| Issue/Objective |
Breast cancer is the leading cause of cancer-related deaths among women worldwide and a growing public health burden in sub-Saharan Africa, where incidence rose by 247% between 1990 and 2019. In Lesotho, it is the second most common cancer among women, compounded by fragile health systems and low screening rates. This study aimed to identify determinants of breast cancer screening uptake among reproductive-age women in Lesotho using the Andersen Behavioral Model and the newly released Lesotho Demographic and Health Survey (LDHS). |
| Methodology/Approach |
We conducted a cross-sectional analysis of LDHS data, which employed a stratified two-stage sampling design across 400 Enumeration Areas and 9,976 households. The weighted sample included 6,413 women aged 15-49 years. Predisposing, enabling, and need factors were examined using the Andersen Behavioral Model. Multilevel mixed-effects logistic regression was performed in Stata 16, with adjusted odds ratios (AOR) and 95% confidence intervals (CI) reported. Statistical significance was set at P < 0.05. |
| Results |
Overall, 22.2% (95% CI 21.19-23.23) of reproductive-age women reported undergoing breast cancer screening. Significant predictors included age 25-34 (AOR=1.54; 95% CI 1.26-1.88) and 35-49 (AOR=2.10; 95% CI 1.71-2.58), healthcare facility visits in the past 12 months (AOR=1.47; 95% CI 1.26-1.71), health insurance coverage (AOR=1.86; 95% CI 1.36-2.53), high media exposure (AOR=1.23; 95% CI 1.01-2.52), contraceptive use (AOR=1.18; 95% CI 1.03-1.37), and parity (multiparous AOR=2.29; 95% CI 1.84-2.85; grand multiparous AOR=1.67; 95% CI 1.16-2.40). |
| Discussion/Conclusion |
Breast cancer screening uptake among women in Lesotho remains low, with only one in five reporting screening. The Andersen Behavioral Model highlights key determinants-age, healthcare utilization, insurance, media exposure, contraceptive use, and parity-that shape screening behavior.
Practice Implications
Targeted interventions addressing these determinants are urgently needed. Expanding insurance coverage, integrating screening into reproductive health services, and leveraging media for awareness could strengthen preventive efforts and reduce breast cancer morbidity and mortality in Lesotho.
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| Presenters and Affiliations |
Mesfin Abebe Dilla University |
