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Fatalism in breast cancer and performing mammography on women with or without a family history of breast cancer | BMC Women’s Health


Breast cancer is the main cause of cancer-related mortality in women, hence a major health concern [1, 2]. The risk of women being affected by breast cancer is increasing, such that one in eight women contracts the disease [3].

Although the incidence of breast cancer is high in developed countries, the rate of mortality in less developed countries has been reported to be relatively higher, due to not diagnosing breast cancer at its earliest stages and lack of access to proper caring facilities [4]. Early diagnosis of breast cancer is an important process which increases the survival rate (SR) [5], and studies have shown that there will be a reduction in mortality rate in the next 15 years through screening [6].

The most important step in a timely diagnosis of the disease is screening. Breast cancer has the required criteria for screening and early diagnosis [7]. American Cancer Society suggests that for an early diagnosis of breast cancer, all women aged 40–44 years should undergo screening mammography on an annual basis [8]. Women with a positive family history of breast cancer are more likely to develop cancer [9]. In this regard, Braithwaite et al., (2018) reported a first-degree family history resulted in an absolute increase in 5-year risk of breast cancer [10].

Despite the effect of breast cancer screening on reducing mortality, some women still do not consent to mammography as a method of screening. This is due to the lack of awareness, concerns about the outcome of mammography, the unavailability of mammography from women’s point of view, the ostensible pain involved in the process, lack of knowledge on mammograms, negligence, lack of time, lack of understanding on the part of the spouse, and high costs [11,12,13].

One of the factors that may be negatively effective in the screening behavior is fatalism [14], considered as a socio-psychological factor in preventing cancer and fulfilling the screening behaviors [15]. Fatalism is the belief that conditions, such as disease or catastrophic events occur by a higher power (such as God), and cannot be avoided [14]. In fact, a doctrine that events are fixed in advance so that human beings are powerless to change them. (Webster’s Dictionary 2019) [16].

According to the results noted by Ghahramanian et al., (2016) 10.8% of women referred to health centers of Tabriz city in Iran, believed in fatalism. Moreover, the findings of some qualitative studies indicated that participating women mainly mentioned fatalism as a feeling of lack of control to prevent breast cancer [17, 18]. In this regard, Charkazi et al., (2013) showed that Iranian Turkmen women had high fatalism belief. They mentioned that fatalism is a significant belief in that society which could be considered as a barrier to breast cancer screening behaviors [15]. However, the results of Farmer et al., (2007) study showed that cancer fatalism was not as a direct correlate of mammography screening [19].

Although women without a family history may get breast cancer, but women with positive family history are at higher risk for getting breast cancer. To ensure that women, especially high-risk groups perform mammography for breast cancer screening, it is necessary to understand barriers that prevent women from having mammography.

Regarding the importance of mammography, especially in people with a positive family history of breast cancer, this study was done with the purpose of analyzing fatalism in breast cancer and mammography in women with or without a family history of breast cancer.

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