Skip to main content

Associations Between Religion-Related Factors and Breast Cancer Screening Among American Muslims

Abstract

American Muslims have low rates of mammography utilization, and research suggests that religious values influence their health-seeking behaviors. We assessed associations between religion-related factors and breast cancer screening in this population. A diverse group of Muslim women were recruited from mosques and Muslim organization sites in Greater Chicago to self-administer a survey incorporating measures of fatalism, religiosity, discrimination, and Islamic modesty. 254 surveys were collected of which 240 met age inclusion criteria (40 years of age or older). Of the 240, 72 respondents were Arab, 71 South Asian, 59 African American, and 38 identified with another ethnicity. 77 % of respondents had at least one mammogram in their lifetime, yet 37 % had not obtained mammography within the past 2 years. In multivariate models, positive religious coping, and perceived religious discrimination in healthcare were negatively associated with having a mammogram in the past 2 years, while having a PCP was positively associated. Ever having a mammogram was positively associated with increasing age and years of US residency, and knowing someone with breast cancer. Promoting biennial mammography among American Muslims may require addressing ideas about religious coping and combating perceived religious discrimination through tailored interventions.

This is a preview of subscription content, access via your institution.

References

  1. DeSantis C, et al. Breast cancer statistics, 2011. CA Cancer J Clin. 2011;61(6):409–18.

    Article  PubMed  Google Scholar 

  2. Brawley OW. Risk-based mammography screening: an effort to maximize the benefits and minimize the harms. Ann Intern Med. 2012;156(9):662–3.

    Article  PubMed  Google Scholar 

  3. Humphrey LL, et al. Breast cancer screening: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2002;137(5 Part 1):347–60.

    Article  PubMed  Google Scholar 

  4. Gotzsche PC, Nielsen M. Screening for breast cancer with mammography. Cochrane Database Syst Rev. 2009;4:CD001877.

    PubMed  Google Scholar 

  5. Centers for Disease Control and Prevention. Cancer screening—United States, 2010. Morb Mortal Wkly Rep. 2012;61(3):41–5.

    Google Scholar 

  6. Henson RM, Wyatt SW, Lee NC. The national breast and cervical cancer early detection program: a comprehensive public health response to two major health issues for women. J Public Health Manag Pract. 1996;2(2):36–47.

    CAS  PubMed  Google Scholar 

  7. Yabroff KR, O’Malley A, Mangan P, Mandelblatt J. Inreach and outreach interventions to improve mammography use. J Am Med Womens Assoc 2001; 56(4):166–73, 88.

    Google Scholar 

  8. Peek ME, Han JH. Disparities in screening mammography: current status, interventions and implications. J Gen Intern Med. 2004;19(2):184–94.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Masi CM, Blackman DJ, Peek ME. Interventions to enhance breast cancer screening, diagnosis, and treatment among racial and ethnic minority women. Med Care Res Rev. 2007;64(5 Suppl):195S–242S.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Muslim Americans: a national portrait—an in-depth analysis of America’s most diverse religious community. 2009. Washington DC. GALLUP, Inc. http://www.gallup.com/strategicconsulting/153572/report-muslim-americans-national-portrait.aspx. Accessed 13 Feb 2014.

  11. Muslim American Demographic Facts. 2000. http://www.allied-media.com/AM/. Accessed 13 Feb 2014.

  12. Smith TW. The Muslim population of the United States: the methodology of estimates. Public Opin Q. 2002;66:404–17.

    Article  Google Scholar 

  13. Ba-Yunus I. Muslims of Illinois, a demographic report. Chicago: East-West University; 1997.

    Google Scholar 

  14. Obama B. Remarks by the President on a New Beginning. 2009. Cairo, Egypt: The White House. http://www.whitehouse.gov/the_press_office/remarks-by-the-president-at-cairo-university-6-04-09/. Accessed 13 Feb 2014.

  15. Padela AI, Curlin FA. Religion and disparities: considering the influences of Islam on the health of American Muslims. J Relig Health. 2013;52(4):1333–45.

    Google Scholar 

  16. Padela AI, et al. Religious values and healthcare accommodations: voices from the American Muslim community. J Gen Intern Med. 2012;27(6):708–15.

    Google Scholar 

  17. Rajaram SS, Rashidi A. Asian-Islamic women and breast cancer screening: a socio-cultural analysis. Women Health. 1999;28(3):45–58.

