn is high. Positive attitudes towards screening provide an opportunity to promote breast self-examination.


  1. Agarwal G and Ramakant P (2008). Breast cancer care in India: The current scenario and the challenges for the future. Breast care, 3, 21-7.
  2. Akel A, Tarawneh MR, Tarawneh MI (2011). Knowledge and practice of Jordanian women towards breast cancer and breast self-examination: A cross-sectional study in 2006. J Royal Med Services, 18, 80-6.
  3. American Cancer Society (2014). Learn about cancer. Breast cancer detailed guide. Retrieved from Accessed on 19 Apr 2014.
  4. Anderson OA, Cazap E, Saghir NS, et al (2011). Optimisation of breast cancer management in low resource and middle resource countries: executive summary of the Breast Health Global initiative consensus, 2010. Lancet Oncol, 12, 387-98.
  5. Aydogan U, Doganer YC, Kilbas Z, et al (2015). Predictors of knowledge level and awareness towards Breast cancer among Turkish females. Asian Pac J Cancer Prev, 16, 275-282.
  6. Das D and Pathak M (2012). The growing rural-urban disparity in India: Some issues. Int J of Adv Res Tech, 1, 1-7.
  7. Dinshaw KA, Rao DN, Ganesh B (1999). Tata memorial hospital cancer registry annual report, Mumbai, India.
  8. Doshi D, Reddy BS, Kulkarni S, Karunakar P (2012). Breast self-examination: knowledge, attitude and practice amongst female dental students in Hyderabad city, India. Indian J Palliative Care, 18, 68-73.
  9. EPI Info 6 TM, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
  10. Ferro S, Caroli A, Nanni O, Biggeri A, Gambi A (1992). A cross-sectional survey on breast self-examination practice, utilization of breast professional examination, mammography and associated factors in Romagna, Italy. Tumori, 78, 98-105.
  11. Hwang ES, Lichtensztajn DY, Gomez SL, Fowble B, Clarke CA (2013). Survival after lumpectomy and mastectomy for early stage invasive breast cancer: the effect of age and hormone receptor status. Cancer, 119, 402-11
  12. International Agency for Research on Cancer (2014). Globocan 2012: Estimated cancer incidence, mortality and prevalence worldwide in 2012. Retrieved from Accessed on 19 Apr 2014
  13. Likert R (1932). A technique for the measurement of attitudes. Archives of Psychology, 140, 1-55
  14. Lavrakas PJ. (2008). Encyclopaedia of survey methods. Retrieved from Accessed on 16th May 2015
  15. Nafissi N, Saghafinia M, Motamedi MK, Akbari ME (2012). A survey of breast cancer knowledge and attitude in Iranian women. J Can Res Ther, 8, 46-9.
  16. National Centre for Disease Informatics and Research. National Cancer Registry Programme: Time trends in cancer incidence rates (1982-2010), Indian Council of Medical Research, Bangalore, July 2013
  17. Noreen M, Murad S, Furqan M, et al. (2015). Knowledge and awareness about Breast cancer and its early symptoms among Medical and Non- medical students of Southern Punjab, Pakistan. Asian Pac J Cancer Prev, 16, 979-984.
  18. Odusanya OO (2001). Breast cancer: knowledge, attitudes and practices of female school teachers in Lagos, Nigeria. Breast J, 7, 171-5.
  19. Odusanya OO and Tayo OO (2001). Breast cancer knowledge, attitudes and practice among nurses in Lagos, Nigeria. Acta Oncol, 40, 844-8.
  20. Okobia MN, Bunker CH, Okonofua FE, Osime U (2006). Knowledge, attitude and practice of Nigerian women towards breast cancer: a cross-sectional study. World J Surg Oncol, 4, 11.
  21. Ramalingam S, Nivedhitha S, Divya P, Madhurima P, Poonguzhali R (2012) Knowledge and attitude about breast cancer and breast self-examination among school teachers in an urban area of Coimbatore. Asian Student Medical Journal, 1.
  22. Saxena S, Rekhi B, Bansal A, et al (2005). Clinico-morphological patterns of breast cancer including family history in a New Delhi hospital, India- a cross-sectional study. World J Surg Oncol, 3, 67.
  23. Shankar A, Rath GK, Roy S, et al (2015). Level of awareness of cervical and breast cancer risk factors and safe practices among college teachers of different sates in India: Do awareness programmes have an impact on adoption of safe practices? Asian Pac J Cancer Prev, 16, 927-932.
  24. Shiryazd SM, Kholasehzadeh G, Neamatzadeh H, Kargar S. (2014). Health beliefs and Breast cancer screening behaviour among Iranian female health workers. Asian Pac J Cancer Prev, 15, 9817-22.
  25. Sharma PK, Ganguly E, Nagda D, Kamaraju T (2013). Knowledge, attitude and preventive practices of South Indian women towards breast cancer. The Health Agenda, 1, 16-22.
  26. Statacorp LP. Stata 13.1, 1985-2013, Texas
  27. Uche EE (1999). Cancer awareness among a Nigerian population. Trop Doct, 29, 39-40.
  28. Website of the Collectorate of Wardha District (2014) Retrieved from Accessed on 19 Apr 2014
  29. Yadav P and Jaroli DP (2010). Breast cancer: awareness and risk factors in college-going younger age group in Rajasthan. Asian Pac J Cancer Prev, 11, 319-22.

Cited by

  1. Examination of Knowledge and Fear Levels of Breast Cancer With the Spiritual Characteristics of Nurses vol.6, pp.2296-2565, 2018,
  2. Patterns of Care of Breast Cancer Patients in a Rural Cancer Center in Western India vol.9, pp.3, 2018,