Breast Cancer Awareness in Urban and Rural Females of Uttarakhand, India: A Cross-sectional Study

Introduction: The second most frequent cancer in women worldwide is breast cancer, which is also the most common cancer among Indian women. Unlike other cancers, breast cancer is eminently treatable, if detected at an early stage. Nevertheless, the need for culturally appropriate breast cancer education and intervention measures remains. Aim: To compare breast cancer awareness in urban and rural females of Uttarakhand, India. Materials and Methods: The present cross-sectional research was carried out in the Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India, between January 2017 and October 2017. The survey sample comprised 400 participants, 200 from cities and 200 from the countryside. All eligible participants were approached by briefing them about the study and providing them with the participant information document. A validated questionnaire divided into four parts was used for the present study. The first part consisted of demographic questions, the second part consisted of questions regarding knowledge of breast cancer, the third part comprised significant risk factors and the fourth part was about early warning signs and symptoms related to breast cancer detection. For gathering data, simple random sampling was used, and participants from both urban and rural locations were included with no prior breast problems ruled out from history. The data was analysed using International Business Machines Statistical Package for Social Science (IBM SPSS) Statistics for Windows, software version 25.0. Results: There were a total of 400 participants; 200 from the city and 200 from the countryside. The mean±Standard Deviation (SD) age of participants of rural areas was 33.4±2.1 years and of urban areas was 37.6±2.4 years. Living in an urban setting was associated with greater awareness of risk factors, such as breast lump (42%), nipple discharge (47.5%), and not breastfeeding (35%), in comparison to rural areas 39%, 46.5% and 21%, respectively. However, there were some misconceptions about a few risk factors, such as the use of oral contraceptives (6%), having children earlier in life (13%), and having more children overall (10%), that were linked to urban living. Conclusion: The understanding of breast cancer risk factors was lower among rural women. However, the present study demonstrates a general lack of breast cancer awareness among female populations in both rural and urban areas. Therefore, the current study strongly advises starting vigorous campaigns to raise awareness of breast cancer in both the educated and uneducated female population.