    Article  CAS  PubMed  Google Scholar 

  18. 2020 Topics and Objectives: Cancer. 2012. Washington DC: U.S. Department of Health and Human Services. http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=5. Accessed 13 Feb 2014.

  19. Health, United States, 2011: with special feature on socioeconomic status and health. 2012. Hyattsville, Maryland: National Center for Health Statistics; 2012.

  20. Hasnain M, Memon U, Ferrans C, Szalacha L. Breast cancer knowledge, attitudes, beliefs, and screening practices among first-generation immigrant Muslim women. Abstracts from Women’s Health 2012: The 20th Annual Congress. Washington, DC. J Women’s Health 2012;34.

  21. Shirazi M, Champeau D, Talebi A. Predictors of breast cancer screening among immigrant Iranian women in California. J Womens Health (Larchmt). 2006;15(5):485–506.

    Article  Google Scholar 

  22. Shaheen MA, Galal OM, Salahi L, Aman Y. Utilization of mammography among Muslim women in Southern California. In: 133rd annual meeting and exposition. Philadelphia: American Public Health Association; 2005.

  23. Boxwala FI, et al. Factors associated with breast cancer screening in Asian Indian women in metro-Detroit. J Immigr Minor Health. 2010;12(4):534–43.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Gomez SL, et al. Disparities in mammographic screening for Asian women in California: a cross-sectional analysis to identify meaningful groups for targeted intervention. BMC Cancer. 2007;7:201.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Ponce N, Gatchell M, Brown R. Health Policy Fact Sheet: cancer screening rates among Asian ethnic groups. Berkeley, CA: University of California; 2003.

    Google Scholar 

  26. Kagawa-Singer M, et al. Breast and cervical cancer screening rates of subgroups of Asian American women in California. Med Care Res Rev. 2007;64(6):706–30.

    Article  PubMed  Google Scholar 

  27. Schwartz K, et al. Mammography screening among Arab American women in metropolitan Detroit. J Immigr Minor Health. 2008;10(6):541–9.

    Article  PubMed  Google Scholar 

  28. Talbert PY. The relationship of fear and fatalism with breast cancer screening among a selected target population of African American middle class women. J Soc Behav Health Sci. 2008;2(1):96–110.

    Google Scholar 

  29. Hall AG, et al. Breast cancer fatalism: the role of women’s perceptions of the health care system. J Health Care Poor Underserved. 2008;19(4):1321–35.

    Article  PubMed  Google Scholar 

  30. Powe BD, Finnie R. Cancer fatalism: the state of the science. Cancer Nurs. 2003;26(6):454–65 quiz 66-7.

    Article  PubMed  Google Scholar 

  31. Gullatte MM, et al. Religiosity, spirituality, and cancer fatalism beliefs on delay in breast cancer diagnosis in African American women. J Relig Health. 2010;49(1):62–72.

    Article  PubMed  Google Scholar 

  32. Spurlock WR, Cullins LS. Cancer fatalism and breast cancer screening in African American women. ABNF J. 2006;17(1):38–43.

    PubMed  Google Scholar 

  33. Straughan PT, Seow A. Fatalism reconceptualized: a concept to predict health screening behavior. J Gend Cult Health. 1998;3(2):85–100.

    Article  Google Scholar 

  34. Mayo RM, Ureda JR, Parker VG. Importance of fatalism in understanding mammography screening in rural elderly women. J Women Aging. 2001;13(1):57–72.

    Article  CAS  PubMed  Google Scholar 

  35. Peek ME, Sayad JV, Markwardt R. Fear, fatalism and breast cancer screening in low-income African-American women: the role of clinicians and the health care system. J Gen Intern Med. 2008;23(11):1847–53.

    Article  PubMed Central  PubMed  Google Scholar 

  36. Tolma E. Is breast cancer fatalism a factor for adherence to mammography screening among American Indian women? In: [Abstract] 139th annual meeting and exposition of the American Public Health Association. Washington, DC; 2011.

  37. Padela AI, Gunter K, Killawi A. Meeting the healthcare needs of American Muslims: challenges and strategies for healthcare settings. Washington, DC: The Institute for Social Policy and Understanding; 2011.

