Barriers to early detection of breast cancer among women in a Caribbean population

ABSTRACT

The purpose of this descriptive study was to identify and describe barriers to early detection of breast cancer, as well as current breast cancer screening behaviors and attitudes regarding the disease, among women aged 20 and older on the Caribbean island of Tobago. Tobago is the smaller of the two islands that make up the nation of Trinidad and Tobago. Between February and June 1996, 265 women fitting the age criteria completed a structured survey questionnaire. Women of African descent made up 89 percent of the respondents. In terms of age, 48 percent of those surveyed were between 20 and 39, 40 percent were between 40 and 59, and 12 percent were 60 or older. Barriers to early detection identified were a low level of breast self-examination, infrequent clinical breast examination as part of regular care, unavailability of mammography services in Tobago, cost of screening, and difficulty of travelling to Trinidad for mammography. Furthermore, only a minority of the study participants had ever attended early detection or public awareness programs. The results were nearly the same for individuals with a family history of breast cancer, who would have higher risk of occurence of the disease. In addition, the majority of the respondents reported what can be considered a cultural barrier to early detection practices, a belief that no matter what they did, if they were to get breast cancer, they would get it. The authors recommend that mammography services be made available on Tobago. The authors also intend to use the findings to help develop an appropriate, culturally sensitive breast cancer awareness and early detection program for women on the island (AU)