The role of knowledge, language, and insurance in endorsement of cancer screening in women of African origin

Background: African women have lower use of cancer screening services compared to women born in the United States yet empirical data are limited about their cancer screening attitudes. Objective: To examine factors that are associated with higher endorsement of screening. Method: We conducted a cross-sectional study of 200 women of African origin recruited via community-based outreach activities in Washington, DC. Endorsement of screening was assessed via self-report. The primary independent variables were cancer knowledge and English-language proficiency. Information was also collected about access, cancer-related beliefs, and prior breast screening behaviors. Results: Most participants (60%) were ≥40 years of age, 54% were married, and 77% were insured. Participants more likely to endorse breast cancer screening were insured (vs. uninsured) (odds ratio = 3.37; 95% confidence interval: 1.24, 9.17) and married (odds ratio = 3.23; 95% confidence interval: 1.14, 9.10) controlling for other factors. The likelihood of endorsing screening was higher among participants with English as a primary language (odds ratio = 3.83; 95% confidence interval: 1.24, 11.87) and those with greater breast cancer knowledge (odds ratio = 1.04; 95% confidence interval: 1.01, 1.08, per 1 point increase). Conclusions: Average cancer knowledge in the sample was low as were non-conventional causes of cancer. Study results highlight the importance of improving cancer knowledge and reducing barriers related to language and insurance. Future studies are needed to consider nuances among diverse women of African origin