Perceived Barriers to Breast Cancer Screening Utilization Among Women in the United Arab Emirates: A Cross-Sectional Study
Abstract
Background: Breast cancer remains the leading cause of cancer-related deaths among women worldwide, with incidence rising due to population growth. Despite global efforts, barriers hinder screening utilization, including financial constraints, low awareness, cultural factors, fear, and psychological concerns. This study aims to identify the perceived barriers to breast cancer screening utilization among women in the United Arab Emirates.
Methods: A cross-sectional study was conducted among women aged 20 and above in the United Arab Emirates. A self-administered data collection form was used to assess sociodemographic, breast cancer screening utilization, and perceived barriers. Data were analyzed using chi-square tests and logistic regression, with p <0.05 considered significant.
Results: A total of 959 women participated. Significant associations were observed between perceived barriers, such as lack of knowledge, fear or anxiety, cost or insurance coverage, and lack of physician recommendation, and breast cancer screening utilization. Unemployment was a significant predictor of perceiving lack of physician recommendation as a barrier (aOR=4.339, 95% CI: 2.036-9.248, p <0.001). Young women (< 40 years) (aOR=1.585, 95% CI: 1.108-2.267, p=0.012) and being married (aOR=1.588, 95% CI: 1.077-2.341, p=0.019) were significant predictors of perceiving a lack of knowledge as a barrier.
Conclusion: These findings emphasize the interplay between sociodemographic factors and perceived barriers to breast cancer screening. Addressing the lack of physician recommendations, improving awareness, and reducing financial and accessibility constraints are crucial for increasing screening uptake. Community initiatives can enhance early detection and reduce the breast cancer burden.
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References
Breast cancer. Who.int. Available from: https://www.who.int/news-room/fact-sheets/detail/breast-cancer
Arnold M, Morgan E, Rumgay H, Mafra A, Singh D, Laversanne M, et al. Current and future burden of breast cancer: Global statistics for 2020 and 2040. Breast. 2022;66:15–23. Available from: http://dx.doi.org/10.1016/j.breast.2022.08.010
Al-Awadhi A, Iqbal F, Kourie HR, Al-Shamsi HO. Breast cancer in the UAE. In: Cancer Care in the United Arab Emirates. Singapore: Springer Nature Singapore; 2024. p. 417–34. Available from: http://dx.doi.org/10.1007/978-981-99-6794-0_26
Pellom ST Jr, Arnold T, Williams M, Brown VL, Samuels AD. Examining breast cancer disparities in African Americans with suggestions for policy. Cancer Causes Control. 2020;31(9):795–800. Available from: http://dx.doi.org/10.1007/s10552-020-01322-z
Advani P, Advani S, Nayak P, VonVille HM, Diamond P, Burnett J, et al. Racial/ethnic disparities in use of surveillance mammograms among breast cancer survivors: a systematic review. J Cancer Surviv. 2022;16(3):514–30. Available from: http://dx.doi.org/10.1007/s11764-021-01046-2
Zavala VA, Bracci PM, Carethers JM, Carvajal-Carmona L, Coggins NB, Cruz-Correa MR, et al. Cancer health disparities in racial/ethnic minorities in the United States. Br J Cancer. 2021;124(2):315–32. Available from: http://dx.doi.org/10.1038/s41416-020-01038-6
Bakarman M, Kalthoum D, Wahby Salem I, Alshuaibi RO, Almohammadi TA, Beser RA, et al. Barriers to using breast cancer screening methods among adult females in Jeddah, Saudi Arabia: A cross-sectional study. Cureus. 2023;15(7):e41739. Available from: http://dx.doi.org/10.7759/cureus.41739
Cataneo JL, Meidl H, Ore AS, Raicu A, Schwarzova K, Cruz CG. The impact of limited language proficiency in screening for breast cancer. Clin Breast Cancer. 2023;23(2):181–8. Available from: http://dx.doi.org/10.1016/j.clbc.2022.11.008
