A comparison of breast cancer screening beliefs and barriers among Afghan and Syrian refugee women

PURPOSE: Breast cancer is the most frequently diagnosed cancer and the second leading cause of cancer-related death among women in the United States. Despite the documented effectiveness of early detection and treatment, disparities in healthcare access and low screening rates remain prevalent, particularly among refugee populations. This study aimed to assess breast cancer screening beliefs - including attitudes toward health checkups, knowledge about breast cancer - and perceived barriers to breast cancer screening among two specific refugee communities resettled in Houston, Texas. The study also examined the relationship between screening beliefs and post-migration stressors. METHODS: A cross-sectional study was conducted with 120 adult refugee women who completed the Breast Cancer Screening Beliefs Questionnaire (BCSBQ). Participants included women from two refugee groups, Syrian and Afghan. Group differences across BCSBQ domains were examined, and associations between screening beliefs, refugee origin, post-migration stressors, health insurance status, and family history of breast cancer were analyzed. RESULTS: Significant differences were found between the two refugee groups across all measures. Syrian women reported more favorable attitudes toward health checkups, greater knowledge of breast cancer and fewer perceived barriers to screening than Afghan women. Refugee origin was significantly correlated with all BCSBQ domains, with Afghan women showing lower scores across all areas. Additionally, health insurance and a family history of breast cancer were positively associated with improved screening beliefs. CONCLUSIONS: Findings highlight the influence of refugee background and healthcare access on breast cancer screening beliefs and underscore the need for culturally tailored outreach and interventions to promote early detection among refugee communities. Addressing structural barriers and enhancing culturally responsive education may improve screening engagement and reduce breast cancer disparities in these populations.