Breast Cancer Genetics Knowledge and Testing Intentions among Nigerian Professional Women
Genetic testing services for breast cancer are well established in developed countries compared to African populations that bear a disproportionate burden of breast cancer (BC). The objective of this study is to examine the knowledge of professional Nigerian women about BC genetics and their intentions to utilize genetic testing services when it is made available in Nigeria. In this study, 165 lecturers and 189 bankers were recruited and studied using a validated self-administered questionnaire. The respondents’ mean age was 34.9 years (SD = 10.9), 6.5% had family history of BC, and 84.7% had limited knowledge of breast cancer genetics. The proportion of women with genetic testing intentions for breast cancer was 87.3%. Health care access (OR = 2.35, 95% CI, 1.07–5.13), religion (OR = 3.51, 95% CI, 1.03–11.92), and perceived personal risk if a close relative had breast cancer (OR = 2.31, 95% CI, 1.05–5.08) independently predicted testing intentions. The genetic testing intentions for BC were high despite limited knowledge about breast cancer genetics. Promotion of BC genetics education as well as efforts to make BC genetic testing services available in Nigeria at reduced cost remains essential.
KeywordsWillingness Professional women Genetic testing BRCA 1 BRCA 2 Breast cancer Nigeria
This study was not funded by any external body aside the authors.
Compliance with Ethical Standards
Conflict of Interest
Samuel O. Ngene, Babatunde Adedokun, Prisca Adejumo, and Olufunmilayo Olopade declare that they have no conflict of interest.
Human Studies and Informed Consent
All the respondents in the study gave written and signed informed consent. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study. No animal studies were carried out by the authors for this article.
No animal studies were carried out by the authors for this article.
Ethical approval for this study was obtained from the Oyo State Research Ethics Review Committee, Ministry of Health, Ibadan, Oyo State, Nigeria.
- Akhigbe, A. O., & Omuemu, V. O. (2009). Knowledge, attitudes and practice of breast cancer screening among female health workers in a Nigerian urban city. BioMedical Central Cancer, 9(1), 203. https://doi.org/10.1186/1471-2407-9-203.
- Akinola, R., Wright, K., Osunfidiya, O., Orogbemi, O., & Akinola, O. (2011). Mammography and mammographic screening: are female patients at a teaching hospital in Lagos, Nigeria, aware of these procedures? Diagnostic and Interventional Radiology, 17(2), 125–129. https://doi.org/10.4261/1305-3825.DIR.3078-09.2.PubMedCrossRefGoogle Scholar
- Amin, T. T., Al-Wadaani, H. A., Al-Quaimi, M. M., Aldairi, N. A., Alkhateeb, J. M., & Al-Jaafari, A. A. (2012). Saudi women’s interest in breast cancer gene testing: possible influence of awareness, perceived risk and socio-demographic factors. Asian Pacific Journal of Cancer Prevention, 13, 3879–3887. https://doi.org/10.7314/APJCP.2012.13.8.3879.CrossRefPubMedGoogle Scholar
- Antoniou, A., Pharoah, P. D. P., Narod, S., Risch, H. A., Eyfjord, J. E., Hopper, J. L., et al. (2003). Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case series unselected for family history: a combined analysis of 22 studies. American Journal of Human Genetics, 72, 1117–1130.CrossRefPubMedPubMedCentralGoogle Scholar
- Bellcross, C. A., Peipins, L. A., McCarty, F. A., Rodriguez, J. L., Hawkins, N. A., Alford, S. H., & Leadbetter, S. (2015). Characteristics associated with genetic counseling referral and BRCA1/2 testing among women in a large integrated health system. Genetics in Medicine, 17(1), 43–50.CrossRefPubMedGoogle Scholar
- Bottorff, J. L., Ratner, P. A., Balneaves, L. G., Richardson, C. G., McCullum, M., Hack, T., … Buxton, J. (2002). Women’s interest in genetic testing for breast cancer risk: the influence of socio-demographics and knowledge. Cancer Epidemiological Biomarkers and Prevention., 11, 89–95.Google Scholar
- Bruno, M., Tommasi, S., Stea, B., Quaranta, M., Schittulli, F., Mastropasqua, A., … Paradiso, A. (2004). Awareness of breast cancer genetics and interest in predictive genetic testing: a survey of a southern Italian population. Annals of Oncology, 15(1), 48–54.Google Scholar
- Bruno, M., Digennaro, M., Tommasi, S., Stea, B., Danese, T., Schittulli, F., & Paradiso, A. (2010). Attitude towards genetic testing for breast cancer susceptibility: a comparison of affected and unaffected women. European Journal of Cancer Care, 19, 360–368. https://doi.org/10.1111/j.1365-2354.2009.01067.x.CrossRefPubMedGoogle Scholar
- Durfy, S. J., Bowen, D. J., McTiernan, A., Sporleder, J., & Burke, W. (1999). Attitudes and interest in genetic testing for breast and ovarian cancer susceptibility in diverse groups of women in western Washington. Cancer Epidemiology Biomarkers Prevention, 8, 369–375.Google Scholar
- Easton, D. F., Pharoah, P. D., Antoniou, A. C., Tischkowitz, M., Tavtigian, S. V., Nathanson, K. L., Devilee, P., Meindl, A., Couch, F. J., Southey, M., Goldgar, D. E., Evans, D. G., Chenevix-Trench, G., Rahman, N., Robson, M., Domchek, S. M., & Foulkes, W. D. (2015). Gene-panel sequencing and the prediction of breast-cancer risk. New England Journal of Medicine, 372(23), 2243–2257. https://doi.org/10.1056/NEJMsr1501341.
