Impact of the family and socioeconomic factors as a tool of prevention of breast cancer

Abstract

The manuscript by Agidew et al, evaluates the critical role of family background and socioeconomic status in shaping breast cancer awareness, attitudes, and preventive behaviors, particularly in low-resource settings. Breast cancer continues to be a leading cause of cancer-related deaths globally, with a disproportionate impact on women in low- and middle-income countries. Recent research by Agidew et al underscores a significant association between family history of breast cancer and elevated levels of knowledge, positive attitudes, and proactive behaviors among women in Northeast Ethiopia. Building upon these findings, this editorial explores the psychological mechanisms and behavioral tendencies that drive greater awareness among women with familial exposure to the disease. Additionally, it highlights persistent socioeconomic challenges—such as limited healthcare access, education disparities, and cultural stigmas—that impede widespread preventive action, especially among women without a known family history. The editorial emphasizes the necessity of integrated public health strategies that combine culturally sensitive education, community outreach, and accessible screening services. Drawing from clinical and policy perspectives, it offers guidance on how to strengthen early detection and preventive care in under-resourced environments. Ultimately, the piece advocates for a more inclusive approach to breast cancer education and prevention that addresses both familial influence and systemic socioeconomic barriers.

Key Words: Breast cancer; Family history; Preventive practices; Socioeconomic factors; Public health strategies

Core Tip: The research explores how breast disease heredity affects knowledge and behaviors towards breast cancer prevention along with attitude development among Ethiopian women of reproductive age in Northeast Ethiopia. The research findings show that women with breast disease history in their families demonstrate superior knowledge and more positive behavior patterns alongside basic preventive measures than those without this history. The study established that academic level along with salary status and area-wide medical insurance coverage act as significant variables which shape these findings. Prevention programs along with targeted policy measures need to be developed specifically for low-resource areas because they enhance breast cancer prevention measures.

TO THE EDITOR

The number of new breast cancer cases continues to grow throughout the world but it worsens the most in low-and middle-income countries (LMICs). Breast cancer remains the principal diagnosis that occurs within women which makes it the second most fatal cancer for women after lung cancer[1]. Breast cancer burden depends on various elements which combine genetic risk factors with economic situations and healthcare availability and knowledge about prevention methods. Healthcare disparities for breast cancer exist because patients manage varying education levels and financial status along with different access to medical care. Breast cancer presents an increasing global challenge because LMICs experience heightened difficulties because they have limited medical resources and weak public health education systems[2]. High mortality continues to increase because of delayed breast cancer detection and negative social class factors strongly influence patient knowledge about screening and treatment commitment. Women’s who have poor financial status combined with lower education achievements and limited health insurance face increased chances of late-stage breast cancer detection with unfavorable treatment results. Social stigmas regarding breast cancer combined with misinterpretations of breast cancer facts hinder early discovery processes[2]. The risk of developing breast cancer grows exponentially high when a woman has a blood relative diagnosed with the disease. The low understanding about genetic risks among various communities leads to delayed medical testing and sickness detection.

This Wadila district-based cross-sectional research involving reproductive-age women occurred throughout the duration of May 1, 2022 to June 30, 2022 in Wollo, Ethiopia with the objective of examining how family history of breast diseases affects women's breast cancer knowledge and attitudes alongside their prevention behaviors. The research included systematic random selection of 143 women who had family history (FH) of breast diseases and 209 women who did not have FH of these diseases in five randomly chosen kebeles[3]. The study determined its sample size at n = 352 through calculation with a single-population proportion method using 68% self-breast examination prevalence and 95%CI alongside 5% margin of error. The research used structured questionnaires which adopted existing study instruments to gather data about socio-demographic characteristics as well as breast cancer knowledge and attitudes and preventive measures. Responses were graded using Likert scales[4]. A pre-collection assessment of the instrument involved first translating it from English to Amharic. The data quality assurance was achieved through the interviews which three experienced female clinical nurses conducted using a face-to-face method. They performed daily checks to verify data completion and accuracy. Epi Data version 3.1 served as the data entry program whereas data analysis occurred within SPSS version 25. The study utilized descriptive statistics for data summarization while bivariate and multivariate logistic regression analyses evaluated variable associations through P < 0.05 significant levels. Ethical clearance emerged from Zemen Postgraduate College Ethical Review Committee while The Wadila District Health Office granted their collaboration[5]. Every participant gave their consent to participate in the study and participants under 18 required their parents to give consent. The entire study executed confidentiality standards without exceptions.

