Abstract
Background: Research suggests that fear of cancer could be a significant predictor influencing participation in cancer screening. However, no tools have been validated to measure breast cancer fear among women in Bangladesh, while the Breast Cancer Fear Scale (BCFS) has been extensively examined in Western contexts. Thus, this study intends to validate the Bangla version of the BCFS among female university students aged (> 18) years, given the urgent need for a culturally relevant tool to evaluate fear associated with breast cancer screening practices in this population. Methods: This cross-sectional study was conducted in 2023 among female university students in Bangladesh. Participants were aged > 18 years, able to read Bangla, and had no personal or familial history of cancer or chronic illnesses. Data were collected via an online survey using a random sampling method, resulting in 456 eligible participants after data cleaning. The BCFS was translated into Bangla following the standard forward-backward translation process. Exploratory and confirmatory factor analyses (EFA and CFA) were conducted to evaluate the structure of the scale factor. Internal consistency, test-retest reliability, and convergent validity were also assessed. Results: The results showed that the mean age of the participants was 22.91 (SD: 1.12). The Bangla version of the BCFS showed a single-factor structure, high internal consistency (Cronbach's α = 0.939), and good test-retest reliability (r = 0.53, p < 0.001). The CFA results are consistent with the EFA findings, confirming that the scale is a good fit for the one-factor structure. The loadings range from 0.679 (Fear1) to 0.920 (Fear4) in the total sample, indicating that the items are significant indicators of the latent construct. The BCFS demonstrated an acceptable model fit, with RMSEA values below the 0.08 cutoff and SRMR values well below the 0.05 threshold across all samples. Additionally, the GFI, AGFI, NFI, TLI, and CFI values were all above the recommended thresholds, indicating a high fit for the model. Conclusions: The Bangla version of the BCFS has proven to be a powerful and reliable tool for gauging the multifaceted nature of breast cancer fear among Bangladeshi women, particularly female university students. This culturally tailored instrument holds the potential to shed light on the psychological barriers that hinder breast cancer screening.