Background: The aim of this study was to investigate the awareness of breast cancer risk factors among female university students in 24 low, middle income and emerging economy countries. A cross-sectional survey was conducted with 10,242 undergraduate university students (mean age 20.7, SD=2.9) from 25 universities in 24 countries across Asia, Africa and the Americas. Using anonymous questionnaires the awareness of links between breast cancer and heredity, diet, overweight, exercise, alcohol use, smoking and stress was assessed. Results indicated that 35.4% of the women were not aware that any of these risk factors could influence breast cancer, 43.8% were aware of a genetic link, and only 12.5%, 10.9% and 10.6% correctly identified alcohol use, overweight and physical inactivity, respectively, as factors causing breast cancer. Moreover, 13.3% rated dietary fat and 11.5% fibre as influencing breast cancer; both low-fat and high-fibre diets may be weakly protective against breast cancer, and smoking (19.4%) and stress (13.5%), the most commonly chosen breast cancer lifestyle risk factors, have less clear impact on breast cancer. There were marked country differences, e.g., in regards of being aware of genetic causes of breast cancer risk in female students from Ivory Coast, India, Madagascar, Nigeria and Laos below 30% and female students from Pakistan, Singapore, Turkey, Grenada and Philippines 60 or more percent. This study provides insight in the breast cancer risk perception of young women, which can be utilized in breast cancer awareness and prevention programmes.
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