Breast Cancer Screening in Tunisia: A Cross-Sectional Study on Women's Knowledge, Attitudes and Practices

In Tunisia, the incidence and mortality rates of breast cancer are relatively high and are projected to remain a significant health burden by 2030. We aimed to evaluate the knowledge, attitudes, and practices of Tunisian women regarding breast cancer screening and to determine the factors associated with good practice using multivariable regression.

We conducted a cross-sectional descriptive study among adult female Tunisian population for 10 days period (from 6 till 16 October 2022), using an online self-administered survey. We assessed knowledge related to breast cancer and screening methods, screening practices and attitudes towards breast cancer screening. Good knowledge, good attitude and good practices were defined as achieving ≥75% correct answers.

In total of 183 females were included (Mean age 33.7±8.2[18 - 64]). Almost all participants (96.7%, n= 177) lived in urban areas and 74.3% (n=136) were married. One-third of the participants were housewives (33.9%, n=62) and 83.6% (n=153) had an academic education. One participant (0.5%) had a personal history of breast cancer, while 26.2% (n=48) reported a family history of breast cancer. Among the participants, 42.6% (n=78) demonstrated good knowledge, 88.5% (n=162) had a good attitude score, and 21.3% (n=39) achieved a good practice score. Good practice was associated with good knowledge (Adjusted OR= 5.0, 95%CI [2.2-11.2],p<0.01), age ≥35 years (Adjusted OR= 2.5, 95% CI [1.1-5.4], p=0.02) and a family history of breast cancer (Adjusted OR= 2.2, 95% CI [1.0-5.1], p=0.04).

Our study showed a moderate knowledge and practice regarding breast cancer screening, alongside a generally good attitude. The factors associated with good practice underscore the importance of educational interventions and the targeted screening strategies.