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      Breast self-examination practice and associated factors among female healthcare workers in Ethiopia: A systematic review and meta-analysis

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      PLoS ONE
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          Abstract

          Background

          Breast cancer is common global public health problem. It is the principal cause of cancer related death. In Ethiopia, study findings regarding prevalence and associated factors of BSE among female healthcare workers have been inconsistently reported and highly variable. Thus, this systematic review and meta-analysis aimed to determine the pooled prevalence of breast self-examination practice and determinants in Ethiopia.

          Methods

          A systematic search of PubMed, Medline, EMBASE, Global Health, Google Scholar, CINAHL and Scopus from April 2, 2020 to April 24, 2020. Data were extracted from articles included in the review using a data extraction tool which was adapted from the Joanna Briggs Institute. the quality of each included article was evaluated using the Newcastle-Ottawa scale. Data analysis was done using STATA 11. The Cochrane Q and I 2 test were used to assess heterogeneity between the studies; and publication bias was assessed using funnel plots and Egger’s test. A random effects meta-analysis was computed to determine the pooled prevalence of breast self-examination. The determinants for breast self-examination were examined. Forest plots were used to present the prevalence and odds ratio with 95% confidence interval.

          Results

          After reviewing 9605 studies, 12 studies involving 4129 female healthcare workers were included for this review and meta-analysis. The pooled prevalence of breast self-examination practice among healthcare workers in Ethiopia was 56.31% (95% CI: 44.37, 68.25). The subgroup analysis further revealed that the higher breast self-examination practice was observed among other healthcare workers, 58.60% (95% CI: 43.31, 73.90). Good knowledge (AOR = 3.02; 95% CI: 1.24, 7.35), positive attitude (AOR = 2.73; 95% CI: 1.95, 4.13) and family history of breast cancer (AOR = 3.21; 95% CI: 1.22, 6.52) were significantly associated with breast self-examination practice among healthcare workers.

          Conclusion

          This meta-analysis found that nearly half of the female healthcare workers were not performed breast self-examination. The finding of this study suggests the need of strengthening early diagnosis of breast cancer and control strategies with a collaborative effort of policymakers and other concerned stakeholders.

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          Most cited references72

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          Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

          This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer (11.6% of the total cases) and the leading cause of cancer death (18.4% of the total cancer deaths), closely followed by female breast cancer (11.6%), prostate cancer (7.1%), and colorectal cancer (6.1%) for incidence and colorectal cancer (9.2%), stomach cancer (8.2%), and liver cancer (8.2%) for mortality. Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality). Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality. The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors. It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries. The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts. CA: A Cancer Journal for Clinicians 2018;0:1-31. © 2018 American Cancer Society.
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            Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

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              Global cancer statistics, 2012.

              Cancer constitutes an enormous burden on society in more and less economically developed countries alike. The occurrence of cancer is increasing because of the growth and aging of the population, as well as an increasing prevalence of established risk factors such as smoking, overweight, physical inactivity, and changing reproductive patterns associated with urbanization and economic development. Based on GLOBOCAN estimates, about 14.1 million new cancer cases and 8.2 million deaths occurred in 2012 worldwide. Over the years, the burden has shifted to less developed countries, which currently account for about 57% of cases and 65% of cancer deaths worldwide. Lung cancer is the leading cause of cancer death among males in both more and less developed countries, and has surpassed breast cancer as the leading cause of cancer death among females in more developed countries; breast cancer remains the leading cause of cancer death among females in less developed countries. Other leading causes of cancer death in more developed countries include colorectal cancer among males and females and prostate cancer among males. In less developed countries, liver and stomach cancer among males and cervical cancer among females are also leading causes of cancer death. Although incidence rates for all cancers combined are nearly twice as high in more developed than in less developed countries in both males and females, mortality rates are only 8% to 15% higher in more developed countries. This disparity reflects regional differences in the mix of cancers, which is affected by risk factors and detection practices, and/or the availability of treatment. Risk factors associated with the leading causes of cancer death include tobacco use (lung, colorectal, stomach, and liver cancer), overweight/obesity and physical inactivity (breast and colorectal cancer), and infection (liver, stomach, and cervical cancer). A substantial portion of cancer cases and deaths could be prevented by broadly applying effective prevention measures, such as tobacco control, vaccination, and the use of early detection tests. © 2015 American Cancer Society.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: SoftwareRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                10 November 2020
                2020
                : 15
                : 11
                : e0241961
                Affiliations
                [001]Department of Nursing, Teda health Science College, Gondar, Ethiopia
                Guttmacher Institute, UNITED STATES
                Author notes

                Competing Interests: The author has declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0003-3879-1330
                Article
                PONE-D-20-12871
                10.1371/journal.pone.0241961
                7654829
                33170880
                67b08cb6-fe2c-42f4-8d90-f459070efac5
                © 2020 Birye Dessalegn Mekonnen

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 5 May 2020
                : 12 October 2020
                Page count
                Figures: 7, Tables: 2, Pages: 18
                Funding
                The author received no specific funding for this work.
                Categories
                Research Article
                Medicine and Health Sciences
                Oncology
                Cancers and Neoplasms
                Breast Tumors
                Breast Cancer
                People and Places
                Population Groupings
                Professions
                Medical Personnel
                Research and Analysis Methods
                Mathematical and Statistical Techniques
                Statistical Methods
                Metaanalysis
                Physical Sciences
                Mathematics
                Statistics
                Statistical Methods
                Metaanalysis
                People and Places
                Geographical Locations
                Africa
                Ethiopia
                Research and Analysis Methods
                Research Assessment
                Systematic Reviews
                Medicine and Health Sciences
                Diagnostic Medicine
                Cancer Detection and Diagnosis
                Medicine and Health Sciences
                Oncology
                Cancer Detection and Diagnosis
                Research and Analysis Methods
                Database and Informatics Methods
                Database Searching
                Medicine and Health Sciences
                Oncology
                Cancer Prevention
                Custom metadata
                All relevant data are within the paper and its Supporting information files.

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                Uncategorized

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