Factors that Influence Awareness of Breast Cancer Screening among Arab Women in Qatar: Results from a Cross Sectional Survey

  • Published : 2015.01.06


Background: Breast cancer is the most common cancer among women in the State of Qatar. Due to low participation in breast cancer screening (BCS) activities, women in Qatar are often diagnosed with breast cancer at advanced stages of the disease. Findings indicate that low participation rates in BCS activities are significantly related to women's low level of awareness of breast cancer screening. The objectives of this study were to: (1) determine the factors that influence Qatari women's awareness of breast cancer and its screening activities: and (2) to find ways to effectively promote breast cancer screening activities among Arabic speaking women in Qatar. Materials and Methods: A multicenter, cross-sectional quantitative survey of 1,063 (87.5% response rate) female Qatari citizens and non-Qatari Arabic-speaking residents, 35 years of age or older, was conducted in Qatar from March 2011 to July 2011. Outcome measures included participant awareness levels of the most recent national recommended guidelines of BCS, participation rates in BCS activities, and factors related to awareness of BCS activities. Results: While most participants (90.7%) were aware of breast cancer, less than half had awareness of BCS practices (28.9% were aware of breast self-examination and 41.8% of clinical breast exams, while 26.4% knew that mammography was recommended by national screening guidelines. Only 7.6% had knowledge of all three BCS activities). Regarding BCS practice, less than one-third practiced BCS appropriately (13.9% of participants performed breast self-examination (BSE) monthly, 31.3% had a clinical breast exam (CBE) once a year or once every two years, and 26.9% of women 40 years of age or older had a mammogram once every year or two years). Awareness of BCS was significantly related to BCS practice, education level, and receipt of information about breast cancer and/or BCS from a variety of sources, particularly doctors and the media. Conclusions: The low levels of participation rates in BCS among Arab women in this study indicate a strong need to increase awareness of the importance of breast cancer screening in Qatari women. Without this awareness, compliance with the most recent breast cancer screening recommendations in Qatar will remain low. An increased effort to implement mass media and public health campaigns regarding the impact of breast cancer on women's health and the benefits of early detection of breast cancer must be coupled with an enhanced participation of health care providers in delivering this message to Qatar population.


