Barriers and facilitators to breast cancer screening among women in Côte d’Ivoire: A qualitative study

Adou S. J. Anoua

Abstract

This study examines breast cancer screening behaviors among women in a working-class neighborhood of Bouaké, Côte d’Ivoire, within the context of economic insecurity and therapeutic pluralism, where biomedical, traditional, and religious care practices coexist. A qualitative interpretive approach was used, based on 23 semi-structured interviews with women aged 18 and above, selected through purposive sampling and analyzed thematically. The findings reveal uneven knowledge of screening, particularly among older and economically vulnerable women, due to limited media exposure and social isolation. Breast cancer is widely associated with mutilation and death, generating ambivalent responses ranging from avoidance to heightened vigilance among women. Screening practices are shaped by intersecting economic, institutional, and time constraints, alongside enabling factors such as social support, prenatal care interactions, and media- and school-based awareness. These findings highlight the need for context-sensitive prevention strategies that integrate local social dynamics and diverse therapeutic landscapes.

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References

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A and Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–249. doi:10.3322/caac.21660.

Darré T, Tchandikou L, Simgban P, Bombone M, Djiwa T, N’Timon B, Sama B, Ketevi A, Douaguibe B, N’Bortche BK, Seddoh Y, Tchaou M and Napo-Koura G. Factors associated with late diagnosis of breast cancer in women in Togo, sub-Saharan Africa. BMC Womens Health. 2023;23(1):106. doi:10.1186/s12905-023-02257-8.

International Agency for Research on Cancer (IARC). Côte d’Ivoire: Cancer country fact sheet. Available from: https://canscreen5.iarc.fr/?page=countryfactsheet&q=CIV&utm. Accessed November 26, 2024.

Gui-Bile LN, Acko-Ohui EV and Soro A. Perception et acceptabilité de la mammographie dans le dépistage du cancer du sein: enquête en zone urbaine et péri-urbaine abidjanaise. J Afr Imagerie Med. 2023;15(1):13–19. doi:10.55715/jaim.v15i1.461.

Ayebeng C, Okyere J, Okantey C and Addo IY. Multifaceted barriers associated with clinical breast examination in sub-Saharan Africa: a multilevel analytical approach. PLoS One. 2025;20(1):e0316800. doi:10.1371/journal.pone.0316800.

Magwesela FM, Msemakweli DO and Fearon D. Barriers and enablers of breast cancer screening among women in East Africa: a systematic review. BMC Public Health. 2023;23:1915. doi:10.1186/s12889-023-16831-0.

Martei YM, Dauda B and Vanderpuye V. Breast cancer screening in sub-Saharan Africa: a systematic review and ethical appraisal. BMC Cancer. 2022;22:203. doi:10.1186/s12885-022-09299-5.

Salisu WJ, Mirlashari J, Varaei S and Seylani K. Limited access to care for persons with breast cancer in Africa: a systematic review. Eur J Oncol Nurs. 2021;50:101867. doi:10.1016/j.ejon.2020.101867.

Ramathuba DU, Ratshirumbi CT and Mashamba TM. Knowledge, attitudes and practices toward breast cancer screening in a rural South African community. Curationis. 2015;38(1):1172. doi:10.4102/curationis.v38i1.1172.

Olivier de Sardan JP. La rigueur du qualitatif. Les contraintes empiriques de l’interprétation socio-anthropologique. Louvain-la-Neuve: Academia-Bruylant; 2008. p. 1-365.

Paillé P and Mucchielli A. L’analyse qualitative en sciences humaines et sociales. 5e éd. Paris: Armand Colin; 2021. p. 1-432.

Patton MQ. Qualitative Research and Evaluation Methods. 4th ed. Thousand Oaks: Sage Publications; 2015. p. 1-832.

Braun V and Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101. doi:10.1191/1478088706qp063oa.

Weber M. Essais sur la théorie de la science. Paris: Plon; 1965. p. 1-539.

Denzin NK. The Research Act: A Theoretical Introduction to Sociological Methods. New York: Routledge; 2017. p. 1-379.

Wongnaah FG, Aboagye RG, Storph RP, Seidu AA, Adnani QES and Ahinkorah BO. Breast cancer screening uptake among women in Ghana: evidence from the 2022 DHS. Arch Public Health. 2025;83:262. doi:10.1186/s13690-025-01741-x.

Afaya A, Seidu AA, Sang S, Yakong VN, Afaya RA, Shin J and Ahinkorah BO. Mapping evidence on breast cancer screening knowledge and uptake in Ghana.

BMC Health Serv Res. 2022;22:526. doi:10.1186/s12913-022-07775-z.

Abebe M, Asgedom YS, Gebrekidan AY and Tebeje TM. Factors influencing breast cancer screening in Lesotho. PLoS One. 2025;20(11):e0336983. doi:10.1371/journal.pone.0336983.

Daniels-Donkor SS and Afaya A. Internet use and uptake of clinical breast examination among Kenyan women. Sci Rep. 2025;15:42574. doi:10.1038/s41598-025-24535-1.

Joho AA, Mdoe MB, Masoi TJ and Yahaya JJ. Factors influencing uptake of breast cancer screening. Sci Rep. 2024;14:12291. doi:10.1038/s41598-024-62218-5.

