Awareness and Attitudes towards Breast Cancer Risk Factors among Female University Students in Bangladesh: Evidence from Sylhet District
Abstract
Breast cancer is a growing health concern among women worldwide, with particularly rapid increases in low-and middle-income countries, including Bangladesh. Despite being preventable and treatable if detected early, it remains a neglected public health issue. Using Social Cognitive Theory, this study examines students’ awareness and attitudes toward breast cancer, their perceptions of risk factors, and the influence of family and institutional settings on preventive practices. Using a qualitative approach within a social constructivist paradigm, the research involved 44 participants from six public and private universities in Sylhet District, including female students, guardians, and university administrators. Thematic analysis revealed that University students showed limited and vague awareness of breast cancer, with misconceptions about its causes and prevention. Their attitudes were marked by shame, stigma, cultural silence, and fear, which discouraged open discussion and preventive practices such as breast self-examination. Understanding of breast cancer was largely shaped by family experiences and cultural myths rather than formal education. Cultural taboos and family silence often delayed symptom recognition and medical consultation. Institutional support was limited, with few seminars and awareness programs, and unavailability of female general healthcare practitioners reflect the institutional negligence of women’s specific health needs. The study recommended gender and student-centered initiatives such as female-only seminars, “Girls’ Help Desks,” and culturally informed rural campaigns to normalize breast health discussions and empower female adolescents. The study highlights the need for a holistic, inclusive, and culturally rooted approach to improve awareness, challenge stigma, and foster proactive preventive behaviors among the university students in Bangladesh.
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References
Abbas, M. O., & Baig, M. (2023). Knowledge and practice concerning breast cancer risk factors and screening among females in UAE. Asian Pacific journal of cancer prevention: APJCP, 24(2), 479.
Abo Al-Shiekh, S. S., Ibrahim, M. A., & Alajerami, Y. S. (2021). Breast cancer knowledge and practice of breast self‐examination among female university students, Gaza. The Scientific World Journal, 2021(1), 6640324.
Akter, M. F., & Ullah, M. O. (2022). Awareness levels of breast cancer among female university and medical college students in Sylhet city of Bangladesh. Cancer Reports, 5(11), e1608.
Al-Marzouqi, Z., Al-Jabri, N. S., Al-Dhoani, A., & Al-Risi, I. (2025). Barriers of breast self-examination among Omani women. Advances in Biomedical and Health Sciences. https://doi.org/10.4103/abhs.abhs_71_24
Alam, N. E., Islam, M. S., Ullah, H., Molla, M. T., Shifat, S. K., Akter, S., Aktar, S., Khatun, M. M., Ali, M. R., & Sen, T. C. (2021). Evaluation of knowledge, awareness and attitudes towards breast cancer risk factors and early detection among females in Bangladesh: A hospital based cross-sectional study. Plos one, 16(9), e0257271.
Almeshari, M., Alzamil, Y., Alyahyawi, A., Abanomy, A., Althmali, O., Al-Enezi, M. S., CG, S., Osman, H., & Khandaker, M. U. (2023). Awareness level, knowledge and attitude towards breast cancer among staff and students of Hail University, Saudi Arabia. Plos one, 18(3), e0282916.
Barrios, C. H. (2022). Global challenges in breast cancer detection and treatment. The Breast, 62, S3-S6.
Begum, S., Mahmud, T., Rahman, T., Zannat, J., Khatun, F., Nahar, K., Towhida, M., Joarder, M., Harun, A., & Sharmin, F. (2019). Knowledge, attitude and practice of Bangladeshi women towards breast cancer: a cross sectional study. Mymensingh Med J, 28(1), 96-104.
Chao, C. A., Masalu, N., Visvanathan, K., Mwakatobe, K., Rositch, A. F., & Huang, L. (2020). Understanding womenu2019s perspectives on breast cancer is essential for cancer control: knowledge, risk awareness, and care-seeking in Mwanza, Tanzania. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-09010-y
Fam, J., Mahendran, R., & Kua, E. H. (2019). Dementia care in low and middle-income countries. Current Opinion in Psychiatry, 32(5), 461-464. https://doi.org/10.1097/yco.0000000000000523
Fouad, N. A., & Guillen, A. (2006). Outcome Expectations: Looking to the Past and Potential Future. Journal of Career Assessment, 14(1), 130-142. https://doi.org/10.1177/1069072705281370
Islam, M. R., Zhu, H., Siddiqua, S. M., Islam, S. M., Hasan, A. K., Saha, B., Akter, N., Khatun, N., Long, J. P., & Ueno, N. T. (2023). Association of reproductive factors with triple-negative breast cancer and hormone receptor–positive breast cancer among Bangladeshi women.