Supported by : Qatar National Research Fund


  1. Ahmed BA (2010). Awareness and practice of breast cancer and breast-self examination among university students in Yemen. Asian Pac J Cancer Prev, 11, 101-5.
  2. Akhtar SS, Nadrah HM, Al-Habdan MA, et al (2010). First organized screening mammography programme in Saudi Arabia: preliminary analysis of pilot round. East Mediterr Health J, 16, 1025-31.
  3. Alam AA (2006). Knowledge of breast cancer and its risk and protective factors among women in Riyadh. Ann Saudi Med, 26, 272-7.
  4. Al-Hamdan N, Ravichandran K, Al-Sayyad J, et al (2009). Incidence of cancer in Gulf Cooperation Council countries, 1998-2001. East Mediterr Health J, 15, 600-11.
  5. Alkhasawneh IM, Akhu-Zaheya LM, Suleiman SM (2009). Jordanian nurses' knowledge and practice of breast selfexamination. J Adv Nurs, 65, 412-6.
  6. Al-Qattan, M; Al Saleh, K; Al-Musallam, S, Masoud, G (2007). Knowledge and factors affecting breast self examination. Kuwait Medical J, 40, 2.
  7. Amin TT, Al Mulhim AR, Al Meqihwi A (2009). Breast cancer knowledge, risk factors and screening among adult Saudi women in a primary health care setting. Asian Pac J Cancer Prev, 10, 133-8.
  8. Azaiza F, Cohen M (2006). Health beliefs and rates of breast cancer screening among Arab women. J Women's Health (Larchmt), 15, 520-30.
  9. Azaiza F, Cohen M (2008). Between traditional and modern perceptions of breast and cervical cancer screenings: a qualitative study of Arab women in Israel. Psychooncology, 17, 34-41.
  10. Azaiza F, Cohen M, Awad M, Daoud F (2010). Factors associated with low screening for breast cancer in the Palestinian Authority: relations of availability, environmental barriers, and cancer-related fatalism. Cancer, 116, 4646-55.
  11. Baron-Epel O (2010). Attitudes and beliefs associated with mammography in a multiethnic population in Israel. Health Educ Behav, 37, 227-42.
  12. Bener A, Alwash R, Miller CJ, Denic S, Dunn EV (2001). Knowledge, attitudes, and practices related to breast cancer screening: a survey of Arabic women. J Cancer Educ, 16, 215-20.
  13. Bener A, Honein G, Carter AO, et al (2002). The determinants of breast cancer screening behavior: a focus group study of women in the United Arab Emirates. Oncol Nurs Forum, 29, 91-8.
  14. Bener A, El Ayoubi HR, Moore MA, et al (2009). Do we need to maximise the breast cancer screening awareness? Experience with an endogamous society with high fertility. Asian Pac J Cancer Prev, 10, 599-604.
  15. CDC AIDS Community Demonstration Projects Research Group. (1999). The CDC AIDS community demonstration projects: a multi-site community-level intervention to promote HIV risk reduction. Am J Pub Health, 89, 336-45.
  16. Cheek J, Fuller J, Gilchrist S, Maddock A, Ballantyne A (1999). Vietnamese women and Pap smears: issues in promotion. Aust NZJ Pub Health, 23, 72-6.
  17. Cochran, W. B. Sampling Techniques (Third ed.). Wiley. 1977.
  18. Cohen M, Azaiza F (2005). Early breast cancer detection practices, health beliefs, and cancer worries in Jewish and Arab women. Prev Med, 41, 852-8.
  19. Dandash KF, Al-Mohaimeed A (2007). Knowledge, attitudes, and practices surrounding breast cancer and screening in female teachers of Buraidah, Saudi Arabia. Int J Health Sci, 1, 61-71.
  20. Donnelly TT (2004). Vietnamese women living in Canada: Contextual factors affecting Vietnamese women's breast cancer and cervical cancer screening practices. doctoral dissertation. the university of British Columbia, Canada: Faculty of Interdisciplinary Studies.
  21. Donnelly TT (2006). The health-care practices of Vietnamese-Canadian women: cultural influences on breast and cervical cancer screening. Can J Nurs Res, 38, 82-101.
  22. Donnelly TT, McKellin W, Hislop G, Long B (2009). Socioeconomic influences on Vietnamese-Canadian women's breast and cervical cancer prevention practices: a social determinant's perspective. Soc Work Public Health, 24, 454-76.
  23. Donnelly TT, Al Khater A, Al-Bader SB, et al (2012). Breast cancer screening among Arabic women living in the state of qatar: awareness, knowledge, and participation in screening activities. Avicenna. Open Access: [].
  24. Donnelly TT, Al-Khater A, Bujassoum Al-Bader S, et al (2013). Arab women's breast cancer screening practices: a literature review. Asian Pac J Cancer Prev, 14, 4519-28.
  25. Dow Meneses K, Yarbro CH (2007). Cultural perspectives of international breast health and breast cancer education. J Nurs Scholarsh, 39, 105-12.
  26. Edwards N, Mill J, Kothari AR (2004). Multiple intervention research programs in community health. Can J Nurs Res, 36, 40-54.
  27. El Hajj MS, Hamid Y (2011). Breast cancer health promotion in Qatar: a survey of community pharmacists' interests and needs. Int J Clin Pharm, 33, 70-9.
