Date Published: February 21, 2017
Publisher: AIMS Press
Author(s): Karent Zorogastua, Pathu Sriphanlop, Alyssa Reich, Sarah Aly, Aminata Cisse, Lina Jandorf.
Health disparities related to breast and cervical cancer among African American and African-born Muslim women in the United States have been identified in previous literature. Our study aimed at exploring the breast and cervical screening rates and factors that influence this population’s disposition to adhere to cancer screening exams.
Mixed methods were used to collect data with African American and African-born Muslim women in New York City. Data were collected from a total of 140 women; among them, 40 participated in four focus groups.
Focus groups revealed nine themes: healthcare practices; lack of knowledge/misconceptions; negative perceptions and fear; time; modesty; role of religion; role of men; role of community; stigma and shame. Among 130 women who reported their cancer screening status, 72.3% of those age 21 and over were adherent to cervical cancer screening; 20.0% never had a Pap test. Among women age 40 and over, 80.2% reported adherence to recommended mammogram; 12.8% never had one. Among women under age 40, 52.2% had their last clinical breast exam (CBE) less than three years ago. Among women age 40 and over, 75.0% were adherent to yearly CBE.
While rates of screenings were above the national average and higher than expected, specific barriers and facilitators related to religious and health beliefs and attitudes that influence the decision to adhere to screening were revealed. These factors should be further explored and addressed to inform future research and strategies for promoting regular breast and cervical cancer screenings.
Breast cancer is the most commonly diagnosed cancer among women in the United States (US), regardless of race or ethnicity . Early detection of breast cancer through clinical breast exams (CBE) and mammography is key to reducing morbidity and mortality. Increased mammography screening has contributed to the nearly 20% decline in breast cancer mortality in the past 20 years –. Nonetheless, higher rates of breast cancer incidence continue to persist for minority groups largely due to lower rates of breast cancer screening and delayed follow-up of abnormal screening results –.
Mixed methods were used due to the exploratory nature of this study. Qualitative and quantitative data were collected through focus groups and individual questionnaires with self-identified African American and African-born Muslim women in NYC. Focus groups and questionnaires aimed at eliciting screening knowledge and behaviors as well as barriers to breast and/or cervical cancer screening, particularly those related to their cultural and religious beliefs.
Adherence to breast cancer screening via mammography and cervical cancer screening were both higher among our sample compared to that of the national average. In addition, neither socio-cultural predictors to screening including marital status, country of origin, length of time in the US, English proficiency, level of religiosity, nor socio-economic predictors to screening including employment status, level of education, income, or health insurance status were found. However, focus groups not only revealed notable barriers to screening including lack of knowledge and the cultural issue of modesty but also the different levels of influence that family, friends, and community play among women in the African Muslim community on health behavior.