Barriers to breast cancer screening: an integrative review.

Breast cancer has been increasing at an alarming rate and is considered to be of epidemic proportions in the United States, with current estimates indicating that 1 in 8 women will develop breast cancer during their lifetimes, according to Breast Cancer Facts and Figures, 1997, by the American Cancer Society [ACS]. In spite of the advances in technology to improve early diagnosis and an increased emphasis on education to promote awareness of early detection, 46,000 women die annually. A significant number of these losses could be prevented through risk reduction measures, yet many women do not practice breast self-exam (BSE) or receive adequate clinical screening. The purpose of this integrative review is to provide an analysis of the barriers to breast cancer screening with recommendations for future research. The studies will be categorized using the three modalities for breast cancer screening, mammography, clinical breast exam (CBE) and BSE. Demographic variables that impede breast cancer screening will be integrated into each section. The evidence is clear that in spite of breast cancer screening guidelines, increased awareness and access to mammography screening, women in the United States are not being screened adequately. Recommendations for future research will be included.