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Barriers to Breast Cancer Screening among Palestinian Women in Nablus Region, North-ern West Bank
  • December 2020
  • Palestinian Medical and Pharmaceutical Journal 5(2):75-82
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Article
Barriers to Breast Cancer Screening among Palestinian Women in Nablus Region, North-ern West Bank
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A cross-sectional study that used a random sampling method recruited women from four women centers in Nablus district in West Bank including 127 women from
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Abstract
Breast cancer incidence in Palestinian Occupied Territories is less than western countries but it is the leading cause of cancer mortality among women. The Performance of breast can-cer screening leads to early detection and reduction of mortality. Hence it is important to un-derstand the barriers to breast cancer screening. A cross-sectional study that used a random sampling method recruited women from four women centers in Nablus district in West Bank including 127 women from Nablus city, 133 women from villages and 40 women from the refugee camps. A questionnaire was distributed to collect data on breast cancer screening per-formance attitudes including knowledge and barriers in addition to demographic variables. Data included information on breast self-examination (BSE), clinical breast examination (CBE) and mammogram. The results of the study indicated that a low number performed breast screening with 60.2% never did CBE and 74% never did a mammogram. Only 67.3% of women knew about (BSE), 47.6% women knew about (CBE) and 59.5% knew about a mammogram. Fear from many aspects related to disease and its consequences on an individ-ual, relationship to partner and family represented the major barrier. Also, the financial situa-tion was an obstacle, whereas religion as a barrier was present in 50% of participants. Time and financial were the main reasons behind the application of the study only in the Nablus district. The study concluded that there is a low performance of breast screening among Pal-estinian women that is associated mainly with fear of disease consequences.
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Palestinian Medical and Pharmaceutical Journal (PMPJ). 2020; 5(2): 75-82 Barriers to Breast Cancer Screening among Palestinian Women in Nablus Region, Northern West Bank† Mariam Al-Tell1*; Nihal Natour1 & Dina Younes2 1Department of Public Health, Faculty of Medicine and Health Sciences, An- Najah National University, Nablus, Palestine. 2MOE, Nablus directorate, Nablus, Palestine *Corresponding author: [email protected] Received: (26/8/2019), Accepted: (15/11/2019) Abstract Breast cancer incidence in Palestinian Occupied Territories is less than western countries but it is the leading cause of cancer mortality among women. The Performance of breast cancer screening leads to early detection and reduction of mortality. Hence it is important to understand the barriers to breast cancer screening. A cross-sectional study that used a random sampling method recruited women from four women centers in Nablus district in West Bank including 127 women from Na-blus city, 133 women from villages and 40 women from the refugee camps. A questionnaire was distributed to collect data on breast cancer screening performance attitudes including knowledge and barriers in addition to demographic variables. Data included information on breast self-examination (BSE), clinical breast examination (CBE) and mammogram. The results of the study indicated that a low number performed breast screening with 60.2% never did CBE and 74% never did a mammogram. Only 67.3% of women knew about (BSE), 47.6% women knew about (CBE) and 59.5% knew about a mammogram. Fear from many aspects related to disease and its conse-quences on an individual, relationship to partner and family represented the major barrier. Also, the financial situation was an obstacle, whereas religion as a barrier was present in 50% of participants. Time and financial were the main reasons behind the application of the study only in the Nablus district. The study concluded that there is a low performance of breast screening among Palestinian women that is associated mainly with fear of disease consequences. Keywords: Breast Cancer, Screening, Mammogram, Breast Self-Exam. † This research was submitted as part of Master thesis in Women's Studies by Dina Younes at An-najah National University dated 1/4/2015 INTRODUCTION Although the incidence of breast cancer in Palestine (60 per 100,000) is lower than in western countries and Israel [1]. In occupied Palestinian territories, the leading cause of cancer mortality among women is due to breast cancer [2]. The standardized mortality rate due to breast cancer in West Bank is 7.1 per 100,000 [3]. Compared to developed countries, breast cancer in developing coun-tries manifests at a younger age [4]. The mean age of women with breast cancer is 51.5 years. Fewer Arab women compared to Jewish women are diagnosed with mammog-raphy, with most the women being diagnosed with physical examination [5]. Early detection of breast cancer which is possible through (BSE), (CBE) and mam-mography in addition to effective treatment can reduce mortality by 25-30%[6-8]. Early detection of breast cancer can lead to suc-cessful treatment[9], but Arab women are usually detected late in the stage of the dis-ease[10]. Late diagnosis is directly related to mortality from breast cancer [11]. In a tele-phone survey of women in Israel, 66.8% of Arab women compared to 74.2% of Jewish women undergone mammography in the past 2 years [12]. In the United States (US), official guide-lines call on average women aged more than 20 y to perform CBE and for annual mam-mography for women who are 40 y or more, whereas Israeli guidelines recommend bien-nial mammography examination for women who are 50 y and older [1]. In Jordan, a country that is close to Pal-estinian territories and has a large population of Palestinians, many barriers were associat-ed with a cancer diagnosis including fear,