Evaluating the Sociocultural Barriers Impacting Cervical and Breast Cancer Screening Among Nepali and Bhutanese Women in the Dallas-Fort Worth Metroplex

Despite widely accessible screening, cervical and breast cancer remain prevalent diseases, especially amongst Nepali women. The Dallas-Fort Worth Metroplex in Texas is home to one of the largest Nepali immigrant communities in the United States. This study seeks to understand barriers preventing this population from accessing preventative reproductive healthcare. A mixed-methods survey assessing health beliefs and reproductive cancer screening utilization was completed in English by 58 women and in Nepali by 4 women. Despite most participants reporting knowledge of the importance of reproductive cancer screening (94% breast cancer, 87% cervical cancer, 74% HPV), the rates of receiving obstetric and gynecologic care in the past year (57%), receiving a cervical exam (42%), breast exam (29%), and history of HPV vaccination (47%) were low in comparison. One-way ANOVA showed a significant difference in reproductive health knowledge and having ever seen an OBGYN (p = .018). Education did not correlate with cancer screening behavior as measured by the Health Belief Model (Susceptibility: p = 0.091, Severity: p = 0.141, Barriers: p = 0.38, Benefits: p = 0.22). Free-response results yielded comments about modesty, cultural competency, and praise for the American healthcare system as it compares to foreign medical systems. There is a discrepancy between the DFW Nepali immigrant community's reproductive knowledge and their reproductive healthcare utilization. Healthcare providers in DFW should consider exam modification and community outreach to encourage Nepali women to receive cancer screenings and ultimately reduce morbidity and mortality of reproductive cancers in this population.