Preventive Cancer Screening Among Resettled Refugee Women from Muslim-Majority Countries: A Systematic Review
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REVIEW PAPER
Preventive Cancer Screening Among Resettled Refugee Women from Muslim‑Majority Countries: A Systematic Review Hafifa Siddiq1 · Qais Alemi2 · Janet Mentes3 · Carol Pavlish3 · Eunice Lee3
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract As refugee populations continue to age in the United States, there is a need to prioritize screening for chronic illnesses, including cancer, and to characterize how social and cultural contexts influence beliefs about cancer and screening behaviors. This study examines screening rates and socio-cultural factors influencing screening among resettled refugee women from Muslim-majority countries of origin. A systematic and integrative review approach was used to examine articles published from 1980 to 2019, using PubMed, CINAHL, and PsycINFO. A total of 20 articles met the inclusion criteria. Cancer screening rates among refugee women are lower when compared to US-born counterparts. Social and cultural factors include religious beliefs about cancer, stigma, modesty and gender roles within the family context. The findings of this review, suggest that resettled refugee women underutilize preventive services, specifically mammography, Pap test and colonoscopy screening, and whose perceptions and behaviors about cancer and screening are influenced by social and cultural factors. Keywords Refugee · Cancer screening · Mammography · Colonoscopy · Cultural factors
Introduction Despite the increased uptake of cancer screening in nativeborn populations in the United States (US), foreign-born populations continue to underutilize cancer screening services [1]. Since 1980, more than 3 million refugees or * Hafifa Siddiq [email protected] Qais Alemi [email protected] Janet Mentes [email protected] Carol Pavlish [email protected] Eunice Lee [email protected] 1
Division of General Internal Medicine and Health Services Research, School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
2
School of Behavioral Health, Loma Linda University, 1898 Business Center Dr., San Bernardino, CA 92408, USA
3
School of Nursing, University of California, Los Angeles, Factor Bldg, 700 Tiverton Avenue, Los Angeles, CA 90095, USA
individuals fleeing their homelands from persecution have resettled in the US [2]. Ongoing political violence in Muslim-majority countries continues to increase the number of Muslim refugees resettling in the US and other industrialized nations. Refugees from predominantly Muslim countries, including Somalia, Iraq, Afghanistan, and Syria, represent over half of the entire world’s population of refugees [3], and Muslim refugees present with unique health beliefs and behaviors rooted in their respective cultures that are largely understudied [4]. Studies show that most refugees are unfamiliar with preventive health care, and for many providers, discussing preventive services, especially cancer screening, may not be a priority in early resettlement [4, 5]. As refugee populations continue to
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