Cervical Cancer Disparities: Knowledge, attitudes, beliefs and screening practices of ethnically diverse Black women

Background: Epidemiological data show that Black women have high rates of cervical cancer mortality compared to women of other racial and ethnic groups. Paradoxically, Black women have the highest cervical screening rates nationally of all racial and ethnic groups. The discrepancy between mortality and screening rates suggest a failure of current interventions to address cultural diversity within this population. Purpose: The purpose of this study was to address gaps in research on cervical cancer screening among Black women of various ethnic backgrounds. Methods: We conducted six focus groups with Haitian, African, English-speaking Caribbean and African American women to assess their cervical cancer knowledge, attitudes and practices. Results: There was limited knowledge and confusion across ethnic groups about cervical cancer and its risk factors, the Pap test, and the Human Papilloma Virus (HPV) and its association with cervical cancer. There were also distinct differences in knowledge and cultural beliefs about cervical cancer. Patient-doctor relationship was the single most important facilitator for cervical cancer screening among all groups. Barriers to cervical cancer screening included cost, busy work schedule, fear of the unknown, lack of insurance or being unemployed, and fear of disclosing immigration status. Conclusion: Interventions with Black women would benefit from recognizing cultural barriers and misconceptions that vary by ethnic group. Culturally-based strategies suggested by the focus groups include the use of existing social networks, the use of community-based health workers, and the inclusion of women of all ages in cervical cancer education because of their roles in extended families.