Breast cancer is the most frequently diagnosed cancer in women globally, and it remains the leading cause of cancer mortality in high-income countries [1] . In 2020, GLOBOCAN reported 2.3 million new cases and over 685,000 deaths worldwide [2] . In Cameroon, breast cancer is also the primary cause of cancer mortality among women, with 4170 new cases and 2108 deaths recorded in 2020, closely followed by cervical cancer [3] . These alarming statistics underscore the urgency of adopting effective control strategies, with early detection being the foremost priority [4] [5] .

Breast cancer is defined as a malignant tumor of the breast, specifically an uncontrolled proliferation of ductal and lobular cells in the breast that have acquired the ability to invade neighboring and distant organs [6] . Early diagnosis of breast cancer is a major prognostic factor, significantly improving survival rates [7] . In developed countries, organized screening programs based on mammography have reduced breast cancer mortality by 25% to 30% [8] . However, in low-income countries, these programs are often non-existent or underdeveloped.

In this context, healthcare staff play a crucial role. As the first line of contact with patients, healthcare professionals are ideally positioned to educate, raise awareness, and guide women toward appropriate screening methods [9] . Their own level of knowledge, attitudes, and screening practices are key indicators of the quality of care and advice they can offer [10] . Studies conducted in other sub-Saharan African countries have revealed gaps in the KAP of healthcare professionals, which can hinder large-scale screening efforts [11] [12] .

In Cameroon, the scientific literature on the knowledge, attitudes, and practices of healthcare professionals regarding breast cancer screening is limited. Understanding these factors is essential for designing targeted continuing education programs and more effective public health policies. It is within this context that we conducted this study at the Yaoundé Central Hospital (YCH), a reference hospital, with the aim of evaluating the KAP of healthcare staff concerning breast cancer screening.

A prospective, descriptive cross-sectional study was conducted from September to October 2023 in various departments of the Yaoundé Central Hospital (YCH). The study population consisted of all medical and paramedical staff at the YCH.

Our study reveals that healthcare professionals at the Yaoundé Central Hospital have a good level of theoretical knowledge about breast cancer and its screening methods. This result is consistent with other studies conducted in hospital settings in Africa, such as in Nigeria and Burkina Faso [10] [11] . The high exposure to information through continuing education and media undoubtedly contributes to this high level of knowledge [13] .

However, a significant gap was observed between this knowledge and actual attitudes and practices. First, despite recognizing the effectiveness of screening, a small proportion of professionals (11.5%) systematically integrates screening into their clinical practice. This lack of proactivity aligns with the conclusions of Sawadogo et al. in Burkina Faso [14] and could be linked to the absence of a national organized screening program in Cameroon. The National Cancer Control Program is the national body responsible for planning and coordinating cancer control in a country. It oversees the development of a strategic plan to eliminate the disease, as well as an operational plan to implement this control. It organizes the development of guidelines and standards for screening and treatment of the disease, and also ensures the implementation of an organized program for screening and treatment of the disease. In Cameroon, this organized screening program is not yet operational, and screening is carried out sporadically as part of health campaigns on major cancer awareness days.

Furthermore, knowledge about the frequency of screening methods is flawed. The recommendation for daily BSE and annual mammography, made by a portion of the staff, is an unadvised practice. Breast self-examination is recommended monthly, and biennial mammography is the standard for mass screening in most countries. An excessive frequency of mammography can lead to unnecessary radiation exposure and generate additional costs for patients. These incorrect attitudes indicate a need for continuing education and retraining for healthcare professionals [15] .

Moreover, the personal screening practice rate among female healthcare professionals is low (48.7%). This is alarming and reflects a trend observed in other African studies [16] [17] . Literature shows that even with privileged access to information and care, many factors can explain this low adherence, including fear of diagnosis, the cost of examinations, lack of time, or stigmatization. Breast self-examination, although widely practiced, is not sufficient and does not replace a screening mammogram for at-risk women [18] . The low rate of mammography use for screening (31.6%) is explained by the same barriers as those reported in the general population: high cost, lack of equipment, and lack of national screening programs [19] .

The discrepancy between knowing the importance of screening and having low personal practice highlights the existence of significant psychological and structural barriers, even for individuals who are supposed to be the best informed. It is therefore crucial to establish breast cancer screening programs for healthcare professionals themselves.

The main limitation of this study is its single-center nature and the small number of participants, which limits the generalizability of the results. Additionally, the data are self-reported, which may lead to social desirability bias (participants might overestimate their knowledge and practices).

Healthcare professionals at the Yaoundé Central Hospital possess a good level of theoretical knowledge about breast cancer. However, significant gaps persist in their attitudes and screening practices, particularly concerning the frequency of examinations and their own use of mammography. It is imperative to integrate targeted and regular training sessions on the definition of breast cancer, importance of screening, correct screening frequencies, and strategies to improve patient communication for healthcare professionals. By improving their own practices, they will be better equipped to play their crucial role in raising awareness and guiding the population, which is essential to reduce breast cancer mortality in Cameroon.