Knowledge, Fear of Breast Cancer, And Breast Self-Examination Practices Among Female Undergraduate Students: A Cross-Sectional Study in Bekasi City, Indonesia

Background: The practical and free Breast self-examination (BSE) method can be used more widely for breast cancer screening in developing countries. This study aims to examine the relationship between a) knowledge of breast cancer, b) fear of breast cancer, and c) BSE practices among female undergraduate students.. Methods: This cross-sectional study was conducted in September 2023, surveying 261 female undergraduate students from a polytechnic of health in Bekasi City, Indonesia, using an online questionnaire via Google Forms.Results: 66.3% of participants practiced BSE. The proportion of participants with good knowledge about BSE was 51.3%, while those with good knowledge about breast cancer risk factors were 29.1%. The proportion of participants who had a high fear of breast cancer reached 60.9%. Participants identified social media (28.7%), physician (28.3%), and websites (22.6%) as the top three sources of breast cancer information, out of a total of nine options. Multivariate logistic regression analysis revealed that having good knowledge about BSE (OR=2.460, 95% CI: 1.403-4.312, p<0.05) and being 20 years or older (OR=2.238, 95% CI: 1.282-3.907, p<0.05) were significant independent predictors of BSE practice. Knowledge about breast cancer risk factors and fear of breast cancer were not statistically significant as determinants of BSE practice. Conclusion: Female undergraduate students with good knowledge of BSE and older are likelier to practice BSE. We recommend that breast cancer awareness campaigns targeting female undergraduate students emphasize practical, hands-on instruction on BSE techniques via social media or interactive mobile applications by physicians, including health information messages, video-based tutorials, and Q&A sessions.