Perception, Awareness, Knowledge, and Attitude (PAKA) Towards Breast Cancer in Ethiopia: A Systematic Review and...

Breast cancer perception, awareness, knowledge, and attitude, play a crucial role in effective prevention, early detection, and treatment. This systematic review and meta-analysis aims to assess these aspects among different population groups in Ethiopia, providing a comprehensive understanding of the current state and trends. The study seeks to identify gaps in awareness and knowledge, analyze variations in attitudes and perceptions across diverse groups, and evaluate changes over time.

To achieve these objectives, studies were systematically reviewed and stratified based on population characteristics. Studies focusing on single groups, such as female teachers, were excluded from the meta-analysis of awareness, knowledge, and attitude measures to ensure broader applicability. The analysis employed a random-effects model to account for heterogeneity, assessed through the I² statistic and Q-test. Subgroup analyses explored variations based on participant characteristics and study settings. To strengthen the validity of findings, a leave-one-out sensitivity analysis was conducted, and publication bias was evaluated using funnel plots and Egger's regression test. Additionally, meta-regression analysis examined associations between participant characteristics and outcomes. Statistical significance was determined at P < .05 with 95% confidence intervals.

Significant gaps in breast cancer awareness were noted over time, with a decline observed in studies published since 2020 onwards (OR: .37, P-value: .040). Knowledge levels varied, with 46% (95% CI: 37%-55%) overall demonstrating a moderate level of knowledge. Attitudes were predominantly positive, with 64% (95% CI: 55%-72%) of participants expressing favorable views toward breast cancer prevention, early detection, and screening practices.

This review highlights substantial gaps in breast cancer awareness and knowledge across different population groups in Ethiopia, suggesting opportunities for targeted educational and public health efforts to improve early detection and prevention.PROSPERO Registration Number:CRD42023494550.