Explainer: Why a lot of Nigerian Women are hesitant to get screened for breast cancer

Breast cancer is currently the most common type of cancer worldwide, with 2.26 million cases recorded in 2020, according to the World Health Organisation (WHO). Based on these figures, 28,380 (38.7 percent) Nigerian women were affected by breast cancer last year which means one in four people diagnosed with cancer has breast cancer. Breast cancer is also responsible for one in five cancer-related deaths. Although many women in Nigeria know about these scary statistics, there is still a reluctance to undergo essential screenings. Here’s why:

Stories of Diagnosis & False-Positive results 

Although routine screenings for breast cancer can lower one’s risk of dying of breast cancer, mammograms may not give you the perfect results since a mammogram does not detect some cancers. There are also cases where mammograms find things that look like cancer which turn out not to be cancer. This is called a false-positive result, which often leads to more testing, which is time-consuming and can cause unnecessary anxiety.

Another issue with screening is overdiagnosis. This means finding something on a mammogram that is breast cancer or has a chance of becoming breast cancer but is such a low-risk type of tumour that it would never have caused any health problems if left alone. In such cases of overdiagnosis, these treatments are unnecessary and costly and can have both physical and psychological side effects. Studies estimate that 1 in 5 breast cancers found on mammograms is overdiagnosed and unnecessary treatment.

There is also the fact that many Nigerians only visit health centres when the disease symptoms are hard to ignore and cannot result from over-the-counter drugs. Regular health check-ups are very uncommon.

Ignorance

Women are only likely to have cancer screening if they believe they are at risk, and getting screened would reduce this risk. Most ladies won’t visit until they have severe breast pain. You can also blame negative attitudes, such as anxiety, carelessness, and cancer denial, significantly decreasing women’s chances of getting their breasts checked.

Research shows that women have at least basic knowledge of cancer in Nigeria, as they get their information from family, friends, the media, and hospitals. However, there are misconceptions about it, like wearing “iron Bras”, putting money in their breast, having abortions, using deodorants which they continue to believe will give them cancer. Instead of going to the hospital, they think they will be safe from cancer if they follow these guidelines. 

Aside from the cost of screening, many women say there is a shortage of facilities and trained female healthcare workers, especially in rural Nigeria. In addition, traditional medicine has also discouraged access and acceptability of cancer screening.

Religious and Marital factors

Certain cultures and religions consider the breast sacred, as such should only be seen or touched by a woman’s spouse. In the absence of female health workers, women with this belief refused to get screened. Shockingly some women say that cancers are punishment from God and that prayer is the only cure.

What can be done?

For the uptake of cancer screening to be improved, services and trained health professionals are needed in primary healthcare centres across Nigeria. More organizations liaising with the ministry of women affairs can develop TV programs, dramas in communities, and women’s enlightenment programs in various languages across Nigeria. 

The government needs to do all they can to partner with foreign organizations to train and equip more community health workers with all they need to spread the breast cancer awareness campaign and attend to women in rural communities to reduce the spike in cancer in Nigeria. 

The first ladies of various states and the first lady of the country can create a grass root program that leaves no stone unturned in educating and assisting in paying bills of affected women. 

Breast cancer survivors that are comfortable enough to speak out should also be involved in these campaigns to drive home the importance of having breast cancer screenings. 

Accurate information on breast and cervical cancer is also needed in this population. Cultural misconceptions and practices should be addressed appropriately by community health workers. Campaigns should emphasize and encourage male contributions towards improving cancer screening in northern Nigeria.

Community and religious leaders should also design programs tailored explicitly for improving breast and cervical cancer screening practices. Husbands, Imams and pastors should be educated by health workers to speak to their wives and congregation on the importance of breast cancer screenings.