The research showed that women who lacked breast disease family background demonstrated lower breast cancer knowledge rates and preventive measures compared to those participants who had such family history[6]. A family history among participants produced superior breast cancer knowledge levels at 83.9% whereas individuals without a family history displayed 10.5% good knowledge levels. Breast cancer prevention received positive attitudes from 49% of women with family history but only 32.1% of women without family history. Women who had family breast disease history engaged in a higher frequency of preventive practices when compared to women who did not have such a background (74.1% vs 16.7%). The research investigation uncovered major differences between women who had breast disease in their family history and those who did not regarding their knowledge levels and their attitudes towards prevention and preventive measures[7]. Participation surveys based on family history status showed good breast cancer knowledge attainment for 83.9% of participants in the group with family history but only 10.5% success for participants without family history. Women with a family history showed positive breast cancer preventive attitudes in 49% of cases vs 32.1% in women who did not have a family history of breast cancer. Women who had family members with breast disease performed preventive exams at rates that were higher than nonsufferers by 74.1% vs 16.7%. Research tells us that healthcare programs need to focus on implementing intervention methods which tackle breast cancer risk finders that stem from genetic and socioeconomic factors[8]. The combination of intensified public health education programs together with better healthcare access and improved breast cancer early detection awareness will create better risk outcome results among breast cancer prone women. People who carry a breast disease history in their families demonstrated higher knowledge and positive attitudes and better preventive behaviors compared to those who lack such genetic risk (83.9% vs 10.5% and 49% vs 32.1% and 74.1% vs 16.7%). Study results indicate that judgment based on education level combined with stable income and health insurance presents as crucial elements for increasing breast cancer awareness together with preventive actions. The shortage of financial support combined with inadequate healthcare facilities made it more challenging for communities to execute early detection screening programs and treatment procedures.

This study introduces a new perspective by assessing community breast disease background influences on knowledge alongside preventive practices and attitudes of female subjects within Ethiopia. This country shows limited research on this subject. This study diverges from existing studies that studied breast cancer awareness in general by showing how women without breast disease heritage differ from those who do in terms of their knowledge levels along with their screening practices and their health-seeking tendencies. The study discloses multiple socioeconomic indicators including education level together with income and health insurance status which help explain why these differences persist in prevention of breast cancer within areas with limited resources. The study creates foundations which authorities as well as healthcare staff can use to build targeted screening initiatives along with educational programs for early breast cancer identification and management among underserved communities.

Critical analysis and broader implications

Psychological and behavioral mechanisms: Data shows that females who have relatives with breast cancer tend to show stronger knowledge of preventative actions. The findings suggest that individuals with familial breast cancer risk display enhanced concern about their health conditions because they receive more medical information within their families. The research fails to establish the key psychological processes which contribute to observed behavioral patterns among women. Folks who have relatives diagnosed with breast cancer show higher tendencies to look for medical knowledge and join genetic counseling sessions and follow screening guidance because their felt danger feels stronger. Further investigations should analyze the impacts of health anxiety along with risk communications on preventive actions through assessment of decision-making practices.

Socioeconomic barriers to prevention: The research shows that breast cancer knowledge and prevention are influenced by educational attainment and income levels and health insurance coverage but lacks specific proposed policies to resolve such socioeconomic inequalities. Three major factors which delay breast cancer diagnosis in LMICs are financial obstacles along with minimal access to screening services and cultural beliefs about cancer. Health care organizations together with governments need to introduce specific measures which include: (1) Medical facilities should fund surveying screenings for disadvantaged people who lack adequate healthcare; (2) Healthcare organizations should organize community education initiatives which aim to educate people about breast cancer prevention and detection; (3) Integration of breast cancer screening into primary healthcare services; and (4) Healthcare professionals must receive training to help overcome errors in breast cancer understanding among patients and cultural barriers that result in delayed diagnosis.

