Breast self-examination prevalence and determinants in low- and middle-income countries: an umbrella review of systematic reviews and meta-analyses

Abstract

Background Low- and middle-income countries (LMICs) face a dual burden of infectious and chronic diseases, including breast cancer. Breast self-examination (BSE) is a vital tool for early detection, improving outcomes, and reducing mortality. Assessing its prevalence and determinants in LMICs is crucial for enhancing early diagnosis and treatment. Methods A comprehensive search was conducted across PubMed, Web of Science, Scopus, Cochrane, and Google Scholar using PICO criteria to identify systematic reviews and meta-analyses on breast self-examination in Low- and middle-income countries. Methodological quality was assessed using the AMSTAR tool. A random-effects meta-analysis pooled estimates, with heterogeneity ( I 2 ) and publication bias (funnel plot) evaluated. Forest plots presented pooled prevalence with 95% confidence intervals (CI). Results This umbrella review included 10 studies (110,622 participants). The pooled BSE prevalence was 32.15% (confidence interval: 22.61–40.75), with high heterogeneity ( I 2 = 100%, p = <0.001). Significant determinants included BSE knowledge (OR = 3.95; 95% CI: 3.02–4.87), a positive attitude (OR = 2.73; 95% CI: 2.02–3.45), and a family history of breast cancer (OR = 1.81; 95% CI: 1.23–2.38). Conclusion The prevalence of breast self-examination (BSE) in low and middle-income countries (LMICs) remains relatively low at 32.15%. Key factors influencing BSE practice include knowledge, attitudes, and family history of breast cancer. To enhance BSE practice, targeted strategies such as public awareness campaigns, training for healthcare providers, and incorporating family history assessments are essential. Additionally, strengthening research and policy initiatives can help address existing gaps in awareness, promote early detection, and improve breast cancer outcomes in low and middle-income countries. Systematic Review Registration PROSPERO CRD42023491634.