Breast cancer screening attitudes, beliefs, and behaviors of Zuni Pueblo women: identifying cornerstones for building effective mammogram screening intervention programs

Kate Cartwright; Deborah Kanda; Mikaela Kosich; Judith Sheche; Samantha Leekity; Nicholas Edwardson; V Shane Pankratz; Shiraz I Mishra

doi:10.1007/s10552-023-01814-8

Breast cancer screening attitudes, beliefs, and behaviors of Zuni Pueblo women: identifying cornerstones for building effective mammogram screening intervention programs

Cancer Causes Control. 2024 Apr;35(4):583-595. doi: 10.1007/s10552-023-01814-8. Epub 2023 Nov 9.

Authors

Kate Cartwright¹, Deborah Kanda², Mikaela Kosich², Judith Sheche², Samantha Leekity², Nicholas Edwardson³, V Shane Pankratz^{2

4}, Shiraz I Mishra^{2

5}

Affiliations

¹ School of Public Administration, University of New Mexico, Albuquerque, NM, USA. kcartwright@unm.edu.
² Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA.
³ School of Public Administration, University of New Mexico, Albuquerque, NM, USA.
⁴ Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA.
⁵ Departments of Pediatric and Family and Community Medicine, University of New Mexico, Albuquerque, NM, USA.

Abstract

Purpose: Breast cancer is the leading form of cancer and has the second highest mortality rate of cancers for American Indian/Alaska Native (AI/AN) women. Early screening is critical. This study examines the breast cancer-related knowledge, beliefs, and behaviors of Zuni women in the Southwest United States (U.S.).

Methods: In 2020 and 2021, a survey was administered to better understand cancer screening patterns in Zuni Pueblo; 110 women from 50 to 75 years of age were recruited to respond to the breast cancer screening portion. Inclusion criteria included self-identifying as AI, a member of the Zuni tribe, or married to a Zuni tribal member, and meeting the age and gender requirements. Descriptive statistics and bivariate analyses were conducted examining the associations between measures of breast cancer knowledge, beliefs, and behaviors and breast cancer screening status (never, ever/non-compliant, and ever/compliant).

Results: Of survey participants, 47.3% have had a breast cancer screening and are up-to-date, 39.1% have had a screening in the past but are not up-to-date, and 13.6% have never been screened. Age was the only statistically significant socioeconomic predictor of breast cancer screening; the median (interquartile range) ages of each group are 62 (54, 68) ever/compliant, 56 (54, 68) ever/non-compliant, and 53 (51, 55) never (p-value < 0.001). Significant differences by health status and access to medical care include having a regular health care provider and going to see a provider for routine check-ups. The survey also shows differences in knowledge about breast cancer risk factors, beliefs, and behaviors. Women across all three screening statuses reported that they would get screened if encouraged by a health care provider.

Conclusion: While survey respondents report a relatively high rate of ever having had a breast cancer screening, less than half are compliant with screening guidelines, which shows there is an opportunity to improve breast cancer screening rates. With culturally tailored interventions, providers have the potential to improve breast cancer screening for Zuni women.

Keywords: American Indian/Alaska Native health; Breast cancer screening; Health equity.

MeSH terms

Breast Neoplasms* / diagnosis
Breast Neoplasms* / prevention & control
Early Detection of Cancer
Female
Health Knowledge, Attitudes, Practice
Humans
Indians, North American*
Mammography
Mass Screening
Patient Acceptance of Health Care

Abstract

MeSH terms

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