Factors Associated with Decisions to Attend Cervical Cancer Screening among Women Aged 30-60 Years in Chatapadung Contracting Medical Unit,Thailand

Background: This study aimed to identify factors associated with women’s decisions to attend cervical cancer screening and to explore those linked with intention to attend in the coming year and to continue regular screening. Materials and Methods: A community based case-control study was conducted among woman 30-60 years of age in catchment area of Chatapadung Contracting Medical Unit (CCMU), networking of Khon Kaen Center Hospital, Thailand. Self-administered questionnaires were used to collect data, and in-depth interviews were then performed to explore in greater detail. Results: There were 195 participants. Only one third (32.3 %) had been screened for cervical cancer within the past 5 years. Some 67.7% reported that they had not been screened becausethey had no abnormal symptoms, single marital status, and no children. Only 10.6% of those never had screening intent to be screened within the next 12 months. High family income (adjusted OR=2.16, 95%CI=1.13-4.14), good attitude towards a Pap test (OR=1.87, 95%CI=1.09-4.23), and having received a  recommendation from health care providers were important factors associated with decisions to attend cervical cancer screening (OR=1.73, 95%CI=1.01-4.63). From in-depth interviews, there were five reasons of their decisions to attend cervical cancer screening including yearly check-up, postpartum check-up, having abnormal symptom, encouragement by health care providers, and request from workplace. Conclusions: High family income, good attitude towards a Paptest, and receiving proper recommendation by health care providers, were important factors associated with decision to have cervical cancer screening among women 30-60 years old. Trying to enhance these factors and reduce barriers regarding screening, may increase the coverage rate for cervical cancer screening in Thailand.     

Awareness of cervical cancer and socio‐demographic variations among women in Libya: An exploratory study in Az‐Zawiya city

Cervical cancer is still a public health problem worldwide, and almost 80% of cervical cancer cases occur in developing countries. In Libya, cervical cancer ranks as the third most frequent cancer among women. This paper presents the results of a study conducted to assess women's awareness of the symptoms and risk factors of cervical cancer and to identify socio‐demographic variations in their level of awareness. A population‐based cross‐sectional survey was carried out in the city of Az‐Zawiya, Libya from 1 January 2014 to 31 August 2014. A total of 412 adult women of the reproductive age (18–50 years) were selected randomly from the population registry. A face‐to‐face interview was conducted, using a validated Arabic version of the Cervical Cancer Awareness Measure (CAM) questionnaire. More than 63% of respondents were unable to recall any warning signs and 66.7% were unable to recall any risk factors. Respondents scored considerably higher on recognition rather than on recall for both the warning signs and the risk factors of cervical cancer. Recall and recognition of cervical cancer symptoms and risk factors were higher in women who had a higher level of education and who earned a higher income. However, overall awareness of cervical cancer symptoms and risk factors among women in the city Az‐Zawiya in Libya was low. The findings underline the need to improve public awareness of cervical cancer and its prevention by using several health promotion strategies.     

Cervical Cancer Screening in Iranian Women: Healthcare Practitioner Perceptions and Views

Background: Although regular screening for cervical cancer with the Papanicolaou test is an important element for reducing the incidence and mortality of cervical cancer, the actual screening program in Iranian women is not sufficiently comprehensive at present. The purpose of this study was to explore healthcare provider perceptions of factors affecting cervical cancer screening in Iranian women. Methods: In this qualitative study performed from September 2015 to August 2016 in Hamadan, Iran, we conducted semi-structured in depth interviews with 14 healthcare providers selected purposefully. All interviews were recorded, transcribed and analyzed according to a conventional thematic analysis approach. MAXQDA10 software was employed for data analysis. Results: Four themes were extracted from data: "Inefficient management of cervical cancer screening process, Personal and professional characteristics of health care providers, Individual barriers and facilitators, Need for health system authorities to pay attention". Conclusion: Increased official attention to screening, and identifying challenges and providing strategies based on these challenges will help in achieving a successful screening program. It is necessary to attend to professional features of medical science students and increase the skills of interaction with clients in addition to academic training. Efforts should be made to increase trust in healthcare providers regarding the Pap test and receptiveness of society to this screening modality through informing the public, with encouragement through the media.     

