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Abstract

ABSTRACT:

Purpose: The purpose of this article is to identify barriers for breast cancer screening in Native Hawaiian (NH) Women, identify ways to overcome those barriers, and increase breast cancer screening in NH Women.

Method: A PubMed literature search was conducted with search terms barriers to reasons to screen for breast cancer, barriers to breast cancer screening, barriers to breast cancer screening in Hawaii, barriers to breast cancer screening in Native Hawaiian women, breast cancer screening AND Native Hawaiian Women. Seventeen pertinent articles were retrieved and serve as the basis for this clinical review.

Results: Some barriers to mammography for breast cancer screening include pain, fear, embarrassment, cost, no recommendation, modesty, not understanding the need, and no family encouragement.1 Culturally sensitive training and education, as well as engaging NH Breast Cancer Survivors to share their stories and provide education regarding mammogram and early detection would also help remove barriers to BC screening.5,9 

Conclusion: Studies have shown that Native Hawaiian women face many barriers that decrease their participation in Breast Cancer screening as compared to non-Hispanic White women. More solutions need to be explored to eliminate these barriers. Additionally, services that currently exist like BCCCP need to be more widely available and known to healthcare providers. In addition to those touched on above, creating culturally sensitive training for providers and their staff as well as mobile mammography could reduce BC incidence in Native Hawaiian Women.

Keywords: Barriers, Breast Cancer, Native Hawaiian Women, Prevalence, Screening, Mammography.

HIGHLIGHTS

The key points are as follows:

  1. To educate the target audience on current breast cancer statistics of Hawaii as compared to the remainder of the United States, and more specifically to Native Hawaiian Women as compared to all other women in Hawaii.
  2. To educate the target audience on the barriers to breast cancer screening, especially for culturally sensitive groups and specifically for Native Hawaiian Women.
  3. To educate the target audience on the risks of delaying breast cancer screening. 
  4. To provide the target audience with ways to overcome the barriers to breast cancer screening, especially for Native Hawaiian Women.
  5. To improve breast cancer screening for Native Hawaiian Women.

References

1. Miller BC, Bowers JM, Payne JB, Moyer A. Barriers to mammography screening among racial and ethnic minority women. Soc Sci Med. 2019;239:112494. doi:10.1016/j.socscimed.2019.112494.

2. Ihenacho, U., McKinley, M.A., Vu, A. et al. Characterizing breast cancer incidence and trends among Asian American, Native Hawaiian, and non-Hispanic White women in Hawaiʻi, 1990-2014. Cancer Causes Control (2022). https://doi.org/10.1007/s10552-022-01659-7.

3. Breast and Cervical Cancer Control Program (BCCCP). State of Hawaii, Department of Health, Chronic Disease Prevention and Health Promotion Division. Published 2023. Accessed February 15, 2023. https://health.hawaii.gov/cancer/program-priorities/bcccp/#2.

4. Britt KL, Cuzick J, Phillips KA. Key steps for effective breast cancer prevention. Nat Rev Cancer. 2020;20(8):417-436. doi:10.1038/s41568-020-0266-x.

5. Ka'opua LS, Park SH, Ward ME, Braun KL. Testing the feasibility of a culturally tailored breast cancer screening intervention with Native Hawaiian women in rural churches. Health Soc Work. 2011 Feb;36(1):55-65. doi: 10.1093/hsw/36.1.55. PMID: 21446609; PMCID: PMC3070905.

6. Shamsi M, Pirayesh Islamian J. Breast cancer: early diagnosis and effective treatment by drug delivery tracing. Nucl Med Rev Cent East Eur. 2017;20(1):45-48. doi:10.5603/NMR.2017.0002.

7. Nazari SS, Mukherjee P. An overview of mammographic density and its association with breast cancer. Breast Cancer. 2018;25(3):259-267. doi:10.1007/s12282-018-0857-5.

8. Cancer Facts and Figures 2023. American Cancer Society, Inc. 2023. Accessed February 13, 2023. P. 6-12.  https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2026/2026-cancer-facts-and-figures.pdf.

9. Eide P. Native Hawaiian women and the experience of breast cancer. Women Health. 2006;44(4):41-59. doi:10.1300/j013v44n04_03.

10. Huhmann K. Barriers and Facilitators to Breast and Cervical Cancer Screening in Somali Immigrant Women: An Integrative Review. Oncol Nurs Forum. 2020;47(2):177-186. doi:10.1188/20.ONF.177-186.

11. Hawaii: 2020 Census. United States Census Bureau. Published: August 22, 2022. Accessed February 13, 2023. https://www.census.gov/library/stories/state-by-state/hawaii-population-change-between-census-decade.html.

12. Ka’opua LS, Anngela L. Developing a Spiritually Based Breast Cancer Screening Intervention for Native Hawaiian Women. Cancer Control. 2005;12(4_suppl):97-99. doi:10.1177/1073274805012004S15.

13. Mokuau N, Braun KL, Daniggelis E. Building family capacity for Native Hawaiian women with breast cancer. Health Soc Work. 2012;37(4):216-224. doi:10.1093/hsw/hls033.

14. Ginsburg O, Yip CH, Brooks A, et al. Breast cancer early detection: A phased approach to implementation. Cancer. 2020;126 Suppl 10(Suppl 10):2379-2393. doi:10.1002/cncr.32887.

15. Seely JM, Alhassan T. Screening for Breast Cancer in 2018—What Should We be Doing Today? Current Oncology. 2018; 25(s1):115-124. https://doi.org/10.3747/co.25.3770.

16. Duffy S, Vulkan D, Cuckle H, et al. Annual mammographic screening to reduce breast cancer mortality in women from age 40 years: long-term follow-up of the UK Age RCT. Health Technol Assess. 2020;24(55):1-24. doi:10.3310/hta24550.

17. Taparra K, Fukui J, Killeen J, Sumida K, Loo LWM, Hernandez BY. Racial and Ethnic Disparities in Rates of Invasive Second Breast Cancer Among Women With Ductal Carcinoma In Situ in Hawai'i. JAMA Netw Open. 2021 Oct 1;4(10):e2128977. doi: 10.1001/jamanetworkopen.2021.28977. PMID: 34668945; PMCID: PMC8529402.

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