Barriers Related to Mammography Use for Breast Cancer Screening Among Minority Women

Purpose: The purpose of this review was to better understand possible social, economic, cultural, behavioral, and systems barriers to breast cancer screening among minority women.

Methods: Relevant manuscripts were identified through a MEDLINE/PubMed search for English-language literature from October 1971 through April 2009. The abstracts from a total of 515 manuscripts were reviewed. Only studies conducted among minority women in the United States and examining barriers related to screening mammography were considered. Of 64 relevant articles, 13 cross-sectional and 4 prospective studies met inclusion criteria. Study design; patient characteristics; outcomes regarding knowledge, attitudes and beliefs; social norms; accessibility; and cultural competence regarding breast cancer screening were abstracted. Studies were rated using a methodological quality score (MQS).

Results: Pain and embarrassment associated with screening mammography, low income and lack of health insurance, poor knowledge about breast cancer screening, lack of physician recommendation, lack of trust in hospitals and doctors, language barriers, and lack of transportation were the most frequently identified barriers. The average MQS of the studies selected was 10.9 (SD = 3.25, range, 4-20).

Conclusions: Multiple barriers limit screening mammography among minority women. Recognizing predictors of screening among minority women and addressing culturally specific barriers may improve utilization of screening mammography among these women.