Evaluation of Arab Cultural Barriers That Influence Muslim Arab Iraqi Women's Breast Cancer Screening Behavior.

Abstract

Little is known about Iraqi women's practice towards breast cancer screening (BCS), breast self-examination (BSE), clinical breast examination (CBE) and mammography, and the influence of Arab culture. The aim of this study was to assess women's behavior towards BCS, and to explain the influence of specific Arab culture barriers. This descriptive study was carried out with 1,066 women. Three structured questionnaires were used in the data collection. Descriptive statistics and multivariable logistic regression were used for data evaluation. Many Iraqi women did not practice regular BSE, CBE, and mammography. The most common reason was "not having a breast complaint". Specific Arab cultural barriers such as exposure [odds ratio (OR) = 0.545; 95% confidence interval (CI) = 0.440 to 0.674; p<0.001], environment (OR = 0.571; 95% CI = 0.464 to 0.703; p<0.001) and uneasiness barriers (OR = 0.736; 95% CI = 0.557 to 0.974; p=0.032) were predictors for BSE while exposure (OR = 0.553; 95% CI = 0.447 to 0.684; p<0.001), and environment barriers (OR = 0.585; 95% CI = 0.474 to 0.772; p<0.001) was predictor for CBE. Additionally, exposure (OR = 0.324; 95% CI = 0.251 to 0.419; p<0.001), environment (OR = 0.636; 95% CI = 0.500 to 0.809; p<0.001), and uneasiness barriers (OR = 0.644; 95% CI = 0.464 to 0.893; p = 0.008) were predictors for mammography screening of Iraqi women. Arab specific cultural barriers may be one of the key obstacles to BSC uptake in Iraq. Health education, including cultural education, may have the potential to increase BCS awareness and down-staging of the disease at presentation.