Breast Cancer Risk Perception, Knowledge, Attitudes, Beliefs and Screening Behaviors of Chamorro Women in Guam

Background: Breast cancer is a serious public health issue in Guam and in the world. Chamorro women in Guam have the highest incidence and mortality rates of breast cancer among other ethnic groups of women living in Guam. Early detection reduces breast cancer morbidity and mortality. Little is known regarding factors associated with Chamorro women’s breast cancer screening behaviors. Purpose: This qualitative descriptive study was designed to obtain a straight forward description of perspectives and insights of Chamorro women in Guam ages 45 – 65 years, about their breast cancer risk perception, knowledge, attitudes, beliefs and breast cancer screening behaviors. Sample: A purposeful sample of 15 participants yielded broad insights and rich data regarding breast cancer risk perception, knowledge, attitudes, beliefs and breast cancer screening behaviors of Chamorro women. The sample size was determined by “data saturation”. Methods: The researcher conducted four focus group interviews to gain broad insight using open-ended questions. Interviews were audio-recorded, transcribed and analyzed using qualitative content analysis. Findings: Data analysis ascertained the following categories: risk perception, knowledge, attitudes, beliefs, behaviors including motivators, benefits and barriers towards breast cancer screening. Identified subcategories: perceived breast cancer risk as multiple family members’ diagnoses of breast cancer. Breast cancer knowledge was sparse with responses addressing not knowing about breast cancer, however, participants alluded that early detection towards breast cancer was the key to breast cancer screening. Cultural beliefs in suruhana/suruhano was not causing or treat cancer. Staying healthy by eating healthy foods and exercising were behaviors in living a healthy life as a breast cancer screening behavior. Screening motivators were knowing family or friends with breast cancer, mammogram reminders, and having a health insurance coverage. Overall there was a consensus of the benefits of mammogram and the need for early detection notwithstanding barriers such as painful mammograms, hurtful comments from health care providers. Conclusion: Findings contributes to literature and future studies about Chamorro women breast cancer risk perception, knowledge, attitudes, beliefs and behaviors as well as motivators, benefits and barriers to breast cancer screening. The study contributes to nursing knowledge and practice in understanding breast cancer in women and their families within the social context as Chamorros