Breast cancer screening uptake and its associated factors among women in Ghana: evidence from the 2022 Demographic and Health Survey.

INTRODUCTION: Early detection of breast cancer enhances the likelihood of effective treatment and prevention, thereby reducing the disease burden. Despite its significance, breast cancer screening services in Ghana are underutilised, with variations across the 16 regions. This study estimated the uptake of breast cancer screening and examined its associated factors in Ghana. METHODS: A weighted sample of 15,014 women of reproductive age from the 2022 Ghana Demographic and Health Survey was analysed. A spatial map illustrated regional variations in breast cancer screening uptake. Multilevel binary logistic regression was used to examine factors associated with screening uptake. Adjusted odds ratios (aORs) with 95% confidence intervals (CI) were reported, with statistical significance set at p < 0.05. RESULTS: The national prevalence of breast cancer screening was 18.4% [17.2, 19.6], with regional variations. The likelihood of screening increased with age, peaking among women aged 45-49 (aOR = 4.88; 95% CI = 3.58-6.66). Women with secondary (aOR = 1.76; 95% CI = 1.39-2.24) and higher (aOR = 4.25; 95% CI = 3.15-5.75) education, those who were employed (aOR = 1.25; 95% CI = 1.03-1.51), insured (aOR = 1.82; 95% CI = 1.38-2.41), or had recent health facility visits (aOR = 1.53; 95% CI = 1.33-1.77) were more likely to be screened. Media exposure via radio (aOR = 1.21; 95% CI = 1.03-1.42), newspaper (aOR = 1.41; 95% CI = 1.16-1.71), and internet use (aOR = 1.34; 95% CI = 1.14-1.59) increased screening odds, while rural residence (aOR = 0.65; 95% CI = 0.52-0.82) and Islamic affiliation (aOR = 0.77; 95% CI = 0.61-0.98) reduced the odds. Women in Bono East, Oti, Savannah, and Upper West regions were less likely to be screened. CONCLUSION: The study reveals low participation in breast cancer screening in Ghana, with notable regional disparities. Major factors associated with breast cancer screening included women's age, level of education, wealth index, religious affiliation, employment status, health insurance coverage, recent health facility visits, media exposure, place of residence and region. Culturally and religiously sensitive screening interventions are essential for addressing regional and religious variations. Expanding Ghana's national health insurance to cover breast cancer screening will enhance access. Awareness campaigns, conducted through both traditional and digital platforms, are crucial for boosting participation.