iBackground/i: Breast cancer is the leading cause of cancer-related morbidity and mortality among women globally, with disproportionate impacts in low-resource settings due to delayed diagnosis and limited access to screening. In Ethiopia, breast cancer accounts for over 30% of all female cancers, yet early detection remains critically underutilized. Harar Town, located in Eastern Ethiopia, presents unique challenges and opportunities for community-based interventions. This study aimed to strategically advance breast cancer prevention through a market-centered screening and awareness initiative targeting women in Shewa-Ber, the largest public market in Harar. iMaterials and Methods/i: A cross-sectional, community-based screening program was conducted on October 28–29, 2023. Women aged 16 years and above who visited Shewa-Ber market were recruited using convenience sampling. A total of 204 women underwent clinical breast examinations performed by trained healthcare professionals, and 166 completed structured interviews. The survey instrument captured socio-demographic data, reproductive history, substance use, breast health complaints, and knowledge and practice of self-breast examination (SBE). Ethical clearance was obtained, and referrals were provided for suspected cases. iResults/i: Among the 166 respondents, only 43.4% had prior knowledge of SBE, and 23.5% reported practicing it. Notably, 13.3% of screened women exhibited clinical signs suggestive of breast cancer and were referred for further diagnostic evaluation. Risk factors included early menarche (≤13 years), family history of breast cancer (4.2%), contraceptive use (41%), and substance exposure (chat: 24.7%, alcohol: 5.4%, tobacco: 1.8%). Educational attainment was low, with 25.3% of participants having no formal education. Despite 26.5% reporting breast-related symptoms, only one woman had previously accessed ultrasound screening. The intervention revealed significant gaps in awareness, screening access, and health-seeking behavior. iConclusion/i: This initiative demonstrated the 1581350 feasibility and effectiveness of decentralized, community-based breast cancer screening in a high-traffic public setting. The findings underscore the urgent need for integrated public health strategies that combine education, screening, and referral systems to improve early detection and reduce mortality in underserved populations. iRecommendations/i: We recommend scaling this model across similar urban and peri-urban markets in Ethiopia. Health authorities should prioritize training of frontline health workers in breast cancer awareness, embed SBE education into routine outreach, and establish referral linkages for diagnostic follow-up. Future studies should assess longitudinal outcomes, cost-effectiveness, and integration with national cancer control programs.
Wondwossen et al. (Tue,) studied this question.