Breast Cancer Awareness, Early Detection Practices, and Knowledge of Risk Factors among Women in Outpatient Clinics in Benghazi, Libya: A Cross‑Sectional Study

Abstract

Breast cancer constitutes 31.4% of female cancer diagnoses in Libya, yet awareness and early detection rates remain critically low, particularly in Benghazi — a region whose healthcare infrastructure has been severely disrupted by prolonged conflict. This study aims to assess breast cancer awareness, knowledge of risk factors, and early detection practices among women attending outpatient clinics in Benghazi, Libya. A cross-sectional study was conducted from March to August 2024 among 302 women at five primary care and gynecology outpatient clinics. A structured, pilot-tested questionnaire captured socio-demographic data, risk factor and symptom knowledge, screening awareness, and screening practices. Binary logistic regression identified independent predictors of adequate knowledge and regular breast self-examination (BSE). Only 38.4% demonstrated adequate breast cancer knowledge. Although 85.8% were aware of BSE, merely 21.2% practiced it regularly, and only 58.3% knew the correct technique. Mammography and breast MRI awareness were low (50.7% and 35.1%, respectively). Family history and genetic factors were the most recognized risk factors (81.5%), whereas nulliparity was identified by only 23.8%. University education (AOR=3.82, 95% CI: 2.14–6.81, p<0.001), prior attendance at awareness campaigns (AOR=2.45, 95% CI: 1.32–4.56, p=0.005), and family history of breast cancer (AOR=2.18, 95% CI: 1.15–4.12, p=0.017) were independent predictors of adequate knowledge. Despite moderate general awareness, significant knowledge gaps persist regarding preventable risk factors and correct screening practices. Targeted educational interventions, strengthened primary healthcare capacity, and expanded mammography access are urgently needed to improve early detection and potentially reduce breast cancer mortality in Libya.