The Effects of Educational Level on Breast Cancer Awareness: A Cross-Sectional Study in Turkey


Breast self-examination (BSE) is important for early diagnosis of breast cancer (BC). However, the majority ofTurkish women do not perform regular BSE. We aimed to evaluate the effects of education level on the attitudesand behaviors of women towards BSE. A descriptive cross-sectional study was conducted on 413 women (20–59years), divided into university graduates (Group I, n = 224) and high school or lower graduates (Group II, n =189). They completed a 22-item scale assessing the knowledge level, attitudes and behaviors regarding BSE, andthe Turkish version of the Champion’s Revised Health Belief Model. A significantly higher number of womenin Group II did not believe in early diagnosis of BC. A significantly higher number of Group I had conductedBSE at least once, and their BSE frequency was also significantly high. Moreover, a significantly lower numberof Group I women considered themselves to not be at risk for BC and the scores for “perceived susceptibility”and “perceived barriers” were significantly higher. Logistic regression analysis identified the university graduategroup to have a higher likelihood of performing BSE, by 1.8 times. Higher educational levels were positivelyassociated with BSE performance. Overall, the results suggest that Turkish women, regardless of their educationlevel, need better education on BSE. Consideration of the education level in women will help clinicians developmore effective educational programs, resulting in more regular practice and better use of BSE.