  28. El Saghir NS, Khalil MK, Eid T, et al (2007). Trends in epidemiology and management of breast cancer in developing Arab countries: a literature and registry analysis. Int J Surg, 5, 225-33.
  29. Gursoy AA, Hindistan S, Nural N, et al (2009). Comparison of three educational interventions on breast self-examination knowledge and health beliefs. Asian Pac J Cancer Prev, 10, 765-72.
  30. Haji-Mahmoodi M, Montazeri A, Jarvandi S, et al (2002). Breast self-examination: knowledge, attitudes, and practices among female health care workers in Tehran, Iran. Breast J, 8, 222-5.
  31. Hartman E, van den Muijsenbergh ME, Haneveld RW (2009). Breast cancer screening participation among Turks and Moroccans in the Netherlands: exploring reasons for nonattendance. Eur J Cancer Prev, 18,349-53.
  32. Hoffman RM, Lewis CL, Pignone MP, et al (2010). Decisionmaking processes for breast, colorectal, and prostate cancer screening: the DECISIONS survey. Med Decis Making, 30, 53-64.
  33. IARC International Agency for Research Cancer, WHO. World cancer report 2008 and Global cancer statistics. [].
  34. Jaradeen, N (2010). Breast cancer risk-factors and breast self examination practice among Jordanian women. Bahrain Medical Bulletin, 32, 1.
  35. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90.
  36. Madanat H, Merrill RM (2002). Breast cancer risk-factor and screening awareness among women nurses and teachers in Amman, Jordan. Cancer Nurs, 25, 276-82.
  37. McPhee SJ, Stewart S, Brock KC, et al (1997). Factors associated with breast and cervical cancer screening practices among Vietnamese American women. Cancer Detect Prev, 21, 510-21.
  38. McPhee SJ, Nguyen TT (2000). Cancer, cancer risk factors, and community-based cancer control Trials in Vietnamese Americans. Asian Am Pac Isl J Health, 8, 18-31.
  39. McPhee SJ, Nguyen TT, Shema SJ, et al (2002). Validation of recall of breast and cervical cancer screening by women in an ethnically diverse population. Prev Med, 35, 463-73.
  40. Milaat WA (2000). Knowledge of secondary-school female students on breast cancer and breast self-examination in Jeddah, Saudi Arabia. East Mediterr Health J, 6, 338-44.
  41. Montazeri A, Vahdaninia M, Harirchi I, et al (2008). Breast cancer in Iran: need for greater women awareness of warning signs and effective screening methods. Asia Pac Fam Med, 7, 6.
  42. Nasseri K (2009). Breast cancer in the Middle Eastern population of California, 1988-2004. Breast J, 15, 182-8. Erratum in: Breast J. 2009 May-Jun;15, 325. Breast J. 2009 May-Jun; 15, 324.
  43. Petro-Nustas WI (2001). Factors associated with mammography utilization among Jordanian women. J Transcult Nurs, 12, 284-91.
  44. Qatar Census. Final Results of Census 2010 [].
  45. Rashidi A, Rajaram SS (2000). Middle Eastern Asian Islamic women and breast self-examination. Needs assessment. Cancer Nurs, 23, 64-70.
  46. Ravert PK, Huffaker C (2010). Breast cancer screening in women: An integrative literature review. J Am Acad Nurse Pract, 22, 668-73.
  47. Ravichandran K, Al-Hamdan NA, Mohamed G (2011). Knowledge, attitude, and behavior among Saudis toward cancer preventive practice. J Family Community Med, 18, 135-42.
  48. Sadler GR, Dhanjal SK, Shah NB, et al (2001). Asian Indian women: knowledge, attitudes and behaviors toward breast cancer early detection. Public Health Nurs, 18, 357-63.
  49. Shirazi M, Champeau D, Talebi A (2006). Predictors of breast cancer screening among immigrant Iranian women in California. J Womens Health (Larchmt), 15, 485-506.
  50. Soskolne V, Marie S, Manor O (2007). Beliefs, recommendations and intentions are important explanatory factors of mammography screening behavior among Muslim Arab women in Israel. Health Educ Res, 22, 665-76.
  51. Tabar L, Vitak B, Chen HH, et al (2000). The Swedish Two-County Trial twenty years later. updated mortality results and new insights from long-term follow-up. Radiol Clin North Am, 38, 625-51.
  52. Tarabeia J, Baron-Epel O, Barchana M, et al (2007). A comparison of trends in incidence and mortality rates of breast cancer, incidence to mortality ratio and stage at diagnosis between Arab and Jewish women in Israel, 1979-2002. Eur J Cancer Prev, 16, 36-42.
  53. Tavafian SS, Hasani L, Aghamolaei T, Zare S, Gregory D (2009). Prediction of breast self-examination in a sample of Iranian women: an application of the Health Belief Model. BMC Womens Health, 9, 37.
  54. Watters JK, Biernacki P (1989). Targeted sampling: Options and considerations for the study of hidden populations. Social Problems, 36, 416-30.
  55. Yavari P, Hislop TG, Bajdik C, et al (2006). Comparison of cancer incidence in Iran and Iranian immigrants to British Columbia, Canada. Asian Pac J Cancer Prev, 7, 86-90.

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