Factors influencing breast and cervical cancer control in ethnically diverse groups of women

Utilization of breast and cervical cancer control behaviours in Australia is less than optimal, particularly amongst Eastern European and Arabic populations. Psychosocial factors have generally been found to predict cancer control uptake, yet little is known of the role of these factors amongst these ethnic populations. Guided by comprehensive health behavior theories, this research assessed the associations of cognitive and affective psychosocial variables to the utilization of breast and cervical cancer control behaviours among Croatian-, Lebanese-, Macedonian- and Australian-born women. In the absence of appropriate measures, the Revised Illness Perception Questionnaire for healthy people (IPQ-RH) was empirically validated in the Arabic, Croatian and English languages for breast and cervical cancer contexts. Across several studies (total N = 904) women representing each of the four ethnic groups completed self-report measures relating to cognitive (e.g., attitudes towards the efficacy of mammography to detect cancer) and affective (e.g., breast cancer worry) factors and cancer control behaviour use (i.e., self-examination of the breasts (BSE), clinical breast examination (CBE), mammography, Pap smear and human papillomavirus (HPV) vaccine uptake). Overall, Lebanese women were significantly lower users of BSE and mammography than Australian and Croatian women, and Macedonian women were less likely to have accepted the HPV vaccine than Australian women. Multiple regression analyses showed that across the studies a number of psychosocial and behavioural factors were associated with breast cancer screening (i.e., breast cancer worry, general risk factors and negative emotional representations) and cervical cancer control use (i.e., identity (symptoms), cyclical timelines for cervical cancer, perceived efficacy of cervical cancer control and general risk factors). The modifiable psychosocial factors that were identified in this research can provide the basis for future tailored health promotion initiatives targeting these ethnic groups to enhance their utilization of the cancer control strategies.