Association between cancer screening perception and breast cancer fear among nurses and its implications for screening counselling: a cross-sectional structural equation modelling study

Background Nurses play a central role in cancer prevention by providing screening education and counseling to patients. However, nurses' cognitive perceptions and emotional responses to cancer may influence how screening information is conveyed in clinical practice. Although cancer screening behaviors have been widely studied, it is not well understood whether nurses' perceptions of screening are related to cancer-related fears and how this may be reflected in the counseling process. This study aimed to examine the relationship between nurses' perceptions of cancer screening and breast cancer fear. Methods This cross-sectional study was conducted with 307 nurses working at a tertiary hospital in central Turkey between February and April 2025. Data were collected using a demographic information form, the Cancer Screening Perception Scale, and the Breast Cancer Fear Scale. Descriptive statistics, Pearson correlation analysis, confirmatory factor analysis, and structural equation modeling (SEM) were applied. SEM was used to evaluate the relationship between latent variables, taking measurement error into account. The study was reported according to the STROBE guidelines and obtained ethical committee approval. Findings Nurses' perception of cancer screening was high (94.08 ± 11.44) and breast cancer fear was moderate to high (29.85 ± 5.48). A positive and statistically significant relationship was found between screening perception and fear of breast cancer (r = 0.19, p = 0.001). Structural equation modeling showed that cancer screening perception significantly predicted breast cancer fear (β = 0.433, p < 0.01) and the model explained 18.7% of the variance in fear. The magnitude of the standardized effect indicates that the relationship is not only statistically but also clinically significant. Conclusion Increased awareness of cancer screening among nurses was found to be associated with increased fear of breast cancer. Unaddressed cancer-related fear may affect the clarity, trustworthiness, and effectiveness of screening counseling offered to patients. These findings suggest that cancer screening education in nursing should focus not only on knowledge and guidelines but also on emotional preparedness. Integrating communication skills and emotional coping training into nursing education and in-service programs may enhance counseling quality and support participation in preventive screenings.