Women's intentions to receive cervical cancer screening with primary human papillomavirus testing

We explored the potential impact of human papillomavirus (HPV) testing on women's intentions to be screened for cervical cancer in a cohort of Canadian women. Participants aged 25–65 years from an ongoing trial were sent a questionnaire to assess women's intentions to be screened for cervical cancer with HPV testing instead of Pap smears and to be screened every 4 years or after 25 years of age. We created scales for attitudes about HPV testing, perceived behavioral control, and direct and indirect subjective norms. Demographic data and scales that were significantly different (p < 0.1) between women who intended to be screened with HPV and those who did not intend were included in a stepwise logistic regression model. Of the 2,016 invitations emailed, 1,538 were received, and 981 completed surveys for a response rate of 63% (981/1,538). Eighty‐four percent of women (826/981) responded that they intended to attend for HPV‐based cervical cancer screening, which decreased to 54.2% when the screening interval was extended, and decreased further to 51.4% when screening start was delayed to age of 25. Predictors of intentions to undergo screening were attitudes (odds ratio [OR]: 1.22; 95% confidence interval [CI]: 1.15, 1.30), indirect subjective norms (OR: 1.02; 95% CI: 1.01, 1.03) and perceived behavioral control (OR: 1.16; 95% CI: 1.10; 1.22). Intentions to be screened for cervical cancer with HPV testing decreased substantially when the screening interval was extended and screening started at age of 25. Use of primary HPV testing may optimize the screening paradigm, but programs should ensure robust planning and education to mitigate any negative impact on screening attendance rates.     

Enhancement of the Cervical Cancer Screening Program in Malaysia: A Qualitative Study

Introduction: Cervical cancer has long been known as a preventable disease. Yet it still is a prime women’shealth issue globally. In Malaysia, the current cervical cancer screening program, introduced in the 1960s, hasbeen found to be unsuccessful in terms of Pap smear coverage. The aim of this study is to determine providersperceptives on the program and the feasibility of practicing an organized cervical screening program in Malaysia.Methods: 11 key informant interviews were conducted with policy makers and health care providers from theMinistry of Health in Malaysia from October 2009 to May 2010. Interviewees’ perceptions were explored oncurrent and organized cervical screening program based on their expertise and experience. Results: The resultshighlighted that the existing cervical screening program in Malaysia faced flaws at all levels that failed to reducecervical cancer morbidity and mortality. The identified weaknesses were poor acceptance by women, lack ofcommitment by health care providers, nature of the program, an improper follow-up system, limited resourcesand other competing needs. Complementarily, all interviewees perceived an organized cervical screening programas an alternative approach both feasible and acceptable by women and government to practice in Malaysia.Conclusion: Better screening coverage depends on an effective screening program that incorporates a behaviourbasedstrategy. A new program should be focused in the policy-making context to improve screening coverageand to effectively combat cervical cancer.     

Exploring Effective Contextual Factors for Regular Cervical Cancer Screening in Iranian Women: A Qualitative Study

Background: Adherence to regular screening programs for cervical cancer in Iranian women is not common.The aim of this study was to explore contextual factors influencing behavior and compliance with guidelines.Methods: This qualitative content analysis study was conducted in 2016-2017 in Hamadan city, Iran. Semi-structuredin-depth interviews were conducted with 31 participants who were selected purposefully on referring to health centers.Twenty-three were women with various experiences of cervical cancer screening and 8 were health care providers(4 midwives, 1 gynecologist, 1 general practitioner and 1 family health expert). Guba and Lincoln criteria were usedfor tustworthiness. MAXQDA10 software was employed for data analysis. Results: Four themes were extracted fromthe data: an opportunity maker system, opportunities to become acquainted, concerns for healthy living, and perceptionof cancer. Conclusion: The results showed sensitivity of health care providers and their appropriate performancein relation to regular screening behavior of women is very important. Women’s perception of cancer and its curabilityis another factor with a major effect on screening behavior. Opportunities for people to become acquainted with thePap smear in a variety of ways and concern for healthy living and the need to have a healthy life to ensure qualityof life were also found to be important.     

