Bridging the Knowledge-Practice Gap in Breast Cancer Awareness: A Nationwide Online Cross-Sectional KAP Study Among...

Breast cancer (BCa) is a major cause of cancer morbidity and mortality among women in Nigeria, with late presentation contributing to poor outcomes. This study assessed knowledge, attitudes, and willingness to perform breast self-examination (BSE) among adult females in Nigeria and examined associated factors.

We conducted a descriptive cross-sectional online survey between February 16 and April 30, 2024. A structured, pretested questionnaire was disseminated through digital platforms, yielding 711 consenting adult female respondents from all six geopolitical zones. Knowledge, attitude, and willingness-to-perform-BSE measures were analyzed using descriptive statistics, linear regression, and binary logistic regression. Associations were assessed using two-sided tests with α = 0.05. Because recruitment was online and non-probability based, the sample should not be interpreted as nationally representative.

Of 711 respondents, 692 (97.3%) knew what BCa was, whereas 259 (36.4%) were aware of early screening modalities, and 321 (45.1%) reported knowledge of the BSE procedure. Positive attitudes toward screening were common: 704 (98.9%) considered screening useful for early detection, and 691 (97.3%) believed early screening improves survival. Although 696 (97.9%) reported willingness to perform BSE after instruction, this represented intention rather than verified regular or technically correct practice. Higher educational attainment was associated with greater willingness to perform BSE, but estimates were imprecise because the basic-education reference group was very small. Reliance on social media, radio/television, and campaigns was associated with lower knowledge scores, although these observational associations do not establish causality, and participants could report multiple information sources.

Among this digitally connected and relatively highly educated sample of adult Nigerian females, general awareness and attitudes toward BCa screening were favorable, but detailed knowledge of risk factors, screening modalities, and BSE procedures remained limited. Public health interventions should move beyond awareness creation to provide accurate, skill-based education through trusted channels. The findings should not be generalized to all Nigerian women, particularly those who are rural, less educated, older, or have limited digital access.