Jaafar, H., Ismail, S. Y., & Azzeri, A. (2023). Period Poverty: A Neglected Public Health Issue. Korean J Fam Med, 44(4), 183-188. https://doi.org/10.4082/kjfm.22.0206
Joseph, S. A. J. (2024). Determinants of Breast Cancer Screening among Nuns in the Catholic Archdiocese of Nairobi JKUAT-COHES].
Morshid, G. (2023). The current cancer situation in metropolitan Dhaka Brac University].
Mubarik, S., Liu, X., Iqbal, M., Hussain, S. R., Yu, C., Sharma, R., & Nawsherwan, N. (2022). Breast Cancer Mortality Trends and Predictions to 2030 and Its Attributable Risk Factors in East and South Asian Countries. Frontiers in nutrition, 9. https://doi.org/10.3389/fnut.2022.847920
Myrick, J. G., & Yang, Y. (2022). Social Cognitive Theory. In The International Encyclopedia of Health Communication (pp. 1-4). https://doi.org/https://doi.org/10.1002/9781119678816.iehc0666
Nabi, R. L., & Prestin, A. (2020). Social Cognitive Theory. In The International Encyclopedia of Media Psychology (pp. 1-14). https://doi.org/https://doi.org/10.1002/9781119011071.iemp0159
Okulicz-Kozaryn, A., & Valente, R. R. (2019). No urban malaise for Millennials. Regional Studies, 53(2), 195-205.
Rahman, S. A., Al–Marzouki, A., Otim, M., Khayat, N. E. H. K., Yousef, R., & Rahman, P. (2019). Awareness about breast cancer and breast self-examination among female students at the University of Sharjah: a cross-sectional study. Asian Pacific journal of cancer prevention: APJCP, 20(6), 1901.
Roberto, A., Colombo, C., Candiani, G., Satolli, R., Giordano, L., Jaramillo, L., Castagno, R., Mantellini, P., Falini, P., & Carnesciali, E. (2020). A dynamic web-based decision aid to improve informed choice in organised breast cancer screening. A pragmatic randomised trial in Italy. British Journal of Cancer, 123(5), 714-721.
Sarker, R., Islam, M. S., Moonajilin, M. S., Rahman, M., Gesesew, H. A., & Ward, P. R. (2022). Effectiveness of educational intervention on breast cancer knowledge and breast self-examination among female university students in Bangladesh: a pre-post quasi-experimental study. BMC cancer, 22(1), 199.
Shamsi, T. (2021). Burden of breast cancer in Bangladesh‐current and future and financing treatment with link to willingness to pay. Int J Community Med Public Heal, 8(11), 5525-5528.
Srinath, A., Van Merode, F., Rao, S. V., & Pavlova, M. (2022). Barriers to cervical cancer and breast cancer screening uptake in low- and middle-income countries: a systematic review. Health policy and planning, 38(4), 509-527. https://doi.org/10.1093/heapol/czac104
Usher, E., & Ford, C. J. (2022). Social Cognitive Theory and Personal Agency. https://doi.org/10.4324/9781138609877-ree48-1
Usher, E. L., & Morris, D. B. (2023). Self-efficacy. In H. S. Friedman & C. H. Markey (Eds.), Encyclopedia of Mental Health (Third Edition) (pp. 117-124). Academic Press. https://doi.org/https://doi.org/10.1016/B978-0-323-91497-0.00085-0
Yip, C. H., Buccimazza, I., Cheung, P. S. Y., Hartman, M., & Deo, S. V. S. (2014). Improving outcomes in breast cancer for low and middle income countries. World Journal of Surgery, 39(3), 686-692. https://doi.org/10.1007/s00268-014-2859-6
Copyright (c) 2026 Esmat Ara, Mohammed Kamruzzaman, Md. Assraf Seddiky, Md. Khairul Islam
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