title: Knowledge, attitudes, beliefs, behaviour and breast cancer screening practices in Ghana, West Africa.
abstract: BACKGROUND
  Late presentation has been observed as the hallmark of breast cancer in Ghanaian women where over 60% of patients report with either stage 3 or 4 of the disease. This cross-sectional study aimed at exploring breast cancer related knowledge and practices in order to develop an appropriate socio-economic and cultural specific model to improve breast cancer care in Ghana.
  
  
  METHODS
  The study which was conducted in Accra and Sunyani in Ghana used both quantitative and qualitative methods and employed the theory of planned behavior as a communication and educational model. Information was collected from 474 women using questionnaires. In addition semi-structured interviews were conducted on 10 breast cancer patients; 10 breast clinic attendants; 3 Oncology Consultants and 2 herbalists.
  
  
  RESULTS
  Generally, the respondents displayed knowledge deficit about the disease. However, higher levels of education was associated with better appreciation of the disease (rs = 0.316, N = 465, p < 0.001). The respondents' attitudes include fear of the disease which was linked to death in most cases; denial and guilt; as well as supernatural attributes. The self-reported breast cancer screening rate (BSE 32%, CBE 12% and mammogram 2%) was poor, however, higher educational of the respondents was very significant for breast cancer screening practices.
  
  
  CONCLUSIONS
  The study found that routine mammography screening is not feasible in Ghana at the moment which therefore requires a different approach.
authors.affiliation: Department of Radiography, School of Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana.
authors.forename: Samuel Yaw
authors.initials: SY
authors.lastname: Opoku
authors.forename: Martin
authors.initials: M
authors.lastname: Benwell
authors.forename: Joel
authors.initials: J
authors.lastname: Yarney
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology / Q000523:psychology; D002277:Carcinoma / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology / Q000523:psychology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003469:Culture; D003625:Data Collection / Q000706:statistics & numerical data; D055088:Early Detection of Cancer / Q000191:economics / Q000523:psychology / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D005869:Ghana / Q000453:epidemiology; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D008327:Mammography / Q000191:economics / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged