title: Lay perceptions of breast cancer in Western Kenya.
abstract: OBJECTIVE
  To explore lay perceptions of causes, severity, presenting symptoms and treatment of breast cancer.
  
  
  METHODS
  In October-November 2012, we recruited men and women (18 years and older) from households and health facilities in three different parts of Western Kenya, chosen for variations in their documented burdens of breast cancer. A standardized and validated tool, the breast cancer awareness measure (BCAM), was administered in face-to-face interviews. Survey domains covered included socio-demographics, opinions about causes, symptoms, severity, and treatment of breast cancer. Descriptive analyses were done on quantitative data while open-ended answers were coded, and emerging themes were integrated into larger categories in a qualitative analysis. The open-ended questions had been added to the standard BCAM for the purposes of learning as much as the investigators could about underlying lay beliefs and perceptions.
  
  
  RESULTS
  Most respondents were female, middle-aged (mean age 36.9 years), married, and poorly educated. Misconceptions and lack of knowledge about causes of breast cancer were reported. The following (in order of higher to lower prevalence) were cited as potential causes of the condition: Genetic factors or heredity (n = 193, 12.3%); types of food consumed (n = 187, 11.9%); witchcraft and curses (n = 108, 6.9%); some family planning methods (n = 56, 3.6%); and use of alcohol and tobacco (n = 46, 2.9%). When asked what they thought of breast cancer's severity, the most popular response was "it is a killer disease" (n = 266, 19.7%) a lethal condition about which little or nothing can be done. While opinions about presenting symptoms and signs of breast cancer were able to be elicited, such as an increase in breast size and painful breasts, early-stage symptoms and signs were not widely recognized. Some respondents (14%) were ignorant of available treatment altogether while others felt breast cancer treatment is both dangerous and expensive. A minority reported alternative medicine as providing relief to patients.
  
  
  CONCLUSIONS
  The impoverished knowledge in these surveys suggests that lay education as well as better screening and treatment should be part of breast cancer control in Kenya.
authors.affiliation: Violet Naanyu, Chite Fredrick Asirwa, Juddy Wachira, Naftali Busakhala, Job Kisuya, Grieven Otieno, Alfred Keter, Anne Mwangi, Orango Elkanah Omenge, Academic Model Providing Access to Healthcare (AMPATH), Eldoret 30100, Kenya.
authors.forename: Violet
authors.initials: V
authors.lastname: Naanyu
authors.affiliation: Violet Naanyu, Chite Fredrick Asirwa, Juddy Wachira, Naftali Busakhala, Job Kisuya, Grieven Otieno, Alfred Keter, Anne Mwangi, Orango Elkanah Omenge, Academic Model Providing Access to Healthcare (AMPATH), Eldoret 30100, Kenya.
authors.forename: Chite Fredrick
authors.initials: CF
authors.lastname: Asirwa
authors.affiliation: Violet Naanyu, Chite Fredrick Asirwa, Juddy Wachira, Naftali Busakhala, Job Kisuya, Grieven Otieno, Alfred Keter, Anne Mwangi, Orango Elkanah Omenge, Academic Model Providing Access to Healthcare (AMPATH), Eldoret 30100, Kenya.
authors.forename: Juddy
authors.initials: J
authors.lastname: Wachira
authors.affiliation: Violet Naanyu, Chite Fredrick Asirwa, Juddy Wachira, Naftali Busakhala, Job Kisuya, Grieven Otieno, Alfred Keter, Anne Mwangi, Orango Elkanah Omenge, Academic Model Providing Access to Healthcare (AMPATH), Eldoret 30100, Kenya.
authors.forename: Naftali
authors.initials: N
authors.lastname: Busakhala
authors.affiliation: Violet Naanyu, Chite Fredrick Asirwa, Juddy Wachira, Naftali Busakhala, Job Kisuya, Grieven Otieno, Alfred Keter, Anne Mwangi, Orango Elkanah Omenge, Academic Model Providing Access to Healthcare (AMPATH), Eldoret 30100, Kenya.
authors.forename: Job
authors.initials: J
authors.lastname: Kisuya
authors.affiliation: Violet Naanyu, Chite Fredrick Asirwa, Juddy Wachira, Naftali Busakhala, Job Kisuya, Grieven Otieno, Alfred Keter, Anne Mwangi, Orango Elkanah Omenge, Academic Model Providing Access to Healthcare (AMPATH), Eldoret 30100, Kenya.
authors.forename: Grieven
authors.initials: G
authors.lastname: Otieno
authors.affiliation: Violet Naanyu, Chite Fredrick Asirwa, Juddy Wachira, Naftali Busakhala, Job Kisuya, Grieven Otieno, Alfred Keter, Anne Mwangi, Orango Elkanah Omenge, Academic Model Providing Access to Healthcare (AMPATH), Eldoret 30100, Kenya.
authors.forename: Alfred
authors.initials: A
authors.lastname: Keter
authors.affiliation: Violet Naanyu, Chite Fredrick Asirwa, Juddy Wachira, Naftali Busakhala, Job Kisuya, Grieven Otieno, Alfred Keter, Anne Mwangi, Orango Elkanah Omenge, Academic Model Providing Access to Healthcare (AMPATH), Eldoret 30100, Kenya.
authors.forename: Anne
authors.initials: A
authors.lastname: Mwangi
authors.affiliation: Violet Naanyu, Chite Fredrick Asirwa, Juddy Wachira, Naftali Busakhala, Job Kisuya, Grieven Otieno, Alfred Keter, Anne Mwangi, Orango Elkanah Omenge, Academic Model Providing Access to Healthcare (AMPATH), Eldoret 30100, Kenya.
authors.forename: Orango Elkanah
authors.initials: OE
authors.lastname: Omenge
authors.affiliation: Violet Naanyu, Chite Fredrick Asirwa, Juddy Wachira, Naftali Busakhala, Job Kisuya, Grieven Otieno, Alfred Keter, Anne Mwangi, Orango Elkanah Omenge, Academic Model Providing Access to Healthcare (AMPATH), Eldoret 30100, Kenya.
authors.forename: Thomas
authors.initials: T
authors.lastname: Inui
keywords: Breast cancer; Cancer control; Health education; Lay health beliefs