Clinical Breast Examination Uptake among Reproductive Aged Women in Zambia: Evidence from the 2024 Zambia Demographic and Health Survey

Introduction Breast cancer remains a major cause of mortality among women in sub-Saharan Africa driven, in part, by low screening coverage. We assessed the prevalence and determinants of clinical breast examination (CBE) uptake among reproductive-aged women in Zambia. Methods This cross-sectional study utilized data from 13,876 women aged 15–49 years who participated in the 2024 Zambia Demographic and Health Survey (ZDHS). The outcome variable was derived from participants’ response to ‘ever having had a breast examination by a health care provider.’ Descriptive statistics and survey-weighted logistic regression analyses were conducted in Stata, with all estimates adjusted to account for the complex survey design used in the ZDHS. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were reported. Results Overall, 13.3% (n = 1,845) of women reported ever receiving CBE. Among those screened, the majority were aged 30–39 years (35.4%), resided in urban areas (56.5%), had secondary level education (42.7%) and belonged to the richest wealth quintile (30.5%). Furthermore, only 17.8% of screened women had health insurance, and two-thirds (66.2%) had previously undergone cervical cancer screening. Higher education (AOR = 1.58; 95% CI: 1.08–2.32) and health insurance coverage (AOR = 1.30; 95% CI: 1.04–1.62) were positively associated with CBE uptake. Women who had visited a health facility in the previous 12 months (AOR = 1.38; 95% CI: 1.18–1.61) and those ever screened for cervical cancer (AOR = 5.95; 95% CI: 5.18–6.84) had significantly greater odds of receiving CBE, while women living with HIV were less likely to be screened (AOR = 0.82; 95% CI: 0.69–0.98). Regional variation was observed with women in Central (AOR = 1.43; 95% CI: 1.10–1.88), Copperbelt (AOR = 1.42; 95% CI: 1.12–1.78), Luapula (AOR = 1.94; 95% CI: 1.39–2.72), and Northwestern (AOR = 1.33; 95% CI: 1.01–1.77) provinces having higher odds of CBE compared with those in Lusaka, while women in Eastern Province were less likely to receive CBE (AOR = 0.68; 95% CI: 0.49–0.95). Conclusion There is low utilization of CBE services among women aged 15–49 years in Zambia. Strategies which expand access and utilization of breast cancer screening services are warranted.