Background: Breast cancer (BC) is the most common cancer among women in the United States. Mammography screening has been identified as a valuable tool to decrease morbidity and mortality rates from breast cancer. Although the effect of screening with mammography on mortality and morbidity is debatable, it is recommended that mammograms should be continued annually regardless of the age of the woman. Racial disparities in health in the US continue to affect breast cancer screening and early diagnosis even if socioeconomic status is controlled. Arab Muslim and Christian women from different Arab countries may perceive health and screening practices differently. Although general cultural themes can be established, the variations that exist between and within national groups of Arabs, such as country of origin and religion, are important aspects must be considered in the healthcare system to reduce racial disparities and ensure social justice.

Purpose: To explore breast cancer screening rates in Arab Christian and Muslim American women from three Arab countries: Lebanon, Jordan, and Egypt, and to investigate differences in attitudes and beliefs about breast cancer screening among these three subpopulations.

Method: In this comparative, cross sectional study, 316 Arab American women from the three Arab countries completed a survey that combined the sociodemographic variables and the Arab Specific-Culture Barriers instrument. Penderʼs Health Promotion Model was employed to guide the exploration of different biopsychosocial variables in relation to mammography screening.

Results: The results of this study revealed lower mammography screening rates among the three Arab American subpopulations compared to the national screening rate of 67% among all women aged 40 and older in the United States. Of the 316 AAW, 202 (63.9%) reported ever having a mammogram. Having ever had a clinical breast exam (CBE) was reported to be done by 78 (84.8%) women from Lebanon, 81 (76.4%) from Egypt, and 75 (63.6%) from Jordan. Of those women, 80 (77.7%) were Christian, and 154 (72.3%) were Muslim. Performing breast self exam (BSE) was reported by 63 (68.5%) women from Lebanon, 66 (55.9%) from Jordan, and 57 (53.8%) from Egypt. Sixty-one (59.2%) Christian and 125 (58.7%) Muslim women reported performing BSE.

This study presented numerous perceived benefits, barriers, and interpersonal influences on BC screening; it also revealed important differences in mammography screening behaviors among the three subgroups of AAW, Lebanese, Jordanian, and Egyptian, based on religion and country of birth. Several variables influencing utilization of mammography screening were proposed. These variables included sociodemographic characteristics, age, country of birth, religion, marital status, and living status (whether or not the woman lived alone), perceived benefits, barriers, and interpersonal influences. The implications of such findings are significant to nursing practice, knowledge development, and research.

Conclusion: Mammography screening rates in AAW are still lower than those of other ethnic women in the US; therefore, additional efforts are to be made to overcome barriers and motivate these women to make a decision of participating and adhering to BC screening. Influences of religion and culture were addressed in this study which indicated that both of these factors should be taken into consideration when educating AAW about mammography screening. Future endeavors must be made to increase knowledge of AAW about BC sc

Biography:
Dr. Manal Alatrash is an Associate Professor of Western University of Health Sciences/ College of Graduate Nursing. She received her doctoral degree (PhD) in Nursing from Azusa Pacific University in Azusa, California. Her doctorate research focus is on breast cancer screening in Arab American women in order to decrease health disparities in the United States. She obtained her Masterʼs degree in nursing from Georgetown University in Washington, D.C. where she majored in Adult Oncology Nursing. She received her Bachelor of Science in Nursing from Jordan University in Jordan.