title: Women's Knowledge, Attitudes, and Practices about Breast Cancer in a Rural District of Central India.
abstract: BACKGROUND
  Breast cancer accounted for almost 25% of all cancers in women globally in 2012. Although breast cancer is the most prevalent cancer in India, there is no organised national breast cancer screening programme. Local studies on the burden of breast cancer are essential to develop effective context-specific strategies for an early detection breast cancer programme, considering the cultural and ethnic heterogeneity in India. This study examined the knowledge, attitudes, and practices about breast cancer in rural women in Central India.
  
  
  METHODS
  This community-based cross sectional study was conducted in Wardha district, located in Maharashtra state in Central India in 2013. The sample included 1000 women (609 rural, 391 urban) aged 13-50 years, selected as representative from each of the eight development blocks in the district, using stratified cluster sampling. Trained social workers interviewed women and collected demographic and socio-economic data. The instrument also assessed respondents' knowledge about breast cancer and its symptoms, risks, methods of screening, diagnosis and treatment, as well as their attitudes towards breast cancer and self- reported practices of breast cancer screening. Chi-square and t-test were applied to assess differences in the levels of knowledge, attitude, and practice (the outcome variables) between urban and rural respondents. Multivariable linear regression was conducted to analyse the relationship between socio-demographic factors and the outcome variables.
  
  
  RESULTS
  While about two-thirds of rural and urban women were aware of breast cancer, less than 7% in rural and urban areas had heard about breast self-examination. Knowledge about breast cancer, its symptoms, risk factors, diagnostic modalities, and treatment was similarly poor in both rural and urban women. Urban women demonstrated more positive attitudes towards breast cancer screening practices than their rural counterparts. Better knowledge of breast cancer symptoms, risk factors, diagnosis, and treatment correlated significantly with older age, higher levels of education, and being office workers or in business.
  
  
  CONCLUSIONS
  Women in rural Central India have poor knowledge about breast cancer, its symptoms and risk factors. Breast self-examination is hardly practiced, though the willingness to learn is high. Positive attitudes towards screening provide an opportunity to promote breast self-examination.
authors.affiliation: Department of Pathology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, India E-mail : nitingangane@gmail.com.
authors.forename: Nitin
authors.initials: N
authors.lastname: Gangane
authors.forename: Nawi
authors.initials: N
authors.lastname: Ng
authors.forename: Miguel San
authors.initials: MS
authors.lastname: Sebastian
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D016504:Breast Self-Examination; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India; D008875:Middle Aged; D012307:Risk Factors; D012424:Rural Population; D014505:Urban Population; D055815:Young Adult