Awareness of Breast Cancer Among Male and Female High School Students in Southern Ghana

Background: In Ghana, the incidence of breast cancer is increasing with disproportionately high mortality rates. Awareness about the disease process is critical for achieving early diagnosis of breast cancer in countries without a national screening program. Targeting adolescents in school will help to inculcate good health seeking behaviors with widespread reach. This study assessed the baseline knowledge in high school males and females as an important first step to inform the development of appropriate educational interventions to address identified gaps in student knowledge about breast cancer. Methodology: A multisite cross-sectional study was carried out in 14 high schools in two regions in southern Ghana to assess the baseline student knowledge of breast cancer. Self-administered questionnaires were used covering the following four domains: (1) general breast cancer knowledge, (2) breast cancer symptoms, (3) risk factors for breast cancer, and (4) breast self-examination/screening for breast cancer. For each domain of knowledge tested, the total score was categorized as adequate knowledge (≥ 50% of questions answered correctly) or inadequate knowledge (< 50% of questions answered correctly). Logistic regression was used to determine factors associated with each of the knowledge domains. Stata 14.0 was used for the statistical analysis, and a p < 0.05 was considered statistically significant. Results: Nine thousand seven hundred sixty-seven students from 10 coeducational and 4 girls-only schools participated with 68% of respondents being female. The mean student age was 16.9 ± 1.2 years. Eighty-four percent of the students demonstrated adequate general knowledge on breast cancer and 54% demonstrated adequate knowledge of breast cancer symptoms. However, only 34% and 21%, respectively, received a score of adequate knowledge in regard to breast cancer risk factors and BSE/breast cancer screening. After combining all domain scores to evaluate overall breast cancer knowledge, less than half (47%) of the students received an adequate breast cancer knowledge score. Females and the girls-only schools had statistically significant adequate levels of knowledge of breast cancer. Conclusion: The overall knowledge of breast cancer among senior high school students in southern Ghana is inadequate especially on knowledge of breast cancer risk factors, breast self-examination, and breast cancer screening. Breast cancer educational activities should be incorporated into the national school health curriculum in senior high schools across the country to ameliorate this knowledge gap, with special emphasis on risk factors and breast self-examination. Adolescent males should be included in breast cancer education.