Breast Cancer Risk Factors: a Cross- Cultural Comparison between the West and the East

Document Type : Research Articles


1 Azusa Pacific University, Fullerton, United States.

2 Excelsior College, Fullerton, United States.

3 Cal State University, Fullerton, United States.

4 Saint-Joseph University, Lebanon.


Background: The incidence of breast cancer in Lebanon is higher than any other Middle –Eastern country, is
diagnosed at a younger age than women in Western countries, and is more aggressive and fatal. Therefore addressing
risk factors in this population is of paramount importance. Methods: A descriptive cross-sectional, comparative
design evaluated the risk factors for breast cancer in a convenient sample of 105 Lebanese-American women with 250
Lebanese. Odds Ratio, Chi square t-tests or ANOVA were used to compare the two groups’ risk factors and knowledge
of screening tools. Associations found to be statistically significant were included in three multiple logistic regression
models to estimate the odds of each variable for performing a mammography, a clinical breast exam (CBE) and a breast
self-exam (BSE). Results: There were more Muslims in the Lebanese-American sample who perceived having a better
income, and had a better understanding of the effectiveness of the mammogram, the CBE and the BSE. The Lebanese
group reached menopause at an older age, t = 2.66, p = 0.05, smoked more, OR = 1.42, p = 0.001 and were five times
more likely to live close to a main road or highway, OR = 5.75, p = 0.001 than the Lebanese-American group. The
Lebanese- Americana group breast fed longer χ2= 11.68, p = .008, used contraceptives more, OR = 1.74, p = 0.027,
exercised more, OR = 1.61, p < 0.001, and consumed more vegetables and fruits than their Lebanese counterparts, OR=
1.22, p = 0.002, and OR = 1.27 p = 0.001, respectively. For ever having a mammogram, the duration of breastfeeding
(>6 months), effectiveness of the mammogram, and exercise were significant predictors. While for ever having a CBE,
smoking, eating fruits, and exercise were significant. No variables were related to performing a BSE. Conclusion: The
Lebanese women had higher risk factors for developing breast cancer, and had less knowledge of the benefits of breast
cancer screening tools, calling for the importance of promoting healthy life styles and education.


Main Subjects