title: Breast Cancer Awareness and Prevention Behavior Among Women of Delhi, India: Identifying Barriers to Early Detection.
abstract: BACKGROUND
  Globally, breast cancer (BC) has become the leading cause of mortality in women. Awareness and early detection can curb the growing burden of BC and are the first step in the battle against BC. The aim of this qualitative study was to explore the awareness and perceived barriers concerning the early detection of BC.
  
  
  METHODS
  A total of 20 focus group discussions (FGDs) were conducted during May 2013-March 2014. Pre-existing themes were used to conduct FGDs; each FGD group consisted of an average of ~10 women (aged ≥18-70 years) who came to participate in a BC awareness workshop. All FGDs were audio taped and transcribed verbatim. The transcripts were inductively analyzed using ATLAS.ti. Based on emerged codes and categories, thematic analysis was done, and theory was developed using the grounded theory approach.
  
  
  RESULTS
  Data were analyzed in three major themes: i) knowledge and perception about BC; ii) barriers faced by women in the early presentation of BC; and iii) healthcare-seeking behavior. The findings revealed that shyness, fear, and posteriority were the major behavioral barriers in the early presentation of BC. Erroneously, pain was considered as an initial symptom of BC by most women. Financial constraint was also mentioned as a cause for delay in accessing treatment. Social stigma that breast problems reflect bad character of women also contributed in hiding BC symptoms.
  
  
  CONCLUSIONS
  Lack of BC awareness was prevalent, especially in low socioeconomic class. Women's ambivalence in prioritizing their own health and social and behavioral hurdles should be addressed by BC awareness campaigns appropriately suited for various levels of social class.
authors: Associate Professor, Indian Institute of Public Health-Delhi, Public Health Foundation of India, Gurgaon, Haryana, India.
authors: Subhojit
authors: S
authors: Dey
authors: Senior Research Assistant, Indian Institute of Public Health-Delhi, Public Health Foundation of India, Gurgaon, Haryana, India.
authors: Surabhi
authors: S
authors: Sharma
authors: Program Coordinator, State Health Resource Centre, Raipur, Chattisgarh, India.
authors: Arti
authors: A
authors: Mishra
authors: Country Director, Research Triangle Institute Global Pvt. Limited, Shakarpur, New Delhi, India.
authors: Suneeta
authors: S
authors: Krishnan
authors: Honorary Secretary, Indian Cancer Society, Siri Fort, New Delhi, India.
authors: Jyotsna
authors: J
authors: Govil
authors: Epidemiologist, Senior Scientific Officer, Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, Haryana, India.
authors: Preet K
authors: PK
authors: Dhillon
keywords: India; awareness; barriers; breast cancer; early detection; prevention behavior