Knowledge, attitude and practice towards breast cancer and screening among healthcare workers in northwestern China: a cross-sectional study

<h2>Abstract</h2><h3>Background</h3> Breast cancer is a major, life-threatening, public health concern. The role of healthcare workers in educating the people regarding screening tests of breast cancer is very important to detect cancer at an early stage to prevent the high morbidity and mortality. This study aimed to analyze the knowledge, attitude and practice towards breast cancer and screening among healthcare workers in northwestern China. <h3>Methods</h3> A cross-sectional survey was conducted from July to December 2023, in nearly 100 medical institutions in Xi'an, the largest city in northwestern China. All healthcare workers providing medical services related to breast diseases were invited to participate in the survey. Descriptive statistics, multiple linear regressions, binary logistic regressions, and mediating effects tests were performed. <h3>Findings</h3> Of 2214 healthcare workers, the average knowledge scores on risk factors, signs and symptoms, and prevention methods of breast cancer were 8.20 (range 0-10), 6.14 (range 0-7), and 7.97 (range 0-9), respectively. The average score on the overall knowledge of breast cancer was 22.30 (range 0-26). However, 2.9%-4.2% of healthcare workers still had no knowledge of risk factors, signs and symptoms, and prevention methods of breast cancer. The average score of attitudes towards breast cancer screening was 3.96 (range 1-5). 65.7% of female healthcare workers had received breast cancer screening service, and 93.2% of healthcare workers had encouraged their female family members or relatives to undergo breast cancer screening. After adjusting for potential confounding factors, healthcare workers with a higher knowledge score of breast cancer were more likely to receive breast cancer screening service (OR 1.05, 95% CI 1.02-1.07) and to encourage their female family members or relatives to undergo breast cancer screening (OR 1.11, 95% CI 1.09-1.14). Meanwhile, healthcare workers having a more positive attitude towards breast cancer screening presented a significantly higher likelihood to encourage their female family members or relatives to undergo breast cancer screening (OR 1.35, 95% CI 1.14-1.60). Besides, healthcare workers' attitudes towards breast cancer screening played a partial mediating role in the association between their knowledge of breast cancer and having encouraged their female family members or relatives to undergo breast cancer screening. In addition, having received training related to breast cancer screening was significantly associated with the knowledge, attitude and practice towards breast cancer and screening among healthcare workers. <h3>Interpretation</h3> The knowledge, attitude and practice towards breast cancer and screening among healthcare workers in Xi'an still needs to be constantly improved. The government or medical institutions should implement more training programs for healthcare workers providing medical services related to breast diseases; in turn they can educate and enhance more female groups. <h3>Funding</h3> National Natural Science Foundation of China (72204199); Research Project of Humanities and Social Sciences of the Ministry of Education of China (22XJC630001).