Asian Pacific Journal of Cancer Prevention, Vol 7, 2006 509 Barriers for Breast Cancer Screening Among Asian Women Asian Pacific J Cancer Prev, 7, 509-514 MINI-REVIEW Introduction Breast cancer is the most common cancer in women in most parts of the world, but there is a marked geographic variation in the incidence in different countries. The incidence is highest in Northern Europe and North America, intermediate in Mediterranean countries and South America, and lowest in Asia and Africa (Ferlay et al., 2001). Globally the total number of new cases of breast cancer currently exceeds 1 million, and this figure is expected to reach 1.5 million by the end of decade because of major increases in the number of cases in countries with limited resources (Parkin, 2005). By 2010, total annual number of cases in countries with limited resources will exceed the number in developed countries (Parkin, 2005). In Asian countries breast cancer is the most commonly diagnosed cancer among women. According to the National Cancer Registries in different Asian countries, the crude incidence rate of breast cancer varied from 21.3 per 100,000 population in Jordan, 21.4 in Iran, 24.1 in Turkey, 34.86 in Malaysia , 48 in Japan to 54 per 100,000 population in Singapore (Ferlay, 2001; Petro-Nustus, 2002; Harirchi, 2004; Secginli, 2006; Hisham, 2004). Breast cancer occurs in the younger age group of Asian women, 40 to 49 years-old compared to the West, where the peak prevalence is seen between 50 to 59 years. Studies done in Singapore (Yip and Ng, 1996), Malaysia (Hisham Barriers for Breast Cancer Screening Among Asian Women: A Mini Literature Review Parisa Parsa 1 *, Mirnalini Kandiah 2 , H Abdul Rahman 3 , NA Mohd Zulkefli 3 1 Department of Maternal and Child Health, Hamedan University of Medicine and Health Sciences, Iran, 2 Department of Nutrition and Dieticians, and 3 Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia. *For Correspondence: Tel: +60176573574 Email: PParsa2003@yahoo.com Abstract Breast cancer is the most commonly diagnosed cancer among Asian women. Breast cancer is detected in advanced stages and among younger age group women in Asia. The delay in presentation is attributed mainly to the social- cultural perception of the disease, poverty, and the strong influence of traditional medicine. Many of Asian women are not aware of the importance of regular screening. Cultural attitudes toward breast cancer screening tests, modesty, lack of encouragement by family members and physicians are the major inhibitors to women’s participation in breast cancer screening. Health education using media and community health programs to create awareness of the advantages of earlier presentation and diagnosis of breast cancer in Asian women can motivate participation in breast cancer screening programs. Key Words: Asia - barriers - breast cancer screening - motivators and Yip, 2004), Iran (Harirchi et al., 2004), Thailand (Thongsuksal, 2000), Pakistan (Usmani et al., 1996) and Arab women in Palestine (Nissan et al., 2004), reported more than half of new cases of breast cancer were diagnosed in women below the age of 50 years and in advanced stages III, IV. The tumor mass at presentation is much larger, with either locally or metastatic as compared to reported in Western studies, where almost 75% of cases present in the early stages. The delay in presentation is attributed mainly to the social-cultural perception of the disease and screening tests, poverty, and the strong influence of Eastern medicine (Hisham and Yip, 2004; Rashidi and Rajaram, 2000). Breast cancer screening practices are low among Asian women. Only 3.8% in Malaysia (Hisham and Yip, 2004), 6% in Iran (Jarvandi et al., 2002), 7% in Jordan (Petro- Nustus, 2002), 12% in South Asia (Choudhry et al, 1998), and 16% in China (Fung et al., 1998) women reported performing BSE regularly, compared to Sweden where 70% of women aged 25-80 years examined their breasts regularly (Persson et al, 1997). Studies in South Asia showed that only 31.1% to 49% of women over than 40 years had undergone at least one clinical breast examination during their lifetime (Choudhry et al, 1998; Narimah, 1997). Mammography was carried out only in 3.8% of Malaysian women; and there was a significant difference in screening rates between urban and rural areas (50.6% versus 42.3% respectively, P<0.05) (Narimah, 1997). In another study in