Tailored Interventions Are Needed to Reduce Barriers to Breast Cancer Screening in Jordan

Breast Cancer | Image Credit:
© Sebastian Kaulitzki – stock.adobe.com

Results from a survey of women from Jordan identified individual and non-individual factors as contributors to barriers to breast cancer screening. Findings were presented at the 50th Annual Oncology Nursing Congress.1

Findings from the survey showed that the rate of participation in breast cancer screening activities—including routine self-exams, clinical evaluations, and mammograms—was low among the study participants (n = 650). Women who completed the survey pinpointed Individual determinants contributing to lack of participation in breast cancer screening, including uneasiness with one’s own body (µ = 3.44), mammogram-related barriers (µ = 3.04), and exposure barriers (µ = 2.89). Notably, health motivation was associated as a determinant with a high level of perception (µ = 3.73).

Non-individual barriers to breast cancer screening identified by study participants comprised perceived environmental factors (µ = 2.80), influence of religious beliefs regarding cancer (µ = 2.88), and perceived social barriers (µ = 3.65).

“The findings highlight the need for tailored interventions to address these barriers and improve women’s enrollment in [breast cancer] screening,” lead study author Anas Alsharawneh, RN, MSN, ONS, PhD, wrote in a poster presentation of the data. “Breast cancer campaign planners must address personal and internal factors, [as well as] cultural and social norms, [to] improve access to information and resources to increase awareness and encourage participation in [breast cancer] screening activities.”

Alsharawneh is an assistant professor, Faculty of Nursing, at the Hashemite University in Zarqa, Jordan.

Data have demonstrated the improvements in overall survival (OS) associated with screening for breast cancer, which represents approximately 20% of all cancer cases in Jordan.

For example, findings from a retrospective study conducted in Sweden analyzing incidence and survival data for women diagnosed with breast cancer between 1992 and 2016 who received 1 to 5 invitations to screening before diagnosis (n = 37,079).2 Data demonstrated that 4564 of these patients died due to breast cancer, and patients who participated in all 5 screenings experienced a 20-year OS rate of 86.9% compared with 68.9% among patients who did not participate in any screenings prior to diagnosis (HR, 0.28; 95% CI, 0.25-0.33; P < .0001). The HR was 0.34 (95% CI 0.26-0.43; P < .0001) when adjusted for potential self-selection factors.

According to the Centers for Disease Control and Prevention, the US Preventive Services Task Force recommends women between the 40 and 74 years of age who are at average risk for breast cancer should receive a mammogram every 2 years.3

The American Cancer Society (ACS) Guidelines reflect more stringent screening recommendations, with the organization recommending that women at average risk undergo annual mammograms starting between the ages of 45 and 54 years, after having the option to begin annual mammograms at 40 years of age.4 The ACS Guidelines allow for women 55 years of age and older to switch to receiving a mammogram once every 2 years, although continued annual exams are also recommended.

However, worldwide screening rates for breast cancer and other tumor types remain below acceptable levels, according to Alsharawneh. Regarding breast cancer screening in particular, he explained that women in Jordan and around the globe face barriers that can impact the registration for and completion of breast cancer screening.

To better elucidate the specific factors contributing to barriers to breast cancer screening, this study utilized a cross-sectional design to survey women from Jordan regarding these obstacles. Survey participants included women from multiple cities and settings across the country.

Disclosures: Alsharawneh did not report any financial conflicts of interest.

References

1. Alsharawneh A. Factors hindering women's participation in breast cancer screening services. Presented at: 50th Annual Oncology Nursing Society Congress; April 9-13, 2025; Denver, CO. Abstract RS6.
2. Duffy SW, Yen AM, Tabar L, et al. Beneficial effect of repeated participation in breast cancer screening upon survival. J Med Screen. 2024;31(1):3-7. doi:10.1177/09691413231186686
3. Screening for breast cancer. Centers for Disease Control and Prevention. September 16, 2024. Accessed April 10, 2025. https://www.cdc.gov/breast-cancer/screening/index.html
4. American Cancer Society recommendations for the early detection of breast cancer. American Cancer Society. December 19, 2023. Accessed April 10, 2025. https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html