Influence of Sociodemographic Factors on Breast Self-Examination (BSE) and Mammogram Screening Among Women in Accra, Ghana

Background and purpose: In spite of available modern techniques and medications for treatment of cancer in industrialized and less industrialized countries, breast cancer continues to claim lives of many women across countries, including Ghana.  Guided by the health belief model and social cognitive theory, this study examined levels of BSE and mammogram screening and identified sociodemographic factors that influence BSE and mammogram screening among a sample of Ghanaian women living in Accra.  The research questions were: “What are the levels of BSE and mammogram screening among Ghanaian women?  Are there significant associations between BSE and mammogram screening and sociodemographic factors such as age, marital status, income, occupation, education, health insurance coverage, regular visit to healthcare provider, and physician’s recommendation?”

Methods: Ethical clearance and permissions were obtained from appropriate institutions and individuals. Using a cross-sectional survey design, data were collected in 2008. Questionnaires were administered to a convenience sample (N=194) of women recruited from two churches in Accra through church announcements and voluntary participation. Participants’ age ranged from 18 to 72 (M = 42, SD = 12.80).  While 42.3% (n=82) completed middle school and some secondary education, 37.6% (n=73) completed training college and 7.2% (n=14) obtained a university degree.  Traders (n=52) and teachers/other civil servants (n=52) represented 26.8% each of the sample, respectively and 13.9% (n=27) were nurses. Over sixty-five percent (n=127) of the participants had a household monthly income below $400.00.  The measures adopted were questions from the Breast Health Questionnaire. Data analysis procedures included frequency, chi-squared test, and logistic regression using SPSS version 18.  

Results:  Level of education (X²(2,192) = 9.09, p = .011) and occupation (X² (3,169) = 19.76, p = .000) significantly associated with BSE while income significantly associated with mammogram screening (Fisher’s exact test (112), p = .020).  There were no significant associations between age and marital status for both BSE and mammogram screening. About 71% of the participants practiced BSE and 14% underwent mammogram screening. Logistic regression analysis indicated that age and occupation predicted BSE while physician’s recommendation and household monthly income predicted mammogram screening. 

Conclusion and Implications: Overall, the findings suggest a need to increase breast cancer and screening awareness among Ghanaian women.  The findings therefore have implications for social work education, practice, and research. Social workers and other healthcare professionals need to focus more on education of women regarding the need for early detection and prevention of breast cancer.  Additionally, future researchers in this area need to examine the influence of cultural and religious factors on breast cancer screening practices among Ghanaian women.