INTRODUCTION: This study aimed to evaluate the relationship between social determinants of health and women’s knowledge and awareness levels regarding breast cancer in two districts of Ankara with distinct socioeconomic profiles
METHODS: A cross-sectional study was conducted among 368 women aged 30–70 years who applied to Cancer Early Diagnosis, Screening, and Training Centers (KETEM) in Çayyolu (high socioeconomic level) and Mamak (middle socioeconomic level). Data were collected using a sociodemographic questionnaire and the breast cancer awareness scale. The scale demonstrated good to excellent reliability (Cronbach’s α=0.774–0.973; overall α=0.890), and construct validity was supported by exploratory factor analysis and confirmatory factor analysis with acceptable model fit indices. Statistical analyses included Independent Sample t-tests, analysis of variance, and Pearson correlation.
RESULTS: Women attending the Çayyolu KETEM had significantly higher scores than those attending the Mamak KETEM in the sub-dimensions of Knowledge of Risk Factors (2.26±0.56 vs. 1.94±0.56), Knowledge of signs and symptoms (2.66±0.57 vs. 2.13±0.81), attitudes toward breast cancer prevention (3.90±0.93 vs. 3.47±1.25), and health behaviors related to breast cancer awareness (3.12±1.10 vs. 2.59±0.97) (all p=0.001), while no significant difference was observed in the Barriers to Screening sub-dimension (p>0.05). Education level, marital status, employment, income, and family health background were significantly associated with awareness levels. Women who had received education on breast cancer screening and those who had undergone breast ultrasound exhibited higher awareness scores.
DISCUSSION AND CONCLUSION: The findings indicate that social determinants such as education, income, and access to health services significantly influence breast cancer awareness. These results underscore the critical role of primary healthcare and public health services, particularly family health centers and community-based screening units, in delivering targeted, culturally adapted breast cancer awareness and screening programs, especially in socio-economically disadvantaged regions.
Keywords: Attitudes, breast neoplasms, health knowledge, practice, social determinants of health, socioeconomic factors, women’s health