- Fackenthal, J. D., Sveen, L., Gao, Q., Kohlmeir, E. K., Adebamowo, C., Ogundiran, T. O., … Olopade, O. I. (2005). Complete allelic analysis of BRCA1 and BRCA2 variants in young Nigerian breast cancer patients. Journal of Medical Genetics, 42, 276–281. https://doi.org/10.1136/jmg.2004.020446.
- Fagbemiro, L., & Adebamowo, C. (2014). Knowledge and attitudes to personal genomics testing for complex diseases among Nigerians. BioMed Central Medical Ethics, 15(1), 34. https://doi.org/10.1186/1472-6939-15-34.
- Forouzanfar, M. H., Foreman, K. J., Delossantos, A. M., Lozano, R., Lopez, A. D., Murray, C. J., & Naghavi, M. (2011). Breast and cervical cancer in 187 countries between 1980 and 2010: a systematic analysis. Lancet, 378(9801), 1461–1484. https://doi.org/10.1016/S0140-6736(11)61351-2.CrossRefPubMedGoogle Scholar
- Ibrahim, N. A., & Odusanya, O. O. (2009). Knowledge of risk factors, beliefs and practices of female healthcare professionals towards breast cancer in a tertiary institution in Lagos, Nigeria. BioMed Central Cancer, 9(1), 76. https://doi.org/10.1186/1471-2407-9-76.
- Jedy-Agba, E., Curado, M. P., Ogunbiyi, O., Ogaa, E., Fabowale, T., Igbinoba, F., … Adebamowo, C. A. (2012). Cancer Incidence in Nigeria: a report from population-based cancer registries. Cancer Epidemiology, 36(5), 271–278. e271–e278. https://doi.org/10.1016/j.canep.2012.04.007.
- Kessler, L., Collier, A., Brewster, K., Smith, C., Weathers, B., Wileyto, E. P., & Halbert, C. H. (2005). Attitudes about genetic testing and genetic testing intentions in African American women at increased risk for hereditary breast cancer. Genetics in Medicine, 7(4), 230–238.CrossRefPubMedGoogle Scholar
- Kinney, A. Y., Croyle, R. T., Dudley, W. N., Bailey, C. A., Pelias, M. K., & Neuhausen, S. L. (2001). Knowledge, attitudes, and interest in breast–ovarian cancer gene testing: a survey of a large African-American kindred with a BRCA1 mutation. Preventive Medicine, 33, 543–551.CrossRefPubMedGoogle Scholar
- Kinney, A. Y., Gammon, A., Coxworth, J., Simonsen, S. E., & Arce-Laretta, M. (2010). Exploring attitudes, beliefs, and communication preferences of Latino community members regarding BRCA1/2 mutation testing and preventive strategies. Genetics in Medicine, 12(2), 105–115. https://doi.org/10.1097/GIM.0b013e3181c9af2d.CrossRefPubMedPubMedCentralGoogle Scholar
- Lerman, C., Narod, S., Schulman, K., Hughes, C., Gomez-Caminero, A., Bonney, G., … Lynch, H. (1996). BRCA1 testing in families with hereditary breast-ovarian cancer: a prospective study of patient decision making and outcomes. JAMA, 275(12), 1885–1892.Google Scholar
- Lerman, C., Biesecker, B., Benkendorf, J. L., Kerner, J., Gomez-Caminero, A., Hughes, C., & Reed, M. M. (1997). Controlled trial of pretest education approaches to enhance informed decision-making for BRCA1 gene testing. Journal National Cancer Institute, 89(2), 148–157. https://doi.org/10.1093/jnci/89.2.148.CrossRefGoogle Scholar
- MacNew, H. G., Rudolph, R., Brower, S. T., Beck, A. N., & Meister, E. A. (2010). Assessing the knowledge and attitudes regarding genetic testing for breast cancer risk in our region of southeastern Georgia. The Breast Journal, 16(2), 189–192. https://doi.org/10.1111/j.1524-4741.2009.00880.x.CrossRefPubMedGoogle Scholar
- Mavaddat, N., Peock, S., Frost, D., Ellis, S., Platte, R., Fineberg, E., … Easton, D. F. (2013). Cancer risks for BRCA1 and BRCA2 mutation carriers: results from prospective analysis of EMBRACE. Journal of the National Cancer Institute., 105(11), 812–822. https://doi.org/10.1093/jnci/djt095.