    Google Scholar 

  38. Matin M, LeBaron S. Attitudes toward cervical cancer screening among Muslim women: a pilot study. Women Health. 2004;39(3):63–77.

    Article  PubMed  Google Scholar 

  39. Yosef AR. Health beliefs, practice, and priorities for health care of Arab Muslims in the United States. J Transcult Nurs. 2008;19(3):284–91.

    Article  PubMed  Google Scholar 

  40. Facione NC, et al. The self-reported likelihood of patient delay in breast cancer: new thoughts for early detection. Prev Med. 2002;34(4):397–407.

    Article  PubMed  Google Scholar 

  41. Daley CM, et al. Breast cancer screening beliefs and behaviors among American Indian women in Kansas and Missouri: a qualitative inquiry. J Cancer Educ. 2012;27(Suppl 1):S32–40.

    Article  PubMed  Google Scholar 

  42. Thorburn S, et al. Medical mistrust and discrimination in health care: a qualitative study of Hmong women and men. J Community Health. 2012;37(4):822–9.

    Article  PubMed Central  PubMed  Google Scholar 

  43. Logan JR. America’s newcomers. Lewis Mumford Center for Comparative Urban and Regional Research: University at Albany; 2003.

  44. Israel BA, Eng E, Schulz AJ, Parker EA, Satcher D. Methods in community-based participatory research for health. San Francisco: Jossey-Bass; 2005.

    Google Scholar 

  45. Abdel-Khalek A. Happiness, health, and religiosity: significant relations. Ment Health Relig Cult. 2006;9(1):321–34.

    Article  Google Scholar 

  46. Hill PC, Hood RW. Measures of religiosity. Birmingham, AL: Religious Education Press; 1999.

    Google Scholar 

  47. Raiya HA, et al. Lessons learned and challenges faced in developing the psychological measure of Islamic religiousness. J Muslim Ment Health. 2007;2(2):133–54.

    Article  Google Scholar 

  48. Raiya HA, et al. A psychological measure of Islamic religiousness: development and evidence for reliability and validity. Int J Psychol Relig. 2008;18(4):291–315.

    Article  Google Scholar 

  49. Bird ST, Bogart LM. Perceived race-based and socioeconomic status (SES)-based discrimination in interactions with health care providers. Ethn Dis. 2001;11(3):554–63.

    CAS  PubMed  Google Scholar 

  50. Williams DR, et al. Racial differences in physical and mental health: socio-economic status, stress and discrimination. J Health Psychol. 1997;2:335–51.

    Article  CAS  PubMed  Google Scholar 

  51. Franklin MD, Schlundt DG, Wallston KA. Development and validation of a religious health fatalism measure for the African-American faith community. J Health Psychol. 2008;13(3):323–35.

    Article  PubMed  Google Scholar 

  52. Powe BD, Johnson A. Fatalism as a barrier to cancer screening among African-Americans: philosophical perspectives. J Relig Health. 1995;34(2):119–25.

    Article  CAS  PubMed  Google Scholar 

  53. Brownstein JN, et al. Breast and cervical cancer screening in minority populations: a model for using lay health educators. J Cancer Educ. 1992;7(4):321–6.

    Article  CAS  PubMed  Google Scholar 

  54. McCance KL, et al. Validity and reliability of a breast cancer knowledge test. Am J Prev Med. 1990;6(2):93–8.

    CAS  PubMed  Google Scholar 

  55. Harris PA, et al. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81.

    Article  PubMed Central  PubMed  Google Scholar 

  56. Samari G, Kobeissi L, Telesca D, Esfandiari M, Galal O. Screening and early detection of breast cancer among Muslim immigrant women: differences among ethnic groups. In: [Abstract] American Public Health Association 139th annual meeting and exposition. Washington DC; 2011.

  57. Smedley BD, Stith AY, Nelson AR. Unequal treatment: confronting racial and ethnic disparities in health care. Washington, DC: National Academies Press; 2003.

    Google Scholar 

  58. Mouton CP, et al. Impact of perceived racial discrimination on health screening in black women. J Health Care Poor Underserved. 2010;21(1):287–300.

    Article  PubMed Central  PubMed  Google Scholar 

  59. Benjamins MR. Race/ethnic discrimination and preventive service utilization in a sample of Whites, Blacks, Mexicans, and Puerto Ricans. Med Care. 2012;50(10):870–6.