Huf S, Humphrey A, Darzi A, Cunningham D, King D, Judah G. A population survey on barriers and facilitators to breast cancer screening based on the Theoretical Domains Framework. Behav Sci (Basel). 2025;15(2). Available from: http://dx.doi.org/10.3390/bs15020209
Ponce-Chazarri L, Ponce-Blandón JA, Immordino P, Giordano A, Morales F. Barriers to breast cancer-screening adherence in vulnerable populations. Cancers (Basel). 2023;15(3):604. Available from: http://dx.doi.org/10.3390/cancers15030604
Wu Z, Liu Y, Li X, Song B, Ni C, Lin F. Factors associated with breast cancer screening participation among women in mainland China: a systematic review. BMJ Open. 2019;9(8):e028705. Available from: http://dx.doi.org/10.1136/bmjopen-2018-028705
Miller BC, Bowers JM, Payne JB, Moyer A. Barriers to mammography screening among racial and ethnic minority women. Soc Sci Med. 2019;239(112494):112494. Available from: http://dx.doi.org/10.1016/j.socscimed.2019.112494
Adunlin G, Cyrus JW, Asare M, Sabik LM. Barriers and facilitators to breast and cervical cancer screening among immigrants in the United States. J Immigr Minor Health. 2019;21(3):606–58. Available from: http://dx.doi.org/10.1007/s10903-018-0794-6
Rollet Q, Tron L, De Mil R, Launoy G, Guillaume É. Contextual factors associated with cancer screening uptake: A systematic review of observational studies. Prev Med. 2021;150(106692):106692. Available from: http://dx.doi.org/10.1016/j.ypmed.2021.106692
Dehghan Haghighi J, Hormozi M, Sargolzaee N, Izadirad H, Hamdollahi F. Barriers to mammographic screening of breast cancer in women: A cross-sectional study in Southeastern Iran: Barriers to mammography screening. Arch Breast Cancer. 2022;174–8. Available from: https://www.archbreastcancer.com/index.php/abc/article/view/493
Afaya A, Ramazanu S, Bolarinwa OA, Yakong VN, Afaya RA, Aboagye RG, et al. Health system barriers influencing timely breast cancer diagnosis and treatment among women in low and middle-income Asian countries: evidence from a mixed-methods systematic review. BMC Health Serv Res. 2022;22(1):1601. Available from: http://dx.doi.org/10.1186/s12913-022-08927-x
Joho AA, Mdoe MB, Masoi TJ, Yahaya JJ. Perceived barriers and factors influencing uptake of breast cancer screening among women: a population-based cross-sectional study. Sci Rep. 2024;14(1):12291. Available from: http://dx.doi.org/10.1038/s41598-024-62218-5
Alsalamh R, Al-Harbi FA, Alotaibi RT, Al-Harbi ON, Alshahrani N, Alfadhel SM, et al. Barriers to breast cancer screening in Saudi Arabia: A systematic review and meta-analysis. Cureus. 2024;16(7):e65103. Available from: http://dx.doi.org/10.7759/cureus.65103
Castaldi M, Smiley A, Kechejian K, Butler J, Latifi R. Disparate access to breast cancer screening and treatment. BMC Women's Health. 2022;22(1):249. Available from: http://dx.doi.org/10.1186/s12905-022-01793-z
Alenezi AM, Thirunavukkarasu A, Wani FA, Alenezi H, Alanazi MF, Alruwaili AS, et al. Female healthcare workers’ knowledge, attitude towards breast cancer, and perceived barriers towards mammogram screening: A multicenter study in north Saudi Arabia. Curr Oncol. 2022;29(6):4300–14. Available from: http://dx.doi.org/10.3390/curroncol29060344
Mohamed N, Al Falasi A, Farghaly S, Majdi N, Naqibullah M, Adel Y, editors. Knowledge, Attitude and Practice of Female Residents about Breast Cancer in the United Arab Emirates (UAE): A Cross-sectional Study. International Journal of Current Research. 17(02):31787–94. Available from: https://journalcra.com/article/knowledge-attitude-and-practice-female-residents-about-breast-cancer-united-arab-emirates
Albadawi RS, Alsharawneh A, Othman EH. Determinants and barriers to women’s participation in breast cancer screening activities in Jordan: an in-depth study. BMC Public Health. 2025;25(1):1339. Available from: http://dx.doi.org/10.1186/s12889-025-22611-9
