"I have no time for potential troubles": Russian immigrant women and breast cancer screening in Israel.

The author's earlier study of Russian immigrant women's attitudes and practices related to the early detection of cancer has shown their low participation in breast screening activities, from BSE to mammography. Most respondents were educated women who acknowledged their personal risk, understood the role of screening, but still avoided preventive action. In this qualitative research, the gap between cognitions and behavior is explored further by means of in-depth interviews and focus groups with 34 women aged 50-74 who moved to Israel after 1990. All Israeli women of this age are entitled for screening mammography free of charge once every 2 years. The findings point to a low place of preventive health concerns in the personal agenda of female immigrants, loaded by the more immediate survival needs (income, housing, support of other family members, etc.). Other barriers include the lack of referral from primary care providers, fear of cancer diagnosis, apprehensions of irradiation and pain involved in mammography, fatalist general attitude towards health and illness, and mistrust of current cancer therapy. Many older women (60+), whose risks are actually higher, shared a false belief that breast cancer strikes younger women and they are already past the age of concern. Older informants avoided gynecological clinics because of male gender of most gynecologists, their poor command of Hebrew, and a belief that gynecological checkups are irrelevant and even shameful in their age. It is concluded that female immigrants, especially older ones, must be a special target group for preventive health interventions.