Perceived Breast Cancer Risk, Behavioral Intentions, and Personal Care Product Use Among Women in Embu and Nakuru Counties, Kenya: A Latent Class Analysis

Abstract

Breast cancer (BC) is the leading cancer among women, with rising incidence in sub-Saharan Africa. Personal care products (PCPs), including hair products, contain endocrine-disrupting chemicals and carcinogens implicated in BC risk, yet evidence is largely from Western populations. We examined perceived BC risk and its association with hair product use among women in Embu and Nakuru Counties, Kenya. A cross-sectional survey of 744 women aged 15–50 years conducted in May–July 2023 assessed perceived BC risk related to hair product use. Latent class analysis (LCA) identified risk profiles, and multivariable logistic regression examined associations between risk class and PCP use in the prior 7–14 days. LCA identified three risk classes: no/low (11.0%), high (42.7%), and very high (46.2%). Classes differed in concern, behavioral intentions, and information-seeking about hair product ingredients, with the very high-risk class reporting the greatest concern and intention to change practices. However, perceived risk was not associated with lower hair product use after correction for multiple comparisons. Perceived BC risk was associated with greater concern and intention to change hair product practices, but not lower product use. Culturally responsive interventions are needed to translate risk awareness into behavior change and safer PCP use.