Published in PLOS One on 2025-11-13, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Mesfin Abebe, Yordanos Sisay Asgedom, Amanuel Yosef Gebrekidan, Tsion Mulat Tebeje
Source: PLOS One • DOI 10.1371/journal.pone.0336983
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Breast cancer is the leading cause of cancer-related deaths in women globally and a significant public health burden in sub-Saharan Africa, which accounts for approximately 15% of all cancer-related mortality. In sub-Saharan Africa, breast cancer incidences increased by 247% from 1990 to 2019. In Lesotho, breast cancer is the second most common cancer affecting women, a situation worsened by a fragile healthcare system and low screening rates. Despite its high morbidity and mortality, there is limited understanding of the factors influencing breast cancer screening among women of reproductive age. This study aims to identify these factors by utilizing the newly released Lesotho DHS dataset and the Anderson Behavioral Model.
This study utilized a cross-sectional design with data from the recent Lesotho Demographic and Health Survey (LDHS), which employed a stratified two-stage sampling method across 400 Enumeration Areas and 9,976 households. This analysis included a weighted sample of 6,413 reproductive-age women (15–49 years) to determine factors of breast cancer screening. The predisposing, enabling, and need factors were examined using the Andersen Behavioral Model. Stata version 16 was used for a multilevel mixed-effects logistic regression model. Results were presented as adjusted odds ratios (AOR) with 95% confidence intervals, and a P-value less than 0.05 was considered statistically significant.
The prevalence of breast cancer screening among women of reproductive age in Lesotho was 22.20% (95% CI 21.19–23.23). Significant factors included age 25–34 (AOR = 1.54; 95% CI 1.26–1.88), age 35–49 (AOR = 2.10; 95% CI 1.71–2.58), healthcare facility visits in the past 12 months (AOR = 1.47; 95% CI 1.26–1.71), health insurance coverage (AOR = 1.86; 95% CI 1.36–2.53), high media exposure (AOR = 1.23; 95% CI 1.01–2.52), contraceptive use (AOR = 1.18; 95% CI 1.03–1.37), and parity: multiparous (AOR = 2.29; 95% CI 1.84–2.85) and grand multiparous (AOR = 1.67; 95% CI 1.16–2.40).
This finding that 22.2% of reproductive age women in Lesotho underwent breast cancer screening highlights a pressing gap in preventive health efforts. The Andersen Behavioral Model underscores key determinants that significantly influence breast cancer screening uptake in our study. Significant factors included age, healthcare facility visits, health insurance coverage, media exposure, contraceptive usage, and parity. These findings underscore the need for targeted interventions that address model-based determinants to improve breast cancer screening uptake.
Introduction
Breast cancer remains a significant health concern worldwide and ranks as one of the leading causes of cancer mortality among women, particularly in low- and middle-income countries [1,2]. Despite the rising incidence of breast cancer, early detection through screening has been largely suboptimal, resulting in late-stage diagnoses and poor outcomes for many affected women [3]. Globally, an estimated 2.3 million women were diagnosed with breast cancer in 2020, leading to approximately 685,000 deaths, with many of these occurring in sub-Saharan Africa where awareness and screening practices are critically low [3,4]. By 2050, new cases and deaths are projected to rise by 38% and 68%, respectively, with low HDI countries being disproportionately affected [5]. This situation underscores the significant challenges faced by low- and middle-income countries (LMICs), driven by disparities in healthcare access and outcomes [6].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider financing & policy desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2025 Mesfin Abebe, Yordanos Sisay Asgedom, Amanuel Yosef Gebrekidan, Tsion Mulat Tebeje. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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- Evidence brief: Spatial autocorrelation and determinants of low uptake of breast cancer screening among women of reproductive age: A mixed-effect multilevel analysis of Tanzanian population-based survey
- Evidence brief: Barriers to healthcare access among women in sub-Saharan Africa: A pooled analysis of multi-country DHS data (2019–2023)
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