Breast Self-examination Practices and Barriers Among Female University Students at the State University of Zanzibar

Background Breast cancer remains a major public health concern, where late-stage diagnosis is common. Breast self-examination (BSE) is a low-cost strategy for early detection; however, its practice is suboptimal. Objective To assess the practice of BSE and associated barriers among female diploma students at the State University of Zanzibar (SUZA). Methods A cross-sectional study was conducted among 300 female students from the School of Health and Medical Sciences (SHMS) and the Institute of Tourism (IT). Participants were selected using simple random sampling. Data were collected in a structured, pre-tested, self-administered questionnaire. BSE practice was categorized as adequate or inadequate based on a composite score. Descriptive statistics, chi-square ( χ ²) tests, and multivariable logistic regression were performed to identify factors independently associated with BSE practice. Results Overall, 59.7% of participants demonstrated inadequate BSE practice. In multivariable analysis, students from SHMS were more likely to practice BSE compared to IT students (adjusted odds ratio [AOR] = 3.20, 95% confidence interval [CI]: 1.90-5.40, P < .001). Having a family history of breast cancer (AOR = 2.60, 95% CI: 1.30-5.20, P = .007) and prior exposure to breast disease (AOR = 3.10, 95% CI: 1.75-5.48, P < .001) were also significantly associated with BSE practice. Age and marital status were not significantly associated. Knowledge-related barriers were more pronounced among non-health students. Conclusions Despite moderate awareness, BSE practice remains inadequate among university students. Educational exposure, personal risk factors, and prior clinical experience significantly influence practice. Targeted, skill-based interventions are needed to improve correct and consistent BSE behavior across all academic disciplines. Recommendations Targeted, hands-on educational interventions focusing on correct technique and routine practice should be implemented across all faculties. University-wide programs could strengthen early detection behaviors and reduce breast cancer morbidity.