Ethiopian women’s breast cancer self-examination practices and associated factors. A systematic review and meta-analysis

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Background

Neoplasm is a group of diseases causing cells in the body to change and proliferate beyond of control, and form a lump or mass called a tumor, and are named after the part of the body where the tumor originates 123 . In 2018, there were an estimated 18.1 million new cases of cancer and 9.6 million deaths due to cancer, from this 11.6% (about 2.1 million new cases and nearly to 1.2 mortality were owed female breast neoplasm worldwide [124] . For many years, breast cancer like other types of cancer was considered a disease of wealthy countries, but now a days it is the most frequently diagnosed cancer in the vast majority of the countries and is also the leading cause of cancer death in over 100 countries [24] . Even though, breast neoplasm incidence rates are higher in developed countries, the mortality rate show less variability throughout the world [2] . Breast neoplasm mortality can be reduced if cases are detected and treated early. One method of early detection is breast self-examination. It is a check-up of a woman does at home to look for changes or problems in the breast tissue. The purpose of breast self-examination is for a woman to learn the topography of her breast, know how her breasts normally feel and be able to identify changes in the breast should they occur in the future [5] . The goal of early detection is to identify breast cancer early, before it has developed, grown or spread. Treatment of cancer found at an early stage is less aggressive, less expensive and more effective, with higher long-term survival rates and better quality of life [4] . A Systemic review conducted in sub-Saharan Africa revealed that Women with breast cancer in SSA are younger compared with high-income countries. Breast cancer screening and early detection before symptoms onset are poor in low income countries. Ethiopia like much sub-Saharan Africa, does not have breast cancer screening and diagnosis is at symptomatic stages, thus the role of BSE and CBE become relevant and realistic options in this setting [6] . Although there is insufficient evidence that breast cancer self-examination is effective in reducing breast cancer mortality, in countries with limited resources and infrastructure, such as Ethiopia, BSE is the last recourse [7] . In different parts of Ethiopia, breast cancer self-examination practice were studied, however the result of the studies showed high variability which ranged from 6.5% [8] to the 79.9% [9] The variability of the findings were not only the practice but also factors related to the practice were inconsistent with different studies. This systematic review and meta-analysis aimed to argue this variability by pooling varies inconsistent results. The conclusions of this study will have a contribution to policy makers and program planners in the design of appropriate interventions. Additionally, the study will have an importance for clinicians and future researchers in related topics.