Determinants of Breast Cancer Screening Among Reverend Sisters in Kampala Archdiocese, Uganda: A Cross-Sectional Study Determinants of Breast Cancer Screening

Robert K. Basaza (1), Judith Kaddu (2), Emmanuel Otieno (3), Florence Mirembe (4)
(1) Save Mothers Program, School of Medicine, Uganda Christian University Mukono, Uganda, Uganda,
(2) Save Mothers Program, School of Medicine, Uganda Christian University Mukono, Uganda, Uganda,
(3) Gudie University Project, Kampala, Uganda, Uganda,
(4) King Caesar International University, Uganda; Save Mothers Program, School of Medicine, Uganda Christian University Mukono, Uganda, Uganda


Background: Breast cancer in Uganda is the second commonest cancer in women coming only next to cancer of the cervix. This is the first cross-sectional study to investigate the determinants of self-breast cancer screening among Reverend Sisters in Kampala, the largest Archdiocese of Roman Catholic Church in Uganda. The prevention strategies in this country are still not optimal and the key to prevention is breast screening.
Methods: A cross-sectional analytical study was conducted from September, 2018 to June, 2019. A sample of 310 respondents were interviewed using a semi-structured, self-administered questionnaire. Data was analyzed using logistic regression model.
Results: A majority (96.4%) of the respondents did not do a mammography, 54.1% never practiced breast self-examination (BSE) and 34.2% performed it regularly during bedtime. The reasons for performing BSE included: curiosity (61.9%), having a lump (19%) and carrying out screening (9.5%). Significant predictors of breast cancer screening were ordinary level of education (11 years of education), hearing about breast cancer, different screening methods, and symptoms of breast cancer, usefulness of screening for women, a need for sisters to screen, self-breast examination and mammography. Age and other levels of education were not significantly associated with breast cancer screening.
Conclusion: The Reverend Sisters had a low level of knowledge and a small fraction practiced breast cancer screening. This demands a sustainable interventional strategy of breast health awareness campaign, establishment of appropriate health infrastructure related to precision oncology in Uganda and similar settings.

Full text article

Generated from XML file


Jerry DJ, Makari-Judson G, Crisi GM, Dunphy KA. Pregnancy offers new insights into mechanisms of breast cancer risk and resistance. Breast Cancer Res. 2013;15, 312.doi:10.1186/bcr3482.

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: a cancer journal for clinicians 2021. 71(3), 209–249. doi:10.3322/caac.21660.

Karbakhsh M. Global Breast Cancer Initiative: an Integrative Approach to Thinking Globally, Acting Locally. Archives of Breast Cancer 2021. doi: 10.32768/abc.20218263-64.

OECD/European Union. Health at a Glance: Europe: State of Health in the EU Cycle, OECD Publishing, Paris 2020. doi: 10.1787/82129230-en.

Wu SC, Chiang MC, Lee YG, Wang MW, Li CF, Tung TH, et al. Long-term survival and prognostic implications of patients with invasive breast cancer in southern Taiwan, Medicine: February 2020 - Volume 99 - Issue 7 - p e19122. doi: 10.1097/MD.0000000000019122.

Ssentongo P, Lewcun JA, Candela X, Ssentongo AE, Kwon EG, Ba DM, et al. Regional, racial, gender, and tumor biology disparities in breast cancer survival rates in Africa: A systematic review and meta-analysis. PLoS ONE. 2019; 14(11): e0225039. doi: 10.1371/journal.pone.0225039.

Ekdahl Hjelm T, Matovu A, Mugisha N, Löfgren J. Breast cancer care in Uganda: A multicenter study on the frequency of breast cancer surgery in relation to the incidence of breast cancer. PLoS One. 2019; Jul 11;14(7): e0219601. doi: 10.1371/journal.pone.0219601.

Popli P, Gutterman EM, Omene C, Ganesan S, Mills D, Marlink, R. Receptor-Defined Breast Cancer in Five East African Countries and Its Implications for Treatment: Systematic Review and Meta-Analysis. JCO global oncology 2021; (7), 289–301. doi: 10.1200/GO.20.00398.

