Perspectives on Preventive Health Care and Barriers to Breast Cancer Screening Among Iraqi Women Refugees

Since the Iraq war began in 2003, over 4 million Iraqis have been displaced. Little is known about preventive cancer care in this population, but stark disparities have been documented. The purpose of this study was to assess the perspectives of Iraqi women refugees on preventive care and perceived barriers to breast cancer screening. Interviews were conducted in Arabic with twenty Iraqi refugee women by a bilingual (English/Arabic) medical student, transcribed, translated and coded according to established qualitative content and thematic analysis procedures. Psychosocial barriers, culturally mediated beliefs, and health consequences of war were identified as major themes, ultimately showing what factors, alone and collectively, have impeded Iraqi refugee women's ability and motivation to obtain breast cancer screening. To improve cancer prevention and decrease disparities in care in this most vulnerable population, culturally appropriate health education and outreach programs, as well as further community-level targeted studies, are needed.     

Breaking the Silence: Breast Cancer Knowledge and Beliefs Among Somali Muslim Women in Seattle,Washington

We elicited the perspectives of Somali women in Seattle, Washington, about breast cancer. We conducted a focus group of 14 Somali immigrant women at a community center in Seattle, Washington. Participants reported barriers to seeking cancer screening, including fear of pain, difficulty with transport, and lack of knowledge. Participants explained that Somali women tended not to discuss breast cancer or breast cancer screening, and said religion played a central role in their care and treatment decisions and coping mechanisms. If such barriers are addressed, fewer women may present with late-stage breast cancer, resulting in greater chances for long-term breast cancer survival.     

Knowledge and Beliefs About Health Promotion and Preventive Health Care Among Somali Women in the United States

We explored conceptualizations of health promotion and experiences with preventive health services among African refugee women. We asked 34 resettled Somali refugee women about their beliefs and experiences regarding health promotion and common preventive health care services in the United States. Interviews were audiotaped, transcribed, and analyzed using a grounded theory approach. Key themes were the importance of good hygiene, an adequate source of food and water, access to a regular source of health care, spirituality, traditional practices, and functioning well at home. All participants were familiar with the process and rationale for immunizations and routine medical examinations; few understood cancer screening services.     

Implications of Preventive Health Behaviour for Cervical and Breast Cancer Screening Programmes: A Review

The success of screening programmes for breast and cervicalcancer partly depends on women's acceptance and take-up of theservice. Uptake of preventive health care programmes appearsto be related to people's underlying motivations and attitudes,not only towards the disease in question, but towards healthand illness generally. The perceived costs to the individualof embarking on particular courses of action also have to betaken into consideration. These attitudes and motivations varybetween social groups. Unless the reasons for non-participationin preventive health care and screening programmes is understood,programmes will be misdirected and inappropriately designed.However, the failure of any one theory to account for most ofthe variance in health behaviour between social groups emphasizesthe importance of health education and provision of informationabout health and prevention on a personal basis. General practitionersand practice based nurses are in a good position to be ableto elicit the fears, prejudices and priorities of patients inthis area, and thus provide more effective health educationand information about preventive and screening services.     

Asian-Islamic Women and Breast Cancer Screening: A Socio-Cultural Analysis

ABSTRACT

This article explores religious and socio-cultural issues relevant to breast cancer screening practices among older immigrant Asian-Islamic women in the U.S. Some of the Islamic tenets that facilitate breast cancer screening include cleanliness, prevention and individual responsibility in health promotion, diet and eating habits, and exercise, and those that hinder screening practice include gender and modesty considerations and patriarchal marital beliefs. Socio-cultural barriers include patient-physician communication and beliefs about cancer and cancer prevention. Recommendations to increase knowledge and practice of breast cancer screening within a religious and socio-cultural context are provided.     

Influence of Health Care, Cost, and Culture on Breast Cancer Screening: Issues Facing Urban American Indian Women

Background. Breast cancer is the second leading cause of cancer death among American Indian women. Southwestern American Indian women are more likely to have distant spread of the disease, and 5-year survival from breast cancer is poor in comparison to U.S. whites. Mortality from breast cancer could be reduced by more than 30% in American Indian women if current recommendations for screening were followed.Methods. A random household cross-sectional survey was conducted among 519 adult American Indian women in Phoenix, Arizona. Logistic regression was used to identify predictors of recent clinical breast examination and mammogram among those women aged 40 years and older.Results. Just more than half (53.0%) of the women surveyed reported they had received a clinical breast examination in the last year, and 35.7% indicated they had received a mammogram in the last 2 years. Access to care, knowledge of the examinations, and health beliefs were positively associated with breast cancer screening in the multivariate analyses.Conclusions. The cancer screening rates observed in urban American Indian women are far below current national estimates and Healthy People 2000 Objectives. This study confirms the limited access of urban Indians to preventive health services, and supports a role for cancer education in improving screening participation in this special population.     