The transition from breast cancer 'patient' to 'survivor'

Background: While much is now known about breast cancer survivors' long‐term health, quality of life, and psychological state, relatively little is known about the period immediately following completion of treatment, when women transition out of the role of breast cancer ‘patient’ to life as ‘survivor’. Objective: To explore women's fears regarding risk of cancer recurrence, sense of loss of medical monitoring, and social support from health‐care providers and other patients, and the strategies they use to cope with these issues. Method: Focus group interviews were conducted with women who had completed adjuvant chemotherapy or radiation for new stage I or II breast cancer in the prior 12 months. Interviews were audio‐taped, transcribed, and analyzed using a constant comparative analysis approach. Results: Of 216 women identified as eligible, over half (155) were reached by telephone and invited to participate. Of those invited, 47 (30%) agreed. Findings suggest that while women acknowledge positive life changes as a result of the cancer experience, emotional and physical stresses are prevalent following the completion of treatment. Conclusion: The period of time when women who have been treated for breast cancer transition to life without treatment presents numerous emotional and physical challenges. By illuminating patients' experience during this transition period, this study provides insights into the development of interventions to support women after treatment. Copyright © 2008 John Wiley & Sons, Ltd.     

Cervical Cancer Prevention and High-Risk HPV Self-Sampling Awareness and Acceptability among Women Living with HIV: A Qualitative Investigation from the Patients’ and Providers’ Perspectives

Routine cervical cancer screening is important for women living with HIV (WLH) due to the greater incidence and persistence of high-risk HPV (HR-HPV) infection. HR-HPV self-sampling has been proposed to overcome barriers to in-office cervical cancer screening in underserved populations. However, little is known about baseline knowledge of HR-HPV and the acceptability of HR-HPV self-sampling among WLH. This paper describes WLH’s experiences and needs regarding cervical cancer screening, specifically HR-HPV self-sampling, and seeks to reconcile their experiences with the views of their providers. In total, 10 providers and 39 WLH participated in semi-structured interviews and group discussions, respectively. Knowledge of cervical cancer and HR-HPV was generally limited among WLH; when present, it was often due to personal experience of or proximity to someone affected by cervical cancer. Most WLH were not familiar with HR-HPV self-sampling but, despite some of the providers’ skepticism, expressed their willingness to participate in a mail-based HR-HPV self-sampling intervention and highlighted convenience, ease of use, and affordability as facilitators to the uptake of HR-HPV self-sampling. The experiences identified can be used to guide patient-centered communication aimed at improving cervical cancer knowledge and to inform interventions, such as HR-HPV self-sampling, designed to increase cervical cancer screening among under-screened WLH.     

Breast cancer screening in an era of personalized regimens: A conceptual model and National Cancer Institute initiative for risk‐based and preference‐based approaches at a population level