Câmara AB, Moraes Luizaga CT de, Pereira Baltar Cury LC, Contreras CAH, López RVM, Duarte LS, et al. The influence of sociodemographic factors on barriers to breast cancer screening: A cross-sectional study. Cancer Epidemiol. 2025;97(102852):102852. Available from: http://dx.doi.org/10.1016/j.canep.2025.102852
Othman G, Ali F, Mudathir M, Almoliky H, Al-Qahtani M, Alezzi N, et al. Awareness of breast cancer and perceived barriers to breast screening methods: a community-based cross-sectional study among women in Yemen. Discov Oncol. 2024;15(1):692. Available from: http://dx.doi.org/10.1007/s12672-024-01419-w
Abdulelah ZA, Abdulelah AA, AlQirem L, AlSamhori J, Al-Qirem A, AlSamhori AR. Barriers to breast cancer screening in a developing Middle Eastern country: A nationwide survey. J Clin Oncol. 2023;41(16_suppl):e22517–e22517. Available from: http://dx.doi.org/10.1200/jco.2023.41.16_suppl.e22517
Abdullah N, Baharudin N, Mohamad M, Mohamed-Yassin M-S. Factors associated with screening mammogram uptake among women attending an urban university primary care clinic in Malaysia. Int J Environ Res Public Health. 2022;19(10):6103. Available from: http://dx.doi.org/10.3390/ijerph19106103
M Salama BM. Factors affecting mammography screening utilization among educated women in Al Beheira governorate, Egypt. Indian J Community Med. 2020;45(4):522–5. Available from: https://journals.lww.com/ijcm/fulltext/2020/45040/factors_affecting_mammography_screening.28.aspx
Magwesela FM, Msemakweli DO, Fearon D. Barriers and enablers of breast cancer screening among women in East Africa: a systematic review. BMC Public Health. 2023;23(1):1915. Available from: http://dx.doi.org/10.1186/s12889-023-16831-0
Jaafar Sidek MA, Amajid K, Loh YS, Rosli MA, Hashim IS, Mohd Suffian NA, et al. The prevalent factors of anxiety in women undergoing mammography. Front Psychiatry. 2023;14:1085115. Available from: http://dx.doi.org/10.3389/fpsyt.2023.1085115
Hughes DR, Espinoza W, Fein S, Rula EY, McGinty G. Patient cost-sharing and utilization of breast cancer diagnostic imaging by patients undergoing subsequent testing after a screening mammogram. JAMA Netw Open. 2023;6(3):e234893. Available from: http://dx.doi.org/10.1001/jamanetworkopen.2023.4893
Mottram R, Knerr WL, Gallacher D, Fraser H, Al-Khudairy L, Ayorinde A, et al. Factors associated with attendance at screening for breast cancer: a systematic review and meta-analysis. BMJ Open. 2021;11(11):e046660. Available from: https://bmjopen.bmj.com/content/11/11/e046660
Abdel-Salam DM, Mohamed RA, Alyousef HY, Almasoud WA, Alanzi MB, Mubarak AZ, et al. Perceived barriers and awareness of mammography screening among Saudi women attending primary health centers. Risk Manag Healthc Policy. 2020;13:2553–61. Available from: https://www.dovepress.com/perceived-barriers-and-awareness-of-mammography-screening-among-saudi--peer-reviewed-fulltext-article-RMHP
Anaba EA, Alor SK, Badzi CD, Mbuwir CB, Muki B, Afaya A. Drivers of breast cancer and cervical cancer screening among women of reproductive age: insights from the Ghana Demographic and Health Survey. BMC Cancer. 2024;24(1):920. Available from: http://dx.doi.org/10.1186/s12885-024-12697-6
Ilodianya C, Williams MS. Young Black women’s breast cancer knowledge and beliefs: A sequential explanatory mixed methods study. J Racial Ethn Health Disparities. 2024; Available from: http://dx.doi.org/10.1007/s40615-024-02208-5
Elbarazi I, Alam Z, Abdullahi AS, Al Alawi S, AlKhanbashi M, Rabaa A, et al. Knowledge, attitudes and practices of women in the UAE towards breast and cervical cancer prevention: A cross-sectional study. Cancer Control. 2023;30:10732748231211459. Available from: http://dx.doi.org/10.1177/10732748231211459
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