Breast Cancer and Screening

Arab American women have a more aggressive breast cancer phenotype, measured in survival rates, outcomes, and diagnosis stages comparatively across Arab-American, European-American, and African-American women. Arab American women have the highest survival rates for breast cancer but yet were similar in “state, age, and hormone receptors status at diagnosis” to African American women. In comparing estrogen-receptor (ER) to progesterone-receptor (PR) status, Arab American women were more likely to have ER disease than European-American women, and compared with both groups are more likely to have small tumors and positive nodes. This distinct disease phenotype was expected to result in lower survival rates, however, this is not the case, and more studies would need to be done to find out why. One publication identifies the difficulties in conducting these studies, noting that “because Arab ethnicity has been grouped with “Caucasian” in US government population-based data collection efforts, we cannot identify the age structure or total population of Arab–Americans in Detroit or elsewhere in the US. Even if we use self-reported country of origin or language spoken at home, the population estimates are most likely an undercount” (Hensley et al., 2008).

More studies are needed regarding MENA Americans and breast cancer, as there are cultural factors that may prohibit seeking screening. Alkhaifi has identified 5 factors that contribute to this decision: “fatalism, modesty, perceived spousal support, and receiving physician recommendations and mammogram utilization” (Alkhaifi, 2022). For example, a husband’s attitude toward his wife’s health-seeking behaviors has a significant influence on whether or not Muslim Arab women will seek screening. Modesty is also a cultural value that is very prevalent in Muslim and Arab women’s cultures. These women might be embarrassed to talk about breast health or be examined by a doctor, which prevents them from coming to a screening. However, a physician's recommendation to receive a mammogram might be a cue to action that can help these women seek screening and care for their health. Overall, more studies should be done with reliable samples to assess how to best encourage health among Muslim Arab women.