Breast cancer screening holds a prominent place in public health, health care delivery, policy, and women's health care decisions. Several factors are driving shifts in how population‐based breast cancer screening is approached, including advanced imaging technologies, health system performance measures, health care reform, concern for “overdiagnosis,” and improved understanding of risk. Maximizing benefits while minimizing the harms of screening requires moving from a “1‐size‐fits‐all” guideline paradigm to more personalized strategies. A refined conceptual model for breast cancer screening is needed to align women's risks and preferences with screening regimens. A conceptual model of personalized breast cancer screening is presented herein that emphasizes key domains and transitions throughout the screening process, as well as multilevel perspectives. The key domains of screening awareness, detection, diagnosis, and treatment and survivorship are conceptualized to function at the level of the patient, provider, facility, health care system, and population/policy arena. Personalized breast cancer screening can be assessed across these domains with both process and outcome measures. Identifying, evaluating, and monitoring process measures in screening is a focus of a National Cancer Institute initiative entitled PROSPR (Population‐based Research Optimizing Screening through Personalized Regimens), which will provide generalizable evidence for a risk‐based model of breast cancer screening, The model presented builds on prior breast cancer screening models and may serve to identify new measures to optimize benefits‐to‐harms tradeoffs in population‐based screening, which is a timely goal in the era of health care reform. Cancer 2014;120:2955–2964. © 2014 American Cancer Society.     

Human Papillomavirus and Cervical Cancer Knowledge,Perceptions, and Screening Behavior: A Cross-Sectional Community-Based Survey in Rural Philippines

Background: Cervical cancer is the second most common cancer among women in the Philippines. Cervical cancer screening is an effective method to reduce incidence. However, screening utilization is limited. This study aims to assess human papillomavirus (HPV) and cervical cancer knowledge, perceptions, and screening utilization, and to investigate factors influencing screening utilization among rural women in the Philippines. Methods: This cross-sectional community-based study was conducted among 338 rural women aged 20–50 years, with a child under 5 years old registered in one of four public rural health centers in Tacao Island, Masbate Province in October 2017. A questionnaire administered via face-to-face interviews elicited information about demographic characteristics, knowledge, perceived susceptibility and perceived severity of HPV and cervical cancer, and cervical cancer screening utilization. Results: Mean age of participants was 32.5 years. Only 13.9% of participants had ever had cervical cancer screening. Although most women had heard of cervical cancer screening, their knowledge about the cause, risk factors, and preventive measures of HPV and cervical cancer was limited. Older age and higher education status were significantly associated with screening utilization. However, knowledge and perceived susceptibility and severity showed no association. The main reason for having screening was due to a health professional’s request or recommendation, and the reasons for not having screening were cost, not having symptoms, and fear of pain or discomfort and/or embarrassment during the procedure.  Conclusions: Health education must increase knowledge about HPV and cervical cancer and screening among women, including the nature and progression of cervical cancer, benefits of screening, screening cost, and screening procedure. Health care providers have an important role in educating and motivating women to undergo screening.     

Barriers to Breast and Cervical Cancer Screening in Singapore a Mixed Methods Analysis

Background In order to increase breast and cervical cancer screening uptake in Singapore, women's perceived barriers to screening need to be identi ed and overcome. Using data from both focus groups and surveys, we aimed to assess perceived barriers and motivations for breast and cervical cancer screening. Materials and Methods We conducted 8 focus groups with 64 women, using thematic analysis to identify overarching themes related to women's attitudes towards screening. Based on recurring themes from focus groups, several hypotheses regarding potential barriers and motivations to screen were generated and tested through a national survey of 801 women aged 25-64. Results Focus group participants had misconceptions related to screening, believing that the procedures were painful. Cost was an issue, as well as ef cacy and fatalism. Conclusions By identifying barriers to and motivators for screening through a mixed-method design that has both nuance and external validity, this study offers valuable suggestions to policymakers to improve breast and cervical cancer screening uptake in Singapore.     

