Vol.:(0123456789) 1 3 Journal of Public Health https://doi.org/10.1007/s10389-021-01688-7 REVIEW ARTICLE Knowledge, awareness, attitudes and screening practices towards breast and cervical cancer among women in Nepal: a scoping review Candice Rademaker 1  · Shital Bhandary 2  · Helena Harder 3 Received: 9 September 2021 / Accepted: 30 November 2021 © The Author(s) 2021 Abstract Aim Breast and cervical cancers have emerged as major global health challenges and disproportionately afect women in low- and middle-income countries, including Nepal. This scoping review aimed to map the knowledge, attitudes and screen- ing practices for these cancers among Nepali women to improve cancer outcomes and reduce inequality. Methods Five electronic databases (CINAHL, Embase, Global Health, PsycINFO and PubMed), grey literature, and refer- ence and citation lists were searched for articles published in English up to June 2021. Articles were screened against inclu- sion/exclusion criteria, and data from eligible studies were extracted. Results were summarised narratively. Results The search yielded 615 articles, 38 of which were included in this scoping review (27 cervical cancer, 10 breast cancer, 1 both cancers). Levels of knowledge regarding breast and cervical varied widely. The main knowledge gaps were misconceptions about symptoms and risk factors, and poor understanding of screening behaviours. Screening practices were mostly inadequate due to socio-cultural, geographical or fnancial barriers. Positive attitudes towards cervical screening were associated with higher education and increased knowledge of screening modalities. Higher levels of knowledge, (health) literacy and participation in awareness campaigns facilitated breast cancer screening. Conclusion Knowledge and screening practices for breast and cervical cancer among Nepali women were poor and highlight the need for awareness and education programmes. Future research should explore community health worker-led awareness and screening interventions for cervical cancer, and programmes to increase the practice of breast self-examination and clinical breast examinations to support early diagnosis of breast cancer. Keywords Breast cancer · Cervical cancer · Knowledge · Attitudes · Screening practices · Nepal Introduction Cancer is a growing global concern. According to the esti- mates published by GLOBOCAN, there were 19 million new cancer cases and almost 10 million cancer deaths worldwide in 2020 (Sung et al. 2021). The number of new cases is projected to rise by 47% to over 28 million in 2040, with the greatest increases expected in low- and middle-income countries (LMICs) (Sung et al. 2021). This is attributed to population growth and increased exposure to risk factors such as smoking, dietary changes and physical inactivity. It is in keeping with the epidemiological transition which causes a shift in the disease burden from predominantly infectious diseases to non-communicable diseases (NCDs), including cancer (Rai 2018; Remais et al. 2013; Sung et al. 2021). Women in LMICs are disproportionately afected by cancer, and have a higher disease burden due to vulner- abilities related to gender inequality, poverty and environ- mental factors (Ginsburg et al. 2017). Breast cancer (BC) is the most commonly diagnosed cancer and cervical cancer (CC) the fourth most common cancer in women worldwide (Sung et al. 2021). Both cancers have emerged as two major health challenges for women in LMICs, as mortality rates * Helena Harder h.harder@sussex.ac.uk 1 Brighton and Sussex Medical School, University of Sussex, Brighton, UK 2 School of Public Health, Patan Academy of Health Sciences, Patan, Kathmandu, Nepal 3 Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, UK