From knowledge to practice: breast cancer awareness and self- examination in two cohorts of health science students

Breast cancer represents a serious threat to global health due to its high incidence and marked disparities in morbidity and mortality, largely driven by inequities in access to early detection and comprehensive care. In addressing this complex public health issue, healthcare trainees occupy an indispensable role. Comprehensive knowledge of breast cancer enables them to serve as critical frontline advocates in health promotion and primary prevention. To guide future academic endeavor, this study aims to compare knowledge, attitude, and practice (KAP) regarding breast cancer and self-examination practices between undergraduate nursing and paramedical students and to evaluate the effect of a structured educational intervention on both groups. This study was conducted with 256 students: Group A (nursing students, n = 128) and Group B (paramedical students, n = 128). Both groups completed a KAP questionnaire, received an educational intervention consisting of a lecture and a hands-on breast self-examination (BSE) workshop using anatomical models, and completed a follow-up questionnaire four weeks later. Descriptive and inferential statistical analysis revealed that nursing students demonstrated significantly higher baseline knowledge scores (18.4 ± 3.2 vs. 14.1 ± 4.1; t(254) = 8.9, p < 0.001, d = 1.14) and more positive attitudes (28.5 ± 4.3 vs. 24.8 ± 5.1; t(254) = 6.2, p < 0.001, d = 0.77). Post-intervention improvements were significant in both groups. Nursing students’ knowledge increased by a mean of 4.3 points (95% CI: 3.8–4.8, t(127) = 17.2, p < 0.001, d = 1.51), while paramedical students’ knowledge increased by a mean of 5.5 points, (95% CI: 4.8–6.2, t(127) = 15.8, p < 0.001, d = 1.34). However, nursing students maintained higher post-intervention knowledge scores (adjusted mean difference: 2.7 points; F(1,253) = 32.5, p < 0.001, partial η² = 0.114). Specific knowledge gaps persisted among paramedical students regarding risk factors (recognition of BRCA gene mutation increasing risk: 32.8% vs. 60.9% post-intervention; χ² = 20.32, p < 0.001, V = 0.29) and screening guidelines (mammography starting age: 60.9% vs. 89.1%; χ² = 27.01, p < 0.001, V = 0.33). The proposed intervention model offers a practical and effective strategy that could be applied across health care institutions, particularly among healthcare trainees, regardless of their field, to develop the confidence, commitment, and skills needed to effectively promote early detection of breast cancers in their communities. This study provides a clear road map for the curriculum reforms and implementation of effective educational intervention. While causal attribution is limited by the quasi-experimental design, the substantial pre–post improvements observed in both groups suggest that this intervention has potential to enhance breast cancer awareness among health science students.