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Kohler RE, Gopal S, Lee CN, et al. Breast Cancer Knowledge, Behaviors, and Preferences in Malawi: Implications for Early Detection Interventions From a Discrete Choice Experiment. J Glob Oncol. 2017;3(5):480-489doi: 10.1200/JGO.2016.005371.
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, Racquel 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. 3,5 (2017): 480-489. doi: 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. J Glob Oncol. 2017 Apr 21;3(5):480-489. doi: 10.1200/JGO.2016.005371. eCollection 2017 Oct. PMID: 29094086; PMCID: PMC5646878.
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J Glob Oncol. 2017 Apr 21;3(5):480-489. doi: 10.1200/JGO.2016.005371. eCollection 2017 Oct.

Breast Cancer Knowledge, Behaviors, and Preferences in Malawi: Implications for Early Detection Interventions From a Discrete Choice Experiment.

Journal of global oncology

Racquel E Kohler, Satish Gopal, Clara N Lee, Bryan J Weiner, Bryce B Reeve, Stephanie B Wheeler

Affiliations

  1. , , , , , and , University of North Carolina at Chapel Hill, Chapel Hill, NC; and and , UNC Project Malawi, Lilongwe, Malawi.

PMID: 29094086 PMCID: PMC5646878 DOI: 10.1200/JGO.2016.005371

Abstract

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.

Conflict of interest statement

The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Mem

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