- Miki, Y., Swensen, J., Shattuck-Eidens, D., Futreal, P. A., Harshman, K., Tavtigian, S., … Skolnick, M. H. (1994). A strong candidate for breast cancer susceptibility gene BRCA 1. Science, 266(5182), 66–71.Google Scholar
- Montazeri, A., Vahdaninia, M., Harirchi, I., Harirchi, A. M., Sajadian, A., Khaleghi, F., … Jarvandi, S. (2008). Breast cancer in Iran: need for greater women awareness of warning signs and effective screening methods. Asia Pacific Family Medicine, 7(1), 6. https://doi.org/10.1186/1447-056X-7-6.
- Moyer, V. A., LeFevre, M. L., Siu, A. L., Peters, J. J., Baumann, L. C., Bibbins-Domingo, K., … Pignone, M. P. (2014). Risk assessment, genetic counseling and genetic testing for BRCA-related cancer in women: U.S. preventive task force recommendation statement. Annals of Internal Medicine, 160(4), 271–281. https://doi.org/10.7326/M13-2747.
- Obaji, N. C., Elom, H. A., Agwu, U. M., Nwigwe, C. G., Ezeonu, P. O., & Umeora, O. U. J. (2013). Awareness and practice of breast self-examination among market women in Abakaliki, South East Nigeria. Annals of Medical and Health Sciences Research, 1(7), 7–12. https://doi.org/10.4103/2141-9248.109457.CrossRefGoogle Scholar
- Obajimi, M. O., Ajayi, I. O., Oluwasola, A. O., Adedokun, B. O., Adeniji-Sofoluwe, A. T., Mosuro, O. A., Akingbola, T. S., Bassey, O. S., Umeh, E., Soyemi, T. O., Adegoke, F., Ogungbade, I., Ukaigwe, C., & Olopade, O. I. (2013). Level of awareness of mammography among women attending outpatient clinics in a teaching hospital in Ibadan, South-West Nigeria. BioMedical Central Public Health 13(1), 14. https://doi.org/10.1186/1471-2458-13-40.
- Olajide, T. O., Ugburo, A. O., Habeebu, M. O., Lawal, A. O., Afolayan, M. O., & Mofikoya, M. O. (2014). Awareness and practice of breast screening and its impact on early detection and presentation among breast cancer patients attending a clinic in Lagos, Nigeria. Nigerian Journal of Clinical Practice, 17(6), 802–807. https://doi.org/10.4103/1119-3077.144404.CrossRefPubMedGoogle Scholar
- Quinlivan, J. A., Battikhi, Z., & Petersen, R. W. (2014). What factors impact upon a woman’s decision to undertake genetic cancer testing? Frontiers in Oncology, 3(1), 325. https://doi.org/10.3389/fonc.2013.00325.
- Struewing, J. P., Lerman, C., Kase, R. G., Giambarresi, T. R., & Tucker, M. A. (1995). Anticipated uptake and impact of genetic testing in hereditary breast and ovarian cancer families. Cancer Epidemiological Biomarkers and Prevention, 4(2), 169–173.Google Scholar
- World Health Organization. (2002). Genomic and World Health/report of the Advisory Committee on Health Research. http://www.who.int/rpc/genomics_report.pdf.
- World Health Organization. (2014). Cancer country profiles. Nigeria. http://www.who.int/cancer/country-profiles/nga_en.pdf?ua=1.