World Bank Data: Population in Uganda, 2018. Available from:

Allemani C, Matsuda T, Di Carlo V, Harewood R, Matz M, Nikšić M, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018; Mar 17;391(10125):1023-1075. doi: 10.1016/S0140-6736(17)33326-3. (Accessed 29 January 2022)

Galukande M, Wabinga H, Mirembe F, Karamagi C, Asea A. Difference in risk factors for breast cancer by ER status in an indigenous African population. International Scholarly Research Notice: Oncology. 2013; 10:1155. doi: 10.1155/2013/463594.

Kent A. Nuns and contraceptives. Reviews in obstetrics & gynecology, 2012; 5(3-4), e166–e167.

Atuhairwe, C., Amongin, D., Agaba, E. Mugarura S, Taremwa IM. The effect of knowledge on uptake of breast cancer prevention modalities among women in Kyadondo County, Uganda. BMC Public Health 2018;18, 279. doi: 10.1186/s12889-018-5183-5.

World Health Organization. Preventing Cancer, 2021. Available from:

Shallo SA, Boru JD. Practice and associated factors among female healthcare workers in West Shoa Zone, Western Ethiopia: a cross-sectional study. BMC Res Notes 2019;12, 637 (2019). doi: 10.1186/s13104-019-4676.

Tolessa L, Sendo EG, Dinegde NG, Desalew A. Risk Factors Associated with Breast Cancer among Women in Addis Ababa, Ethiopia: Unmatched Case-Control Study. Int J Womens Health. 2021; 13:101-110. Published 2021 Jan 18. doi:10.2147/IJWH.S292588.

Atashi HA, Eslami Vaghar M, Olya M, Mirzamohammadi P, Zaferani Arani H, Hadizadeh M, et al. Knowledge, Attitudes, and Practices toward Breast Cancer: among Midwives in a Breast Cancer Educational Seminar in Tehran. Archives of Breast Cancer [Internet]. 2020;29:29-36. doi: 10.32768/abc.20207129-36.

Odikpo LC, Chiejina EN. “Practice and Outcome of Exercise Intervention on Breast Cancer Specific Quality of Life of Breast Cancer Survivors in Nigeria”, Archives of Breast Cancer, 2021; pp. 174–182. doi: 10.32768/abc.202183174-182.

Peintinger F. National Breast Screening Programs across Europe. Breast Care; 2019;14:354-358. doi: 10.1159/000503715.

Kampala Archdiocese: The Archdiocese of Kampala (A Brief History). Available from: [Accessed on 27 January 2022].

Martins SO, Folasire OF, Irabor AE. prevalence and predictors of prediabetes among administrative staff of a tertiary health centre, southwestern Nigeria. Annals of Ibadan postgraduate medicine. 2017;15(2), 114–123. doi: Not available.

Kiguli-Malwadde E, Mubuuke RG, Bugeza S, Mutungi B. Mammography: a review of records in the Department of Radiology at a National Referral Hospital in Uganda. Pan African Medical Journal. 2014;18:89. doi: 10.11604/pamj.2014.18.89.3237.

Uganda Breast Cancer Working Group. Breast cancer guidelines for Uganda. African health sciences, 2003;3(1), 47–50. doi: Not available

Uganda Cancer Institute. Breast cancer: Information, Education and Communication Booklet for Health Workers. First Edition December 2017. Comprehensive Community Cancer Programme (CCCP). doi: Not Applicable

Seifu, W., Mekonen, L. Breast self-examination practice among women in Africa: a systematic review and Meta-analysis. Arch Public Health 2021; 79, 149. doi: 10.1186/s13690-02100671-8.

Sayed S, Ngugi AK, Mahoney MR, Kurji J, Talib ZM, Macfarlane SB, et al. Breast Cancer knowledge, perceptions and practices in a rural Community in Coastal Kenya. BMC Public Health 19, 180 (2019). doi: 10.1186/s12889-019-6464-3.

Heiko Schöder and Mithat Gönen, 2007. Screening for Cancer with PET and PET/CT: Potential and Limitations Journal of Nuclear Medicine, 48 (1 suppl) 4S-18S. doi: Not available.

