Barriers that Cause Delayed Breast Cancer Screenings Among Older Adult African-American Women: An Integrative Literature Review

Abstract Background: In the U.S., breast cancer incidence has increased among older adult African-American women, particularly among those aged 60 to79 while white women have either decreased or stabilized (CDC, 2016). Within the last 10 years, breast cancer mortality rates are approximately 40% higher among African-American women compared to white women (CDC, 2016). Many barriers limit breast cancer screenings among this population. Recognizing and addressing specific barriers may improve utilization of breast cancer screenings in the future. Objective: The purpose of this study was to identify barriers that caused delayed breast cancer screenings among older adult African-American women. Method: The framework for the integrative literature review was by Whitmore and Knafl’s methodology (2005). Sources were collected from the following databases: PubMed, CINAHL, ProQuest, and Cochrane. Results: After examining the literature, a total of seven studies met the inclusion and exclusion criteria from the years 2006-2016. Common barriers found were limited health literacy/health beliefs, lack of health insurance/cost, fear, inadequate number of cultural competent health care providers, access to transportation and inaccessibility to screening locations, had a significant effect on older adult African-American women delaying breast cancer screenings. Conclusion: Findings suggest that fear was determined the number one barrier why older adult African-American women delayed breast cancer screenings. Future studies need to explore the relationship between the patient’s fear and delayed breast cancer screenings. One possible intervention noted was for nurses to provide culturally congruent care in obtaining breast cancer screenings on time. Efforts targeted at detecting breast cancer at an earlier stage will more than likely improve the outcome of the disease