Dysplasia severity, but not experiences during colposcopy, predicts adherence to follow-up colposcopy

Objective: Patient adherence with treatment recommendations is an essential factor for the effectiveness of cervical cancer screening programs. Psychological factors may play a role in patient adherence to cervical cancer screening. The present study aimed to extend knowledge of women's adherence to follow‐up colposcopy, by examining possible predictive biopsychosocial variables measured at colposcopy and objective attendance rates from patients' medical files. Methods: Baseline data on psychosocial factors (e.g. demographic variables, state anxiety, and pain) were collected from 141 women prior to undergoing colposcopy for the first time (M age = 29.63, SD = 8.39). Experiences of colposcopy and adherence to follow‐up (within two years) were assessed subsequently. Results: There were no associations between adherence and demographic variables. Women with severe dysplasia were more likely to adhere to follow‐up colposcopy than women with other histology grades. Women who did not attend for follow‐up reported significantly greater state anxiety and pain unpleasantness following colposcopy than women who did attend. A multivariate logistic regression analysis revealed that the psychological experiences of colposcopy did not predict adherence status. However, dysplasia severity made a significant contribution to the model. The odds of adhering to colposcopy for patients with severe dysplasia were 3.57 times higher than for patients with normal histology, and 4.35 times higher than for patients with moderate dysplasia (p = 0.005). Conclusions: Colposcopy‐related experiences do not appear to be strong predictors of adherence, but women with dysplasia grades other than ‘severe’ should be targeted for follow‐up recommendations and advice. Copyright © 2010 John Wiley & Sons, Ltd.     

The experience of chemotherapy‐induced alopecia for Australian women with ovarian cancer

This article describes the experience of chemotherapy‐induced alopecia. Data resulted from an ongoing study, which sought to explore the experience of Australian women with a primary diagnosis of ovarian cancer. Phenomenological analysis of written accounts or interviews with 15 Australian women resulted in 13 of these 15 women giving priority to describing their experience of alopecia. The women described alopecia as the most distressing corporeal feature of the ovarian cancer experience. Factors which contributed to women's distress included: loss of sense of self and altered body image; reminder of their illness and potential for an early death; public statement about their private life, practical issues and re‐growth. No literature was located, worldwide, which specifically explores the experience of alopecia for women with ovarian cancer. This article presents the first in‐depth exploration of the experience of alopecia for Australian women with ovarian cancer. Insight gained from this study will inform understanding of the issues associated with alopecia for women with ovarian cancer and may facilitate the provision of optimal supportive care provided by health care professionals for female cancer patients with chemotherapy‐induced alopecia.     

Determinants of mammography screening participation among Turkish immigrant women in Germany – a qualitative study reflecting key informants' and women's perspectives

Mammography screening programmes aiming to reduce mortality from breast cancer are implemented in most European countries. Immigrant women are less likely to participate than women of the respective autochthonous populations in several European countries but not in Germany. Qualitative, semi‐structured interviews were conducted with 16 key informants and 10 Turkish immigrant women aged 50–69 years to analyse the factors influencing their screening participation in Germany. Interviews were analysed using summarising content analysis. The Theory of Planned Behaviour was used for structuring the results. Key informants stated poor German language skills and insufficient knowledge about breast cancer and screening as factors influencing screening participation. Immigrant women demonstrated basic knowledge about screening, but their attitudes towards screening varied. Information from the invitation letter of the screening programme was often filtered by family members. Key informants tended to emphasise barriers and system‐related factors while the Turkish women focused more on factors on the individual level. Contrasting both perspectives is helpful for health professionals to critically assess their own views. Measures to improve screening participation need to address not only barriers but also take women's attitudes and norms into account, thus helping women to make an informed decision.     

Caring for patients with oral cancer in Taiwan: The challenges faced by family caregivers

Family caregivers face multiple challenges when caring for patients with oral cancer at home. Understanding the difficulties they face may assist health professionals to better organise and provide support for family caregivers of oral cancer patients. The aim of this study was to describe the caregivers’ primary tasks and the difficulties they encounter when caring for a family member with oral cancer. This qualitative study included a purposeful sample of 22 primary family caregivers ranging in age from 25 to 71 years old. The researchers used face‐to‐face, semi‐structured and tape‐recorded interviews to collect data and employed qualitative content analysis to elicit caregiving‐related themes. Six task‐related themes and associated challenges were identified. These included managing the patient's nutritional issues, investigating and making decisions about patient care, managing sudden and unpredictable changes in the patient's condition, managing emotional distress, adjusting their attitudes towards patient care, and seeking resources. Family caregivers handle such essential tasks when they care for patients in home settings and they face specific challenges related to them. This study identified several challenges related to each task. From the outset, healthcare providers should actively offer caregiving information and strategies. Health professionals can incorporate strategies for supporting caregivers’ ability to carry out these tasks into their treatment model and can help caregivers manage difficulties that can impede them from doing so.     

