AWACAN Previous Work

The AWACAN-ED Global Research Group follows on from our previous African Women Awareness of CANcer (AWACAN) project that involved developing a valid and reliable tool to measure breast and cervical cancer awareness among women in Sub-Saharan Africa.

In Sub-Saharan Africa:

Read more about the challenge of timely cancer diagnosis in Africa.

The AWACAN research team developed and validated culturally relevant cancer awareness measurement tools to contribute to the development and evaluation of interventions to promote timely diagnosis of cancer in Sub-Saharan Africa, following data collection in SA and Uganda.

The AWACAN tool

Development of the AWACAN breast and cervical cancer tool followed a four-step process of:

  1. Generating tool items by reviewing the UK Breast Cancer Awareness Measurement (BCAM) and Cervical Cancer Awareness Measurement (CCAM) tools, the Awareness and Beliefs about Cancer (ABC) tool, and studies conducted in Sub-Saharan Africa that used these or other relevant tools.
  2. Refining items by assessing content and face validity.
  3. Validating the English version of the AWACAN tool and,
  4. Developing isiXhosa (for SA) and Acholi (for Uganda) language versions of the tool

Click the links below for further information on:

Using the AWACAN tool

Collecting data

The AWACAN tool is a 123-item questionnaire that measures women’s awareness of breast and cervical cancer across. The tool measures awareness in the following domains: risk factors, symptoms, lay beliefs, confidence in appraisal, help-seeking behaviours, and barriers to health care. The tool also has socio-demographic questions.

The AWACAN tool takes 25 minutes to administer and was designed to be delivered face-to-face by a trained interviewer. We developed the tool to address both breast and cervical cancer in one study, however the tool can also be used to collect information on either cancer alone.

The tool is available in EnglishIsiXhosa and Acholi.

Locally developed breast images depicting symptoms of: a change in position of nipplenipple retraction and, orange peel appearance of skin are available for use with the tool (images by Donovan Ward as commissioned by Dr Lydia Cairncross, Groote Schuur Hospital Breast Clinic, Cape Town).

Tool domains

The AWACAN tool domains include:


This document provides guidance on scoring items.


When you come to use the AWACAN tool, please cite:

“Moodley J, Scott SE, Mwaka AD, Constant D, Githaiga JN, Stewart TS, Payne A, Cairncross L, Somdyala NIM, Walter FM.Development and validation of the African Women Awareness of CANcer (AWACAN) tool for breast and cervical cancer. PLOSOne. 2019”

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