Most participants (88.6%) were familiar with breast cancer (BCa), as shown in Fig. 1. Among the 472 women who had heard of BC, 72.2% were aware of the symptoms. Of those who had ever heard of BCa (61.9%; n = 292), 32.2% were knowledgeable about breast self –examination (BSE), and 90.4% performed it. 30.1% (n = 88) had heard of CBE, and 28.4% (n = 25) had undergone it. Furthermore, 10.6% (n = 31) had heard of mammography, but only 7 women (22.6%) had a mammogram. Women residing in rural areas were significantly associated with lower awareness of BCa (OR, 0.207; 95% CI 0.084–0.331), as were those with only primary (OR, 0.418; 95%CI 0.011–0.825) or no education (OR, 0.315; 95%CI 0.152–0.478). Additionally, women aged 32–47 years (OR, 0.108; 95%CI 0.029–0.187) and 48–63 years (OR, 0.306; 95%CI 0.060–0.552) were less likely to be aware of BCa compared to women aged 18–31 years. Overweight or obese women were associated with more awareness of BCa (OR, 1.471; 95%CI 0.664–3.260) and (OR, 1.766; 95%CI 0.527–5.917) than those women with an average body mass index (BMI). However, women with one child, two or three children or more were associated with less awareness of BCa (OR, 0.478; 95%CI 0.176–0.780), (OR, 0.257; 95%CI 0.042–0.471), and (OR, 0.146; 95%CI 0.074–0.217), respectively, compared to women with no children. Single women (OR, 0.301; 95%CI 0.176–0.425) were also less likely to be aware of BCa than married women. Women with a monthly income of less than 50,000 R.Y and 50,000–100,000 R.Y (OR, 0.236; 95%CI 0.156–0.315) and (OR, 0.148; 95%CI 0.066–0.230) were less aware compared to women with a monthly income of more than 100,000 RY. Employed women (OR, 0.183; 95%CI 0.033–0.333) were associated with less BCa awareness than housewives. Furthermore, women with no history of breast cancer (OR, 997; 95%CI 0.892–1.102) or breast cancer in their family (OR, 0.807; 95%CI 0.585–1.028) were associated with less awareness of BCa. Similarly, women with no previous history of chronic diseases (OR, 0.895; 95%CI 0.648–1.142) or who did not smoke cigarettes or shisha (OR, 0.865; 95%CI 0.620–1.110) were associated with less awareness of BCa compared to those who had a history of chronic disease or smoked cigarettes or shisha. (Table 2).

Fig. 1

Illustrates the knowledge and practices of breast cancer and breast cancer screening among the study population

Table 2 Relationship between sociodemographic characteristic and awareness of breast cancer (n = 472)4.1 Barriers affecting breast cancer screening

The reasons given by women who were aware of CBE or mammography for not getting screened included the absence of symptoms or pain (84.2%), insufficient knowledge about breast cancer and its treatment options (62.0%), and not knowing screening was needed (54.1%). Among the barriers that hinder Yemeni women from breast screening werefamily did not allow them to go for screening and the absence of specialty centers, both of which were reported with the least frequency at6.5% and 7.9% respectively (Table 3).

Table 3 Respondents’ Awareness about barriers to breast screening (n = 292)4.2 Various factors were found to be associated with clinical breast examination (CBE) among women

Through multivariable analysis. The findings revealed several trends. Firstly, women with no education were less likely to undergo CBE (OR, 0.419; 95%CI 0.164–1.836; p = 0.020). Additionally, women aged 32–47 years (OR, 0.339; 95%CI 0.115–0.563; p = 0.004) and 48–63 years (OR, 0.667; 95%CI 0.057–1.276; p = 0.032) were less likely to undergo CBE compared to women aged 18–31 years. Furthermore, women with two children (OR, 0.551; 95%CI 0.030–1.072; p = 0.039) were less likely to undergo CBE than women without children. Single women (OR, 0.095; 95%CI 0.067–0.504; p = 0.000) were also less likely to undergo CBE compared to married women. Additionally, women with a monthly income less than 50,000 R.Y and 50,000–100,000 R.Y (OR, 0.422; 95%CI 0.050–0.793; p = 0.027) and (OR, 0.917; 95%CI 0.172–1.662; p = 0.017) respectively were less likely to undergo CBE compared to women with a monthly income more than 100,000 RY. Moreover, women residing in rural areas (OR, 0.207; 95%CI 0.084–0.331; p = 0.001) were less likely to undergo CBE compared to women living in urban areas. Women with no history of breast cancer (OR, 0.312; 95%CI 0.076–0.549; p = 0.010) were less likely to undergo CBE compared to women with a history of breast cancer. Similarly, women with no history of breast cancer in their family (OR, 0.730; 95%CI 0.123–1.338; p = 0.010) were less likely to undergo CBE compared to women with a history of breast cancer in their family. Additionally, women with no history of chronic disease (OR, 0.857; 95%CI 0.003–1.711; p = 0.049) were less likely to undergo CBE than women with a chronic disease history. Lastly, women who did not smoke cigarettes or shisha (OR, 0.340; 95%CI 0.060–0.620; p = 0.018) were less likely to undergo CBE compared to women who did smoke cigarettes or shisha. (Table 4).

Table 4 Various factors were found to be associated with clinical breast examination (CBE) among women (n = 88)4.3 An association between barriers to breast cancer screening and the absence of screening participation

Table 5 demonstrates that women who were not allowed by their families to undergo breast screening had higher odds of not receiving screening (OR = 4.726, 95% CI 2.884–7.744). Additionally, the same finding for, women who had religious reasons (OR = 4.041, 95% CI 2.483–6.577), women who believed there was no accompanying person available for screening (OR = 3.686, 95% CI 2.273–5.978), and women who thought there were no specialty centers for screening (OR = 3.367, 95% CI 2.083–5.442).

Table 5 An association was found between barriers to breast cancer screening and the absence of screening participation