Apsáalooke women's experiences with Pap test screening.

BACKGROUND: Cervical cancer mortality rates are among the highest in the United States for Northern Plains Native American women compared with white and other Native American women. The aims of Messengers for Health, a community-based participatory research project based on the Apsáalooke (Crow Indian) Reservation, are to decrease cervical cancer screening barriers, improve knowledge regarding screening and prevention, and increase the proportion of women receiving Pap tests. This paper presents results from a survey assessing women's perceptions of the level of comfort and care received by health care providers in their most recent Pap test appointment. METHODS: A survey assessing patient communication and satisfaction with their health care providers was conducted with a random sample of 101 Apsáalooke women. Qualitative and quantitative methods were utilized to analyze the survey data. RESULTS: Women reported both positive and negative experiences with their provider regarding their Pap test appointments. They noted positive experiences when trust was established and when the provider offered information, reassured or encouraged them, was personable, was familiar or consistent, maintained confidentiality, and was a woman. The women reported negative experiences when the examination was too short, when they did not have a consistent or female provider, and when they did not feel comfortable with the provider's nonverbal communication. CONCLUSIONS: Continued work with both providers and patients is necessary to decrease communication barriers and increase satisfaction with Pap test appointments.     

Barriers to Cervical Screening among Pacific Women in a New Zealand Urban Population

Background: In Aotearoa/New Zealand cervical screening programmes have reduced cervical cancer;however, half of cervical cancer cases among Pacific women are found among clients who had not attendedcervical screening. Hence, we set out to determine health provider perspectives on barriers that prevent theirservices reaching Pacific women within Aotearoa/New Zealand. Materials and Methods: Twenty semi-structuredinterviews were conducted with health care providers, Pap smear takers and community workers in the Wellingtonregion. Participants were asked their views on factors that enabled and/or constrained the participation of Pacificwomen in their cervical screening services. Results: Six interrelated themes influencing participation in cervicalscreening among Pacific women in the Wellington region were apparent: the funding and practice of servicedelivery; family always coming first; the cost of screening services; type of employment; the appropriateness ofinformation; and attitudes to self and screening. Conclusions: Determining specific ethnic group actual healthneeds and meeting them contributes to overall improvement in New Zealand’s health status. The results identifiedthe need for improvements to the delivery of screening services including adapting cervical screening services tothe requirements of Pacific women through more outreach services at alternate clinic hours; culturally appropriatepractitioners; the ability to take up opportunities for health checks and foster long-term relationships; as wellas appropriate monitoring and evaluation of approaches. Funding and reporting relationships also need to becompatible with the goal of improving outcomes for Pacific women. Further research into client voices for theirparticular needs to compliment the service provider perspective as well as minority groups is called for.     

Risk stratification in cervical cancer screening by complete screening history: Applying bioinformatics to a general screening population

Women screened for cervical cancer in Sweden are currently treated under a one‐size‐fits‐all programme, which has been successful in reducing the incidence of cervical cancer but does not use all of the participants' available medical information. This study aimed to use women's complete cervical screening histories to identify diagnostic patterns that may indicate an increased risk of developing cervical cancer. A nationwide case‐control study was performed where cervical cancer screening data from 125,476 women with a maximum follow‐up of 10 years were evaluated for patterns of SNOMED diagnoses. The cancer development risk was estimated for a number of different screening history patterns and expressed as Odds Ratios (OR), with a history of 4 benign cervical tests as reference, using logistic regression. The overall performance of the model was moderate (64% accuracy, 71% area under curve) with 61–62% of the study population showing no specific patterns associated with risk. However, predictions for high‐risk groups as defined by screening history patterns were highly discriminatory with ORs ranging from 8 to 36. The model for computing risk performed consistently across different screening history lengths, and several patterns predicted cancer outcomes. The results show the presence of risk‐increasing and risk‐decreasing factors in the screening history. Thus it is feasible to identify subgroups based on their complete screening histories. Several high‐risk subgroups identified might benefit from an increased screening density. Some low‐risk subgroups identified could likely have a moderately reduced screening density without additional risk.     