Moodley J, Harries J, Scott SE, Mwaka AD, Saji S, Walter FM. Exploring primary care level provider interpretation and management of potential breast and cervical cancer signs and symptoms in South Africa. Ecancermedicalscience 2021. doi:10.3332/ecancer.2021.1298.

Scheel JR, Giglou MJ, Segel S, Orem J, Tsu V, Galukande M, et al. (2020), Breast cancer early detection and diagnostic capacity in Uganda. Cancer, 126: 2469-2480. doi: 10.1002/cncr.32890.

Smith RA, Andrews KS, Brooks D, Fedewa SA, Manassaram-Baptiste D, Saslow D, et al. Cancer screening in the United States, 2019: A review of current American Cancer Society guidelines and current issues in cancer screening. CA: a cancer journal for clinicians, 69(3), 184–210. doi: 10.3322/caac.21557.

Pippin MM, Boyd R. Breast Self- Examination. In StatPearls. StatPearls Publishing 2021.

Molaei-Zardanjani M, Savabi-Esfahani M, Taleghani F. Fatalism in breast cancer and performing mammography on women with or without a family history of breast cancer. BMC Women's Health 19, 116 (2019) doi:10.1186/s12905-019-0810-6.

Agboola AOJ, Deji-Agboola AM, Oritogun KS, Musa AA, Oyebadejo TY, Ayoade BA. Knowledge, Attitude and Practice of Breast SelfExamination in Female Health Workers in OlabisiOnabanjo University Teaching Hospital, Sagamu, Nigeria. The International Medical Journal. 2009;8(1):5–10. doi: 10.31436/imjm.v8i1.762.

Munyaradzi D, January J, Maradzika J. Breast cancer screening among women of child-bearing age. Health Care Women Int. 2014;35(7-9):818-27. doi: 10.1080/07399332.2014.920843.

Berens EM, Kaucher S, Van Eckert S, Reder M, Kolip P, Spallek J. Knowledge about mammography screening in Germany by education and migrant status – results of a cross-sectional study (InEMa). Appl Cancer Res 39, 6 (2019). doi: 10.1186/s41241-019-0076-1.

Demirkiran F, Ozgun H, Eskin M, Turk G, Cam R, Ozgun O, et al. A. E Cognition of breast cancer among gestational age Turkish women: a cross-sectional study. APJCP. 2011; 12:277– 82. doi: Not available

Abolfotouh MA, BaniMustafa AA, Mahfouz AA, Al-Assiri MH, Al-Juhani AF, Alaskar AS. Using the health belief model to predict breast self-examination among Saudi women. BMC Public Health. 2015; 15:1163. doi:10.1186/s12889-015-2510-y.

Makurirofa L, Mangwiro P, James V, Milanzi A, Mavu J, Nyamuranga M, et al. Women’s knowledge, attitudes and practices (KAP) relating to breast and cervical cancers in rural Zimbabwe: a cross sectional study in Mudzi District, Mashonaland East Province. BMC Public Health. 2019; 19, 109. doi: 10.1186/s12889018-6333-5.

Gebremariam A, Addissie A, Worku A, Assefa M, Kantelhardt EJ, Jemal A. Perspectives of patients, family members, and health care providers on late diagnosis of breast cancer in Ethiopia: A qualitative study. PLoS One. 2019;14(8): e0220769. Published 2019 Aug 1. doi: 10.1371/journal.pone.0220769.

Khin M, Shwe S, May Oo K, Win L-L. Breast Cancer Awareness in Myanmar. Results of a Hospital-based Study in Mandalay. Archives of Breast Cancer [Internet]. 2021; Apr. 27 [cited 2021 Nov. 7];210-5. doi: 10.32768/abc.202183210-215.


Robert K. Basaza (Primary Contact)
Judith Kaddu
Emmanuel Otieno
Florence Mirembe
Basaza RK, Kaddu J, Otieno E, Mirembe F. Determinants of Breast Cancer Screening Among Reverend Sisters in Kampala Archdiocese, Uganda: A Cross-Sectional Study: Determinants of Breast Cancer Screening. Arch Breast Cancer [Internet]. 2022 Mar. 4 [cited 2024 Apr. 23];9(2):221-30. Available from:

Article Details