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Breast cancer knowledge, behaviors, and preferences in Malawi: implications for early detection interventions from a discrete choice experiment

Publication ,  Journal Article
Kohler, RE; Gopal, S; Lee, CN; Weiner, BJ; Reeve, BB; Wheeler, SB
Published in: Journal of Global Oncology
October 1, 2017

Purpose Breast cancer is the most common female cancer in Africa and leading cause of death resulting from cancer; however, many countries lack early detection services. In Malawi, women are frequently diagnosed with large tumors after long symptomatic periods. Little is known about local cancer knowledge. Methods We administered a cross-sectional survey with a discrete choice experiment to a random sample in urban and rural areas of Lilongwe district. Bivariable and multivariable analyses determined factors associated with knowledge. Preference utilities for early detection interventions were estimated using a hierarchical Bayesian model in Sawtooth software. Results Of 213 women recruited, fewer than half were aware of breast cancer. In multivariable analysis, electricity at home and knowing someone with cancer increased the odds of awareness. Women were more knowledgeable about symptoms than treatment or risk factors; more than 60% erroneously believed local misconceptions. Seventeen percent were aware of breast self-examination, and 20% were aware of clinical breast examination (CBE); few reported either behavior. Common barriers included not knowing where to access CBE and transportation difficulties. Discrete choice experiment results indicated the detection strategy (breast health awareness, CBE, or both) was the most important attribute of an intervention, followed by the encounter setting and travel time. Conclusion Addressing misconceptions in health messages and engaging survivors to promote early detection may help improve breast cancer knowledge in Malawi. Program designs accounting for women’s preferences should provide breast health education and CBEs in convenient settings to address transportation barriers, particularly for women with low socioeconomic position.

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Published In

Journal of Global Oncology

DOI

EISSN

2378-9506

Publication Date

October 1, 2017

Volume

3

Issue

5

Start / End Page

480 / 489
 

Citation

APA
Chicago
ICMJE
MLA
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Kohler, R. E., Gopal, S., Lee, C. N., Weiner, B. J., Reeve, B. B., & Wheeler, S. B. (2017). Breast cancer knowledge, behaviors, and preferences in Malawi: implications for early detection interventions from a discrete choice experiment. Journal of Global Oncology, 3(5), 480–489. https://doi.org/10.1200/JGO.2016.005371
Kohler, R. E., S. Gopal, C. N. Lee, B. J. Weiner, B. B. Reeve, and S. B. Wheeler. “Breast cancer knowledge, behaviors, and preferences in Malawi: implications for early detection interventions from a discrete choice experiment.” Journal of Global Oncology 3, no. 5 (October 1, 2017): 480–89. https://doi.org/10.1200/JGO.2016.005371.
Kohler RE, Gopal S, Lee CN, Weiner BJ, Reeve BB, Wheeler SB. Breast cancer knowledge, behaviors, and preferences in Malawi: implications for early detection interventions from a discrete choice experiment. Journal of Global Oncology. 2017 Oct 1;3(5):480–9.
Kohler, R. E., et al. “Breast cancer knowledge, behaviors, and preferences in Malawi: implications for early detection interventions from a discrete choice experiment.” Journal of Global Oncology, vol. 3, no. 5, Oct. 2017, pp. 480–89. Scopus, doi:10.1200/JGO.2016.005371.
Kohler RE, Gopal S, Lee CN, Weiner BJ, Reeve BB, Wheeler SB. Breast cancer knowledge, behaviors, and preferences in Malawi: implications for early detection interventions from a discrete choice experiment. Journal of Global Oncology. 2017 Oct 1;3(5):480–489.

Published In

Journal of Global Oncology

DOI

EISSN

2378-9506

Publication Date

October 1, 2017

Volume

3

Issue

5

Start / End Page

480 / 489