Individual, Provider, and System Risk Factors for Breast and Cervical Cancer Screening Among Underserved Black, Latina, and Arab Women

Background: Socioeconomic and racial/ethnic disparities in breast and cervical cancer screening persist. An exploratory study was conducted to better understand co-occurring risk factors in underserved groups that could inform interventions to improve screening adherence. The objective of this study was to examine associations between breast and cervical cancer screening adherence and co-occurring risk factors in three racial/ethnic groups of underserved women. Methods: Black, Latina, and Arab women (N=514), ages 21 to 70 years, were enrolled into the Kin KeeperSM randomized controlled trial in communities around Detroit, Michigan. We used participant baseline assessments (e.g., demographic characteristics, health literacy) to explore screening risks using an additive approach and multivariate logistic analyses. Results: For black women, having more health literacy risks were associated with reduced odds of a clinical breast exam (CBE), mammogram, and Papanicolaou (Pap) test; more competing priorities were associated with reduced odds of a Pap test; lack of doctor mammogram recommendation was significantly associated with decreased odds of CBE. For Latina women, lack of doctor recommendations were significantly associated with decreased odds of CBE, mammogram, and Pap test. For Arab women, lack of doctor recommendations were significantly associated with decreased odds of CBE, mammogram, and Pap test; more competing priorities were significantly associated with reduced odds of CBE and Pap test. All results were significant at p<0.05. Conclusions: Characteristics associated with breast and cervical screening adherence differs among Black, Latina, and Arab underserved women. Interventions to improve screening should be tailored for racial/ethnic groups with particular attention to competing survival priorities, health literacy risks factors, and provider recommendations.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140125/1/jwh.2013.4397.pd

Assessing Knowledge, Physician Interactions and Patient-Reported Barriers to Colorectal Cancer Screening Among Arab Americans in Dearborn, Michigan.

Colorectal cancer (CRC) is the second leading cause of cancer related deaths among men and women in the United States (Haggar and Boushey in Clin Colon Rectal Surg 22:191-197, 2009). Screening tests have shown to be successful at early detection of precancerous polyps. Between 2000 and 2010, there was a 72% growth in the population that identifies having an Arabic-speaking ancestry (Arab American Institute in https://www.aaiusa.org/demographics, 2011). Despite this, little research has been conducted to assess this unique community\u27s knowledge regarding CRC. Given that low screening rates can be attributed to lack of knowledge, this study was designed to address CRC knowledge and screening barriers in an Arab American community. Between February 2016 and June 2017, an anonymous survey was conducted in English or Arabic among 131 patients from cancer programs at the Arab Community Center for Economic and Social Services (ACCESS) in Dearborn, MI. Program participants were expected to have greater insight and awareness about cancer risk than the general population. Knowledge deficiencies surrounding CRC and the screening process were identified. 70% of participants did not know what a colon polyp is and over 89% were not aware of their individual risk for CRC. 45.8% have never had a CRC screening and leading barriers included screening costs, lack of health insurance, and lack of advice by physicians. The goal of this study was to serve as a tool to healthcare providers by identifying evident gaps in medical knowledge surrounding CRC. In order to help better serve and educate patients, healthcare providers and community organizations are encouraged to fight the stigma and help to reduce misunderstandings