Cultural Barriers to Breast Cancer Screening Among Arab American Women

Introduction
Breast cancer is the second most common cancer among women worldwide (WHO, 2010) and in the US (CDC, 2013). A number
of studies have suggested that cancer is diagnosed at later stages for Arab Americans and that prevention efforts should be
better understood (Arshad, 2011; Hirko et al., 2013). Seventy percent of Arab American women greater than 40 years of age in
the Detroit metropolitan area had received a mammogram compared to 92.6% among all women in Michigan (Schwartz, 2008).
Psychosocial factors associated with breast cancer screening among Arab women include fear of the screening process, fear
of negative results, embarrassment and stigmatization, language barriers, lack of knowledge, transportation and economic
barriers, and cultural and religious barriers (Cohen & Azaiza, 2008).
Objectives
This preliminary paper is part of a larger study that is a cross country comparison of breast cancer screening barriers among
Arab women in Israel and in the US. In this analysis we seek to better understand the cultural barriers that influence breast
cancer screening among Arab women in metropolitan Detroit. The specific aims of this preliminary study were to examine the
relationship of breast cancer screening barriers – 1) environmental; 2) social; 3) body exposure; and 4) religious -- to demographic
characteristics such as age, education, years in US, employment, religion, religiosity, country of origin, and birthplace.
Methods
A heterogeneous sample of 196 women across different socioeconomic strata and Arab ancestry were recruited from a large
health and social services agency and Mosques across the Detroit metropolitan area. Women who qualified to be in the study
were approached by trained Community Health Workers who held meetings in their home or went to the home of the participant
to administer a 15 minute paper and pencil questionnaire that included demographic characteristics, questions on breast cancer
screening frequency and understanding, and an Arab Culture Specific Barriers to Breast Cancer Screening (ACSB) instrument
(Cohen and Azaiza, 2008).
Results
A multiple regression analysis revealed significant relationships between the religious breast cancer screening barrier and less
time in the US, identifying as Muslim, and being from Yemen. Age was significantly associated with the social and body exposure
barriers with younger women indicating greater social and body exposure barriers to BC screening than older women.