A Study of Knowledge, Attitudes and Practices towards Breast Cancer Screening & Mammography Among Somali Refugee Women in Seattle

Abstract

Abstract: Background: Breast cancer awareness is low in Somalia and there is limited cancer diagnosis, modern treatment options, and the cases would present very late in stage when treatment may not be viable. Therefore, Somali women tend to have a fatalistic view about cancer in general and ominously call it an `incurable big wound'. Knowledge, attitude, and practices have been hypothesized as one of the patient-centered screening determinant, but there is limited data available to conclude this for Somali women. This study's objective is therefore to investigate Knowledge, Attitude, and Practices (KAP) towards breast cancer, screening, and mammography among Somali women living in Seattle, Washington. Methodology: A cross-sectional survey was carried out in Seattle Washington between July and September 2014. There were 200 Somali women recruited into the study using a convenience sampling method. Data were collected using a close-ended questionnaire. Data were analyzed descriptively using statistical data analysis software, STATA version 12 and presented as frequency tables, texts and graphs. Scoring scheme and weighted average was used to create two models for logistic regression to compare effects of knowledge on attitudes towards mammography and health care practices respectively. Result: Of the 200 recruited, 175 (87.5%) respondents participated in the survey. 52% (N=91) of the participants were 40 years or younger and slightly less than half, 48% (N=84) were 40 years or older. Participants were either married, 123(70.3%), divorced, 33(18.9) or widowed, 19(10.9). Median years in the United States are 9 years but ranges from a year to 28 years. 62% of respondents said breast cancer leads to death if untreated and 63% said it is curable if detected and treated in early stages. However, 51% said they would be afraid to test lest they get a positive result and only 4% will go for a mammogram without hesitation. High parity, about seven months of breastfeeding and earlier age of first childbirth are some of the beneficial outcomes. There were no differences in responses for mammography knowledge, attitudes towards mammogram and healthcare practices, which were all below 50% of correct scores. There were slight differences in responses based on age and education levels, but no significant difference by years lived in United States. Knowledge of breast cancer and its risk factors were also limited with correct answer scores <50%.Conclusion: Overall, there is limited knowledge, understanding, and poor and fatalistic perception about breast cancer, its risk factors as well as mammography as a screening tool among Somali women participants. These findings highlight the importance of public institutions and planners of carrying out intervention to increase knowledge of breast cancer among underserved women and train providers to take time to assess the breast cancer risks and prescribe screenings to increase early detection.