Breast cancer awareness among women in Eastern China: a cross-sectional study

Background: High breast cancer mortality has been attributed to lack of public awareness, which leads to late diagnoses. As little is known about the level of knowledge and awareness of breast cancer in China, this study was designed to explore it among women in Eastern China. Methods: We conducted a cross-sectional survey covering 122,058 females around Shandong, Hebei, Jiangsu and Tianjin, in Eastern China, using in-person interviews based on a self-designed structured questionnaire. Student's t-test, Pearson's chi(2) test, reliability analysis, exploratory factor analysis, univariate and multivariate logistic regression analyses were performed in the statistical analysis. Results: The results showed poor awareness of breast cancer among women aged 25-70 years in Eastern China. Only 18.6% of women were highly aware in the study, whereas 81.4% were poorly aware. Among all participants, family history of breast cancer was the best accepted risk factor for breast cancer (awareness rate 31.5%), followed by menarche at age before 12 (11.2%), no parity or late childbirth (13.9%), menopause at a late age (13.7%), high-fat diets (19.1%), long time drinking (19.5%) and long-term use of estrogen drugs (20.7%). Multivariate logistic regression analysis (alpha = 0.05) identified nine variables that predicted awareness of breast cancer: age (OR = 0.975, 95% CI: 0.960-0.990), location (OR = 1.675, 95% CI: 1.602-1.752), occupation (OR = 4.774, 95% CI: 4.316-5.281), family history of breast cancer (OR = 1.234, 95% CI: 1.073-1.420), household annual income (OR = 0.418, 95% CI: 0.400-0.436), behavioral prevention score (OR = 4.137, 95% CI: 3.991-4.290), no smoking (OR = 2.113, 95% CI: 1.488-2.999), no drinking (OR = 1.427, 95% CI: 1.018-2.000), overall life satisfaction (OR = 0.707, 95% CI: 0.683-0.731). Conclusions: Our study indicates insufficient awareness of breast cancer among women in Eastern China, and an urgent need for health education programs on this subject.