    Article  PubMed  Google Scholar 

  60. Dailey AB, et al. Perceived racial discrimination and nonadherence to screening mammography guidelines: results from the race differences in the screening mammography process study. Am J Epidemiol. 2007;165(11):1287–95.

    Article  PubMed  Google Scholar 

  61. Crawley LM, Ahn DK, Winkleby MA. Perceived medical discrimination and cancer screening behaviors of racial and ethnic minority adults. Cancer Epidemiol Biomark Prev. 2008;17(8):1937–44.

    Article  Google Scholar 

  62. Allen JD, et al. Dimensions of religiousness and cancer screening behaviors among church-going Latinas. J Relig Health. 2014;53(1):190–203.

    Google Scholar 

  63. Rashidi A, Rajaram SS. Culture care conflicts among Asian-Islamic immigrant women in US hospitals. Holist Nurs Pract. 2001;16(1):55–64.

    Article  CAS  PubMed  Google Scholar 

  64. AHC joins Komen Race for the Cure registration. 2012. http://www.asianhealth.org/site/epage/137936_794.htm Accessed 13 Feb 2014.

  65. Greiner KA, et al. Knowledge and perceptions of colorectal cancer screening among urban African Americans. J Gen Intern Med. 2005;20(11):977–83.

    Article  PubMed Central  PubMed  Google Scholar 

  66. Powe BD. Cancer fatalism among African-Americans: a review of the literature. Nurs Outlook. 1996;44(1):18–21.

    Article  CAS  PubMed  Google Scholar 

  67. Hamdy SF. Islam, fatalism, and medical intervention: lessons from Egypt on the cultivation of forbearance (sabr) and reliance on God (tawakkul). Anthropol Q. 2009;82(1):173–96.

    Article  Google Scholar 

  68. Florez KR, et al. Fatalism or destiny? A qualitative study and interpretative framework on Dominican women’s breast cancer beliefs. J Immigr Minor Health. 2009;11(4):291–301.

    Article  PubMed Central  PubMed  Google Scholar 

  69. Greer S, Morris T, Pettingale KW. Psychological response to breast cancer: effect on outcome. Lancet. 1979;2(8146):785–7.

    Article  CAS  PubMed  Google Scholar 

  70. Soler-Vila H, Kasl SV, Jones BA. Cancer-specific beliefs and survival: a population-based study of African-American and White breast cancer patients. Cancer Causes Control. 2005;16(2):105–14.

    Article  PubMed  Google Scholar 

  71. Mohamed IE, et al. Understanding locally advanced breast cancer: what influences a woman’s decision to delay treatment? Prev Med. 2005;41(2):399–405.

    Article  PubMed  Google Scholar 

  72. Pew Research Center. Muslim Americans: no signs of growth in alienation or support for extremism. Washington, DC; 2011.

  73. Vernon SW, et al. Interventions to promote repeat breast cancer screening with mammography: a systematic review and meta-analysis. J Natl Cancer Inst. 2010;102(14):1023–39.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

We thank our respondents for taking the time to fill out the survey, and our community partners and advisors for their invaluable recruitment assistance and support: Ahlam Jbara and Dr. Zaher Sahloul from the Council of Islamic Organizations of Greater Chicago, Itedal Shalabi from Arab American Family Services, and Dr. Bambade Shakoor-Abdulla of CMECCA. A note of thanks also goes to our research assistants Alison Cook and Nadiah Mohajir. Finally we want to thank all of the staff members at our recruitment sites who made the data collection possible. This project was supported by an Institutional Research Grant (#58-004) from the American Cancer Society, and a Cancer Center Support Grant (#P30 CA14599). Data warehousing was supported by the REDCap project at the University of Chicago, managed by the Center for Research Informatics, and funded by the Biological Sciences Division and the Institute for Translational Medicine CTSA Grant (UL1 RR024999).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Aasim I. Padela.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Padela, A.I., Murrar, S., Adviento, B. et al. Associations Between Religion-Related Factors and Breast Cancer Screening Among American Muslims. J Immigrant Minority Health 17, 660–669 (2015). https://doi.org/10.1007/s10903-014-0014-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-014-0014-y

Keywords

  • Mammography
  • Islam
  • Fatalism
  • Modesty
  • Cancer screening disparities