title: The role of knowledge, language, and insurance in endorsement of cancer screening in women of African origin.
abstract: BACKGROUND
  African women have lower use of cancer screening services compared to women born in the United States yet empirical data are limited about their cancer screening attitudes.
  
  
  OBJECTIVE
  To examine factors that are associated with higher endorsement of screening.
  
  
  METHODS
  We conducted a cross-sectional study of 200 women of African origin recruited via community-based outreach activities in Washington, DC. Endorsement of screening was assessed via self-report. The primary independent variables were cancer knowledge and English-language proficiency. Information was also collected about access, cancer-related beliefs, and prior breast screening behaviors.
  
  
  RESULTS
  Most participants (60%) were ≥ 40 years of age, 54% were married, and 77% were insured. Participants more likely to endorse breast cancer screening were insured (vs. uninsured) (odds ratio = 3.37; 95% confidence interval: 1.24, 9.17) and married (odds ratio = 3.23; 95% confidence interval: 1.14, 9.10) controlling for other factors. The likelihood of endorsing screening was higher among participants with English as a primary language (odds ratio = 3.83; 95% confidence interval: 1.24, 11.87) and those with greater breast cancer knowledge (odds ratio = 1.04; 95% confidence interval: 1.01, 1.08, per 1 point increase).
  
  
  CONCLUSIONS
  Average cancer knowledge in the sample was low as were non-conventional causes of cancer. Study results highlight the importance of improving cancer knowledge and reducing barriers related to language and insurance. Future studies are needed to consider nuances among diverse women of African origin.
authors: Breast Cancer Program and Office of Minority Health and Health Disparities, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, Washington, DC, United States.
authors: Vanessa B
authors: VB
authors: Sheppard
authors: Breast Cancer Program and Office of Minority Health and Health Disparities, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, Washington, DC, United States.
authors: Alejandra
authors: A
authors: Hurtado-de-Mendoza
authors: Breast Cancer Program and Office of Minority Health and Health Disparities, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, Washington, DC, United States.
authors: Minna
authors: M
authors: Song
authors: Breast Cancer Program and Office of Minority Health and Health Disparities, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, Washington, DC, United States.
authors: Fikru
authors: F
authors: Hirpa
authors: African Women's Cancer Awareness Association, Silver Spring, MD, United States.
authors: Ify
authors: I
authors: Nwabukwu
keywords: African immigrants; Breast cancer; Prevention