Seifu BL, Negussie YM, Asnake AA, Chinkey FD, Fente BM and Asmare ZA. Determinants of breast cancer screening in sub-Saharan Africa. PLoS One. 2024;19(12):e0312831. doi:10.1371/journal.pone.0312831.

Tibenderana JR, Kessy SA, Mlaponi DF, Mwaitete NL and Mtenga JE. Predictors of breast cancer screening in Tanzania. PLoS One. 2024;19(11):e0298996. doi:10.1371/journal.pone.0298996.

Malope SD, Norris SA and Joffe M. Culture, community, and cancer: understandings of breast cancer from a non-lived experience among women living in Soweto. BMC Womens Health. 2024;24:594. doi:10.1186/s12905-024-03431-2.

Lambert M, Mendenhall E, Kim AW, Cubasch H, Joffe M and Norris SA. Health system experiences of breast cancer survivors in urban South Africa. Womens Health (Lond). 2020;16:1745506520949419. doi:10.1177/1745506520949419.

Joffe M, Ayeni O, Norris SA, McCormack VA, Ruff P, Das I, Neugut AI, Jacobson JS and Cubasch H. Barriers to early presentation of breast cancer among women in Soweto, South Africa. PLoS One. 2018;13(2):e0192071. doi:10.1371/journal.pone.0192071.

Rainey L, van der Waal D, Jervaeus A, Donnelly LS, Evans DG, Hammarström M, Hall P, Wengström Y and Broeders MJM. European women’s perceptions of risk-based breast cancer screening and prevention: a qualitative study. BMC Cancer. 2020;20:247. doi:10.1186/s12885-020-06745-0.

.Boudreau C. Les besoins des femmes atteintes d’un cancer du sein et leurs perceptions de la maladie [dissertation]. Québec: Université Laval; 2000. Available from: http://hdl.handle.net/1866/31343 . Accessed November 26, 2024.

Afaya A, Anaba EA, Bam V, Afaya RA, Yahaya AR, Seidu AA and Ahinkorah BO. Sociocultural beliefs and perceptions influencing diagnosis and treatment of breast cancer among women in Ghana: a systematic review. BMC Womens Health. 2024;24:288. doi:10.1186/s12905-024-03106-y.

Muyisa R, Watumwa E, Malembe J, Wahangire J, Kalivanda G, Sita AS and Kamwira S. Barriers to timely diagnosis and management of breast cancer in Africa: implications for improved outcomes. Health Sci Rev. 2025;14:100221. doi:10.1016/j.hsr.2025.100221.

Nsabimana A, Nininahazwe A and Niyonkuru E. Breast cancer awareness and screening in Africa: identifying challenges and strategies for improved health outcomes. Int J Med Sci Innov Res. 2024;9(5):160–188. Available from: https://www.ijmsir.com/asset/images/uploads/17316912875183.pdf. Accessed November 26, 2024.

Sarmah N, Sibiya MN and Khoza TE. Barriers and enablers to breast cancer screening in rural South Africa. Curationis. 2024;47(1):e1–e8. doi:10.4102/curationis.v47i1.2583.

Olubodun T, Olaniran A, Wuraola FO, Morhason-Bello IO, Balogun M, Amole TG, Soyannwo T, Adebisi OI, Issa KO, Olorunfemi SO, Ohazurike E, Kingham P and Alatise OI. Practice of opportunistic breast cancer screening and health education among healthcare workers in public facilities in Ogun State, Nigeria: a qualitative study of barriers and facilitators. BMC Health Serv Res. 2025;25:1197. doi:10.1186/s12913-025-13418-w.

Peresu E, Kigozi-Male G, Engelbrecht M and van Rooyen R. Factors associated with uptake of breast cancer screening among women in a South African metropolitan area. S Afr Health Rev. 2024;26:90–99. Available from: https://hdl.handle.net/10520/ejc-healthr-v2023-n1-a13. Accessed November 26, 2024.

Ngowa JDK, Fouedjio HJ, Tchami AM, Likeng JLN, Noche CD, Djouonang BW, Ymele FF, Foumane P, Mboudou ET and Tebeu PM. Diagnostic and therapeutic options of breast cancer patients in Yaounde, Cameroon. Adv Breast Cancer Res. 2022;11(1):50–62. doi:10.4236/abcr.2022.111003.

Mburu W, Mensah ABB, Virnig B, Amuasi JH, Awuah B, Porta CM, Osei-Bonsu E and Kulasingam S. Pathways to breast cancer diagnosis and treatment among women in Ghana: a qualitative study. Womens Health Rep (New Rochelle). 2021;2(1):234–244. doi:10.1089/whr.2020.0117.

Abraham MN, Msoka EF, Hollis T, Serventi F, Cyril PM, Masenga GG, Mmbaga BT and Gutnik L. Understanding the role of the husband in supporting breast cancer care in Northern Tanzania: a qualitative study. BMC Public Health. 2025;25:1998. doi:10.1186/s12889-024-20864-4.

Sirili N, Msami K, Ruwaichi T and Nyamle N. “If diagnosed early, you will be stressed and die…” Drivers of breast cancer screening uptake among women in Dar es Salaam. PLOS Glob Public Health. 2024;4(11):e0003390. doi:10.1371/journal.pgph.0003390.

Sarmah N, Sibiya MN and Khoza TE. Sociocultural influences on breast cancer screening among rural African women in South Africa. Int J Environ Res Public Health. 2023;20(21):7005. doi:10.3390/ijerph20217005.

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