Survey of barriers to breast cancer screening among Navajo Nation women Free

A107

Background: Very little is known about factors influencing prevention and treatment decisions of breast cancer in Navajo women. The Navajo Nation Breast and Cervical Cancer Program (NNBCCP) has received funding from Centers for Disease Control and Prevention (CDC) since 1996. Although cancer screening is increasing, the staff is seeking new strategies for reaching those women who have never been screened for breast cancer or are screened insufficiently.
 
 Methods: A survey was developed to measure logistical and personal barriers to breast cancer screening. The questionnaire was developed in collaboration with Program staff and university researchers using focus groups and pilot testing. The revised survey was then completed by a random sample of women who were registered in the Indian Health Service system for the Chinle service area. Participants were 200 Navajo women (40-64 years of age) who were randomly selected from women who were identified as ‘Never screened’ or ‘Rarely screened’ (>5 years since last mammogram) for breast cancer. Interviews were conducted by NNBCCPP staff in fall 2006. Approvals from the University of Arizona Human Subject’s protection program as well as from the Navajo Nation Human Research Review Board and the Chinle agency council were obtained prior to initiation of the study.
 Results: These Navajo women identified many barriers to cancer screening with transportation barriers most frequently reported, as well as not having time to be screened and fear of screening results. Breast cancer knowledge was fairly high, although ‘Rarely Screened’ women had more knowledge than ‘Never Screened’ women. Women showed interest in learning more and 81% preferred receiving cancer education at an Indian Health Service clinic. Over 76% of women had examined their breasts for lumps, but only 58% thought that mammograms could detect breast cancer and that cancer could be cured (32%).
 Conclusion: Navajo women who had no history or only a past history of receiving mammography identified many screening barriers, with ‘Never Screened’ women identifying more barriers than ‘Rarely Screened’ women. More outreach is needed, particularly about breast cancer and the need for regular screenings. This information will help NNBCCP Program develop new strategies for increasing appropriate cancer screening.