Strengthening policy and clinical recommendations: The following policy and clinical recommendations should be applied to improve breast cancer prevention activities in Ethiopia and comparable circumstances: Community-led prevention programs develop better through active involvement of both healthcare workers and local leaders who create awareness programs that foster preventive behaviors. The successful prevention approaches from other geographic areas should be adopted by countries: Effective breast cancer prevention models in Rwanda and South Africa utilize mobile clinics to serve isolated communities through health workers. An adjustment of existing prevention models would be suitable for implementation in Ethiopia. Low-income population should receive financial assistance for breast cancer diagnostic services through government-allocated programs backed by nonprofitorganizations.

Socioeconomic impact of study

Breast cancer-related knowledge prevention and attitudes of reproductive-age women strongly depend on their socioeconomic status. The three main factors of education levels and income levels and health insurance coverage work together to affect both knowledge levels and early breast cancer detection approaches. Higher levels of education enable women to grasp better information about breast cancer jeopardy signs as well as screening processes and symptoms thus allowing them to obtain prompt medical care. People with stable economic conditions tend to buy healthcare services including screening and treatment because they have sufficient funds. The availability of community health insurance bolsters the chances that people will take part in medical preventive care practices. Healthcare access and treatment outcomes differ in people of varying socioeconomic groups across low- and middle-income countries particularly in Ethiopia due to limited healthcare system resources. The shortage of medical facilities and poor awareness levels found in rural regions make it challenging for women to receive early diagnosis which results in poor medical outcomes and elevates death numbers.

Clinical implications

This investigation delivers clinical implications which aim to enhance breast cancer early detection and awareness among reproductive-age women who do or do not carry FH of breast diseases[9]. The observed large discrepancies between different groups in their knowledge and behaviors and attitudes related to breast cancer prevention warrant group-specific educational strategies and screening initiatives[10]. Healthcare providers need to run awareness campaigns which focus on breast self-examinations as well as clinical breast exams and mammography for women without breast disease family history because this group showed poorer outcomes in preventive practices and less knowledge[11]. The study establishes how education level and household income levels together with health insurance coverage determine breast cancer awareness and care prevention responses among women. Healthcare improvement along with breast cancer screening integration into standard primary care serves combined with cultural-sensitive educational content helps knowledge deficits to disappear and supports early detection[12]. Present-day medical applications of machine learning help pathologists achieve quantitative diagnosis of diseases along with reducing variability between different pathologists. Acute hyper spectral imaging systems function with endoscopes alongside liquid crystal tunable filters to identify cancer through their devices. The technology delivers precise pictures of tissues between cancerous and healthy regions providing potential benefits to human optical diagnosis. Research concludes that operating HSI with computer-aided detection results in efficient breast cancer detection[13]. National cancer prevention strategies need to integrate these study findings because policy makers must provide equal access to breast cancer education together with screening services especially in poor Ethiopian communities. Health systems which tackle these disparities will enhance breast cancer detection rates and decrease mortality rates and improve female health outcomes[14,15].

CONCLUSION

Agidew et al[16] performed a study which delivers important findings about breast cancer awareness prevention through exams. Further examination is required to transform these results into practical intervention methods. Public health officials along with healthcare providers should implement precise interventions to enhance breast cancer prevention through addressing both psychological factors and behavioral and socioeconomic obstacles in limited-resource settings. Further investigations should create culturally appropriate and affordable approaches to enhance breast cancer detection as well as minimize healthcare inequalities among patients. The editorial explains how research data must be integrated into applicable public health practices to achieve fair breast cancer preventive measures and treatment services for all individuals.