Health Literacy and Medication Adherence in Underserved African-American Breast Cancer Survivors: A Qualitative Study

The increased survival rate of breast cancer has brought attention to women who are beyond the diagnosis and treatment phases of breast cancer. Although research has been conducted to address specific medical and psychosocial needs of breast cancer survivors, there has been little attention placed on health literacy and medication adherence among this population. The purpose of this article is to present the findings of a qualitative study conducted with two focus groups of underserved African-American breast cancer survivors. Four themes emerged from the transcribed interviews: inequality of access to health information, acquisition of medication information, medication usage and adherence, and barriers to access to medications.     

Knowledge and Attitudes of Cervical Cancer Screening Among Caribbean Women: A Qualitative Interview Study From Barbados

The purpose of this study was to explore Barbadian women’s attitudes toward and knowledge of routine cervical cancer screening (Pap tests). We conducted semi-structured individual interviews with fourteen female patients between the ages of 20 and 60 years who attended a selected public clinic in Barbados in May and June 2013. Interviews were audio-recorded with participants’ consent. The interviews were then transcribed verbatim and, using thematic content analysis, indexed and coded inductively for emerging similar themes. We identified four themes: (1) women had poor knowledge of the purpose of Pap tests. The most frequently occurring misconception was that the test was for the detection of sexually transmitted infections. (2) The women displayed limited cervical cancer awareness. (3) Health professionals were identified by the women as the main driving force behind women taking up screening. (4) The screening procedure was perceived as painful, but women’s overriding attitude was that screening was necessary. These findings suggest that Barbadian women would benefit from focused health education efforts surrounding cervical cancer screening to eradicate the misconception that the purpose of the Pap test is the detection of sexually transmitted diseases.     

Comparison of Breast Cancer Screening Results in Korean Middle-Aged Women: A Hospital-based Prospective Cohort Study

ObjectivesThe aim of this hospital-based prospective study was to evaluate the diagnostic ability of breast cancer screening in Korean middle-aged women using age, ultrasonography, mammography, and magnification mammography, which are commonly used in most hospitals.MethodsA total of 21 patents were examined using ultrasonography, mammography, and magnification mammography, and their data were prospectively analyzed from August 2011 to March 2013. All patients were divided into benign and malignant groups and the screening results were classified using the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS). The final pathology report was used as the reference standard and the sensitivity and specificity of ultrasonography, mammography, and magnification mammography were evaluated using receiver-operating characteristics (ROC) analysis.ResultsThe analysis included 21 patients who underwent biopsy. Among them, three (14.3%) were positive and 18 (85.7%) negative for breast cancer. The average age was 50.5 years (range = 38–61 years). The sensitivity was the same for ultrasonography and magnification mammography and the specificity of magnification mammography was higher than that of ultrasonography. The highest area under the ROC curve (AUC) was observed in the combination of age and magnification mammography (1.000) and the decreasing order of AUC in others was magnification mammography (0.833), ultrasonography (0.787), mammography (0.667), and age (0.648).ConclusionsIn Korean women, the diagnostic accuracy of magnification mammography was better than that of ultrasonography and mammography. The combination of age and magnification mammography increased the sensitivity and diagnostic accuracy.     

Screening Mammography and Late-Stage Breast Cancer: A Population-Based Study

BACKGROUND: Among 50- to 69-year-old women, randomized clinical trials show breast cancer mortality reductions from screening mammography. However, few studies examine the long-term health effects and outcomes from screening mammography in community practice. The purpose of this study was to evaluate one approach for determining the effectiveness of screening mammography, as it is practiced in community settings, and to measure the prevalence of prior screening mammography among women with incident breast cancer. METHODS: This study was a population-based survey of the general community. Participants were 406 women with breast cancer diagnosed in 1993. The main outcome measure was breast cancer, late stage at diagnosis or fatal within 2 to 3 years of diagnosis. RESULTS: Sixty-four (57.7%) of 111 women with late-stage and 123 (42.1%) of 292 women with early-stage breast cancer did not have a screening mammogram in the 4 calendar years (1989-1992) before diagnosis. Relative to women with early-stage breast cancer, mammography nonuse in 1989-1992 was significantly more frequent among women with late-stage breast cancer (age-adjusted odds ratio 2.3, 95% confidence interval 1.3-4.3). Prior mammography was particularly infrequent among 42 women with breast cancer incident in 1993 and fatal before January 1996. CONCLUSIONS: Prior mammography among women with late-stage or fatal breast cancer was relatively infrequent. Late-stage or fatal breast cancer lacking prior mammography constitutes a missed public health opportunity. Also, this population-based study showed the expected association between prior mammography and late-stage or fatal breast cancer. These results are consistent with the effective practice of mammography in a community setting. The results illustrate and validate a public health approach that uses prior mammography histories among women with incident breast cancer to evaluate mammography penetration and quality in defined communities.     

