Individual-level and community-level factors associated with breast cancer screening among women of reproductive age in Tanzania: a multilevel analysis of the 2022 Tanzania Demographic and Health Survey

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Introduction: Breast cancer is a global health issue, contributing to a significant number of cancer-related deaths among women. Early detection through breast cancer screening is essential for reducing mortality and morbidity rates. We aimed to assess the individual and community-level factors associated with breast cancer screening among women of reproductive age in Tanzania. Methods: An analytical cross-sectional survey was conducted using secondary data from the 2022 Tanzania demographic and health survey. Considering the complex survey design, a multilevel mixed-effects binary logistic regression was used to determine the individual and community-level factors associated with breast cancer screening. Adjusted OR with corresponding 95% CIs was used to estimate the strength of the association. Statistical significance was set at a p<0.05. Results: The prevalence of breast cancer screening among women of reproductive age in Tanzania was 5.2% (95% CI 4.7 to 5.7). At the individual level, being aged ≥25 years, educated, working, living in wealthier households, using contraceptives, having media exposure, healthcare insurance coverage and visiting health facilities in the last 12 months were associated with higher odds of breast cancer screening. At the community level, being from communities with a high level of poverty and residing in rural settings was associated with lower odds of breast cancer screening. While residing in northern, southern and lake zones was associated with higher odds of breast cancer screening. Conclusions: The study highlights a critical need for enhanced efforts in breast cancer screening among women of reproductive age in Tanzania, where current participation rates remain disconcertingly low. The multifactorial nature of screening behaviours, influenced by age, education, employment status and socioeconomic conditions, underscores the complexity of addressing this public health challenge. Implementing targeted educational programmes, improving healthcare access and leveraging community resources can increase awareness and utilisation of screening services.

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