Understanding Breast Health Awareness in the Kingdom of Saudi Arabia: A Systematic Review of the Literature

Breast cancer (BC) is a critical health concern in the Kingdom of Saudi Arabia (KSA). A major factor influencing its incidence is the large proportion of younger Saudi women presenting with BC at an advanced stage. This systematic review aimed to explore health care providers' and women’s experiences and perspectives of breast health awareness in KSA. Electronic data databases: MEDLINE, PubMed, CINAHL and the Web of Science were searched from inception (1946) to February 2017. A systematic search using breast cancer or breast health headings and index terms was conducted. Papers were included if they focused on Saudi women and health care providers (HCPs), breast cancer and breast health awareness. This systematic review was guided by PRISMA guidelines and all relevant studies were individually assessed by the researcher using Critical Appraisal Skills Programme and Milton Keynes Primary Care Trust checklists and reviewed by all authors. Thematic synthesis of data was used to present the results. 56 studies inform this systematic review. There are no national breast cancer education programs or screening programs in KSA. The findings demonstrated a very limited evidence base related to breast health awareness. This limited evidence suggests that the combination of inadequate awareness among women and a reluctance to conduct breast screening and provide education to health care providers has attributed to the absence of screening programs. Breast education and screening programs need to be embedded in KSA. Empirical studies are required to rigorously assess women and HCPs knowledge and awareness towards BC in order to help inform policy and breast cancer education and screening programs. The findings are likely to resonate with countries in the Eastern world where breast education and screening services are under developed.