Determinants of breast cancer screening behavior amongst Nigerian women using the transtheoretical model

Breast cancer is a leading cause of morbidity and mortality amongst women in developing and developed countries. Breast Self-Examination (BSE), mammography and clinical examination are amongst the most effective methods of early detection, however uptake remains low. The Transtheoretical Model (TTM) has been used in many other countries to characterize behavioral shifts related to enable the adoption of more focused tactics for improving breast cancer screening behaviors among Nigerian women. A cross-sectional research study was conducted to assess the level of knowledge and uptake of breast cancer screening practice based on the various stages of readiness and change predictors using the Transtheoretical Model (TTM). The model was applied to identify and characterise key behavioural determinants such as decision balance, stage of change, and process of change (POC) for breast cancer screening through breast self-examination and mammography. A total of 265 adult female respondents in Kaduna State, Northwest, Nigeria was sampled out of which ninety-one (91%) had no family history of breast cancer. Although 80.3% had knowledge of breast cancer disease, 68% of respondents knew how to conduct BSE and only 55% practiced it. In terms of BSE behaviour staging, 29.4% and 26.7% respondents are in the preparation and maintenance stages respectively. In terms of mammography adoption, most respondents (34%) are in the preparation stage. Review of process of change determinants show that breast cancer screening behaviour are driven more by experiential determinants as compared to behaviour determinants. Addressing the complex factors influencing BSE and mammography practice requires a comprehensive social behaviour change approach that may sustaining positive behaviour-driving factors and minimise inhibitive factors that can promote breast cancer screening.