Breast cancer is the most commonly occurring cancer in women and the second most common cancer overall. More than 2 million cases were diagnosed in 2018 worldwide. (“Breast cancer statistics,” 2018) Genetic factors constitute about 80% of the major risk factor leading to cancer. Specifically, BRCA 1 and BRCA 2 gene mutations are responsible for malignancy (Feng et al., 2018) Breast cancer occurs very rarely in men due to incomplete development of breast without mammary glands and extremely low levels of estrogen, the hormone responsible for stimulation of breast cells. (“Breast Cancer Risk Factors,” n.d.) Other risk factors are aging, having dense breasts, radioactive therapy, use of drugs containing Diethylstilbestrol (DES), previous history of breast cancer, positive family history, long reproductive period. These set of risk factors cannot be changed. Those that can be changed are physical inactivity, improper intake of hormones, improper reproductive history like avoiding breastfeeding, consumption of alcohol and obesity control. (“CDC – What Are the Risk Factors for Breast Cancer?” 2018).
The signs of breast cancer are new lump on breast or arm pits, discharge from nipples except for milk, pain, reddish or flaky skin on nipples or breast, pulling in of nipples, Thickening or swelling in any part of the breast and change in size and shape of the breasts. However, sometimes the signs may occur due to any other disease. (“CDC – What Are the Symptoms of Breast Cancer?” 2018) Procedures treating breast cancer results in severe psychological suffering, anxiety, financial hardships depression and disfigurement. Sometimes life threatening too (Guilford, McKinley, & Turner, 2017). Hence, it is better to diagnose the disease in first place through readily available screening procedures to save lives rather than going through all the pain and suffering after having the disease.
According to ACS guidelines, women from the age 40- 45 years should undergo mammography annually till 50 years and the following years biennially. In 2018,266120 cases of invasive cancer are diagnosed and 40920 deaths are reported in USA. Age- adjusted mortality decreased from 1989-2015 with 322600 deaths averted through screening procedures. The favorable statistics are not evenly distributed. Through 2010-2015 death rates are 42% more in African Americans than whites. (Smith et al., 2018). But the new incidence rates are low in African Americans than Whites (“Comparing Breast Cancer Screening Rates Among Different Groups | Susan G. Komen®,” n.d.)
There are several barriers associated with withdrawal of participation from the screening, the first one being health insurance, 68% of those with insurance has undergone screening procedures compared to 31% with no health insurance. There are other barriers as well like lack of closest screening centers, lack of availability of health care provider, difficulty to get sick leaves, lack of child care, lack of awareness, lack of income and fear of bad news, cultural and language differences (“Comparing Breast Cancer Screening Rates Among Different Groups | Susan G. Komen®,” n.d.)
According to the fact sheet 2015 by ACS there are differences in prevalence of mammography in women from 40years older in a way that NHW stands 50%,
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