Abstract
BACKGROUND: Breast Cancer (BC) is a significant leading cause of death among women. With an estimated 2.1 million new cases annually, it represents the most prevalent malignancy affecting women worldwide. The early detection of diseases plays a pivotal role in reducing morbidity and mortality. Therefore, this study aimed to assess the level of knowledge, attitude, and awareness of early BC detection among female university students. METHODS: We conducted a multi-national, multi-center, cross-sectional study among a convenience sample of female undergraduate Arab medical students in three countries. A web-based questionnaire was distributed among the students in Arabic and English. RESULTS: The total number of participants was 1361 (431 from Egypt (32%), 430 from Jordan (32%), and 500 from Syria (37%)). Almost half of the participants showed poor knowledge regarding both risk factors and clinical features of BC (52.5%). The mean scores for knowledge of early detection measures were 59.9% in Egypt, 69.2% in Jordan, and 75.2% in Syria. Regarding knowledge and attitude toward breast self-examination (BSE), the proportion of students with adequate awareness was 16.4%, 17.4%, and 26.8% for Egypt, Jordan, and Syria, respectively. A significant proportion of students had heard about BSE (72.74%), and more than half knew the recommended frequency (62.12%). However, only 33.15% of students regularly performed the BSE at least once every month. Furthermore, a predominant factor contributing to students' non-compliance with the BSE was their lack of knowledge regarding the proper technique (41.92%). The most predictive factor for the practice of BSE was a family history of BC, and the least predictive factor was knowledge level. Mammogram was the most commonly recognized breast cancer screening method, among students (82%), and social media was the most common source for acquiring knowledge on BC and BSE (38%). CONCLUSION: The study showed a lack of knowledge and awareness among students, highlighting the need for comprehensive educational interventions and training programs within university curricula. These measures are essential for enhancing the understanding of BC and promoting the adoption of BSE practices.