Perceptions of Breast Cancer: A Cross-Sectional Study Using the Breast Cancer Perception Scale (BPS)

Breast cancer is the most common malignancy among Saudi women, and early detection remains a critical factor for improving survival outcomes. Despite ongoing awareness initiatives, screening uptake remains low, suggesting that perceptions and beliefs may influence women's engagement in preventive behaviors.

To assess perceptions of breast cancer among women attending Johns Hopkins Aramco Healthcare (JHAH) facilities using the Breast Cancer Perception Scale (BPS) and to examine associations between perception domains and sociodemographic as well as screening-related factors.

A cross-sectional, questionnaire-based study was conducted between October 2024 and March 2025.

Eligible female patients aged 20 years or older with active MyChart accounts were invited to participate electronically. Perception was measured using the validated 24-item BPS, which comprises 6 subscales. Due to non-normal data distribution, non-parametric tests (Kruskal-Wallis and Mann-Whitney U) were employed, with a Bonferroni correction for multiple comparisons.

Participants had a mean age of 37.5 ± 8.3 years, and 61.4% held a university degree. Postgraduate education was significantly associated with higher scores for Perceived Knowledge, Treatment Belief, Health Check, and Risk, as well as lower stigma (P < .001). Employed women demonstrated greater Perceived Knowledge (P < .001). Those with a family history of breast cancer reported higher Fear and Risk perceptions (P < .001). Prior screening experience (clinical breast examination or Mammography) correlated with higher Knowledge and Health Check perceptions and lower stigma (P < .001). Overall, 51.7% of participants reported adequate knowledge, while 64% to 70% expressed moderate to high levels of fear.

Perceptions of breast cancer among Saudi women are shaped by educational level, employment status, family history, and screening experience. Targeted educational interventions that address knowledge gaps and cultural stigmas are essential for enhancing participation in screening and early detection practices.