Influence of health insurance coverage on breast,cervical, and colorectal cancer screening in rural primary care settings

BACKGROUND:

The current study was performed to determine, in rural settings, the relation between the type and status of insurance coverage and being up‐to‐date for breast, cervical, and colorectal cancer screening.

METHODS:

Four primary care practices in 2 rural Oregon communities participated. Medical chart reviews that were conducted between October 2008 and August 2009 assessed insurance coverage and up‐to‐date status for breast, cervical, and colorectal cancer screening. Inclusion criteria involved having at least 1 health care visit within the past 5 years and being aged ≥ 55 years.

RESULTS:

The majority of patients were women aged 55 years to 70 years, employed or retired, and who had private health insurance and an average of 2.5 comorbid conditions. The overall percentage of eligible women who were up‐to‐date for cervical cancer screening was 30%; approximately 27% of women were up‐to‐date for clinical breast examination, 37% were up‐to‐date for mammography, and 19% were up‐to‐date for both mammography and clinical breast examination. Approximately 38% of men and 35% of women were up‐to‐date for colorectal cancer screening using any test at appropriate screening intervals. In general, having any insurance versus being uninsured was associated with undergoing cancer screening. For each type of screening, patients who had at least 1 health maintenance visit were significantly more likely to be up‐to‐date compared with those with no health maintenance visits. A significant interaction was found between having health maintenance visits, having any health insurance, and being up‐to‐date for cancer screening tests.

CONCLUSIONS:

Overall, the percentage of patients who were up‐to‐date for any cancer screening, especially cervical cancer screening, was found to be very low in rural Oregon. Patients with some form of health insurance were more likely to have had a health maintenance visit within the previous 2 years and to be up‐to‐date for breast, cervical, and/or colorectal cancer screening. Cancer 2012. © 2012 American Cancer Society.     

Associations between Spiritual Health Locus of Control,Perceived Discrimination and Breast and Cervical Cancer Screening for Muslim American Women in New York City

BackgroundWe sought to understand the impacts of religion-related factors, namely perceived discrimination and spiritual health locus of control, on breast and cervical cancer screening for Muslim American women.MethodsA total of 421 Muslim American women were surveyed at baseline of a breast and cervical cancer screening intervention, measuring discrimination through the Perceived Ethnic Discrimination Questionnaire (PED-Q), a 17-item scale measuring perceived interpersonal racial/ethnic discrimination; and spiritual beliefs through the Spiritual Health Locus of Control Scale, a 13-item scale measuring the link between control over one's health with a connection to religious beliefs. Multivariable logistic regression models were used to determine factors associated with an up-to-date mammogram and Pap test.ResultsMost women preferred to receive medical care from a healthcare provider of their same gender (75.2%) and same race, ethnicity or religion (62.1%). The middle age group (50–59) and a lower God's Grace Spiritual Health Locus of Control subscale were associated with up-to-date mammogram. Younger age, lower education, higher Exclusion/Rejection subscale, and lower Spiritual Life/Faith Subscale were associated with an up-to-date Pap test.ConclusionThe spiritual beliefs of Muslim American women impact their likelihood of obtaining breast and cervical cancer screenings. Therefore, these services need to be better tailored to match these needs, for example, by ensuring that Muslim American women have access to healthcare providers of their same gender, race, ethnicity or religion.