Determination of Changes in the Sexual Lives of Young Women Receiving Breast Cancer Treatment: A Qualitative Study

This qualitative study was performed to identify changes in the sexual lives of young women receiving breast cancer treatment. The study was conducted with eight exclusively self-defined heterosexual married women whose breast cancer treatments were ongoing in the ambulatory chemotherapy unit. The data were collected through semi-structured and in-depth individual interviews. All interviews were tape-recorded. The raw results were obtained by analyzing the content of the recorded data. In this study, the subject of the interviews was penile-vaginal intercourse, as the participants perceived sexuality as equivalent to penile-vaginal intercourse. The changes in the sexual lives of young women receiving breast cancer treatment were analyzed according to three themes as follows: (1) intermittent penile-vaginal intercourse, (2) sexual activity initiated by the male and (3) sexual dysfunction. This study assists health professionals in recognizing changes in young women’s sexual lives. Thus, healthcare professionals can provide couples with appropriate counseling to promote healthier sexuality and maintain a higher quality of life.     

The Impact of Family History of Breast Cancer on Women's Health Beliefs,Salience of Breast Cancer Family History,and Degree of Involvement in Breast Cancer Issues

ABSTRACT

Prior investigations have employed the Health Belief Model (HBM) to predict health care utilization and cancer screening behaviors. The HBM is expanded in the current investigation to include issue involvement with breast cancer and salience of breast cancer family history. Differences in the constructs of this expanded HBM, as they relate to mammography screening, between women with positive and negative family histories of breast cancer were assessed in 378 women. Perceived benefits and barriers were found to be similar for women with positive and negative family histories of breast cancer. However, susceptibility, cues to action, salience of family history, and issue involvement were found to be more relevant for women with a positive family history of breast cancer. These findings have implications for interventions directed at increasing compliance with recommendations for breast cancer screening.     

Osteoporosis Knowledge,Health Beliefs,and Preventive Behavior: A Comparison Between Younger and Older Women Living in a Rural Area

Osteoporosis is widely recognized as one of the major health problems in postmenopausal and older women. Raising awareness about osteoporosis is an important step in examining how much people know about the disease and their attitudes toward preventive behaviors. The aims of the present study were to examine the differences in osteoporosis knowledge, health beliefs, and preventive behaviors between younger and older Thai women, and to examine the relationship between their osteoporosis knowledge, health beliefs, and preventative behaviors. An understanding of these variables measured in younger and older women is essential for the development and delivery of effective age-tailored intervention

programs.     

Faecal Microbiota Composition Varies between Patients with Breast Cancer and Healthy Women: A Comparative Case-Control Study

The intestinal microbiota plays an essential role in many diseases, such as obesity, irritable bowel disease (IBD), and cancer. This study aimed to characterize the faecal microbiota from early-stage breast cancer (BC) patients and healthy controls. Faeces from newly diagnosed breast cancer patients, mainly for an invasive carcinoma of no specific type (HR⁺ and HER2⁻), before any therapeutic treatment and healthy controls were collected for metabarcoding analyses. We show that the Shannon index, used as an index of diversity, was statistically lower in the BC group compared to that of controls. This work highlights a reduction of microbial diversity, a relative enrichment in Firmicutes, as well as a depletion in Bacteroidetes in patients diagnosed with early BC compared to those of healthy women. A tendency towards a decreased relative abundance of Odoribacter sp., Butyricimonas sp., and Coprococcus sp. was observed. This preliminary study suggests that breast cancer patients may differ from healthy subjects in their intestinal bacterial composition.     

Breast Cancer Screening in Rural Populations: A Pilot Study

This report describes the development and implementation of a pilot intervention project designed to determine the economic, logistic, behavioral, and attitudinal variables that influence rural women's participation in a community-based breast cancer screening program. This paper reports on survey responses of women who registered for this pilot breast cancer screening program. It includes information on all women who registered for the project--both those who received breast cancer screening and those who did not. The study is a pilot intervention project, the overall goal of which was to develop a network of community providers, organizations, and volunteers to facilitate breast cancer screening among rural women. Of the 159 women registered for this pilot program, 101 (63.5%) were screened (receiving both a clinical breast examination and mammogram). The attitudes of women surveyed through the project confirm the importance of a physician recommendation for breast cancer screening. More than 90 percent of both the screened and unscreened groups of women stated that a doctor's recommendation to have breast cancer screening is important. Further, nearly 42 percent of the unscreened group had never had a physician recommend breast cancer screening. Despite existing barriers to screening, this pilot study demonstrated that health care professionals and regional organizations that have not traditionally been associated with delivering health care in this particular community setting can successfully work together to implement breast cancer screening programs.     

Knowledge,Attitudes and Practices of Breast Cancer Screening Among Women in Jordan

Enhancing breast cancer screening in developing countries is pivotal in improving women's health. We aimed at describing knowledge of and perceived reasons for performing breast cancer screening. We interviewed 1,549 population-based randomly selected women. We found that women share limited knowledge about breast cancer screening. Few women performed screening for early detection purposes. The influence of physicians was the main reason for performing mammography. Prevalence of breast cancer screening might be enhanced by integrating screening into other medical services. Health agencies need to invite women for screening and educate them regarding the importance of screening in the absence of symptoms.