ArticleJAMA network open2025
Breast and Cervical Cancer Gaps in Displaced Lebanese Women in Syria.
Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Importance: Breast and cervical cancers are leading causes of cancer mortality in low-resource countries, yet awareness remains critically understudied among displaced populations in humanitarian crises. Lebanese women displaced to Syria represent a group navigating compounded vulnerabilities associated with conflict, displacement, and a collapsed health care system and may experience important gaps in cancer knowledge and access. Objective: To evaluate knowledge of breast and cervical cancer risk factors and symptoms and screening for early cancer detection among displaced Lebanese women in Syria. Design, Setting, and Participants: This cross-sectional study measured breast cancer, cervical cancer, and human papillomavirus (HPV) knowledge using a survey containing validated, Arabic-translated scales administered via structured interviews from November to December 2024. Lebanese women (aged ≥18 years) displaced to Syria and visiting outpatient health care facilities in Damascus were included. Women who were not Lebanese and with acute or severe physical or mental health conditions were excluded. Exposure: Breast cancer and cervical cancer knowledge. Main Outcomes and Measures: The primary outcome was knowledge of cancer symptoms, risk factors, and screening practices. Analyses included Fisher exact test, Kruskal-Wallis test, Mann-Whitney U test, and Spearman rank correlation. Results: Among 378 displaced Lebanese women in Syria (median [IQR] age, 30 [23-39] years), 196 (51.9%) were married, 187 (49.5%) held a university degree, and 222 (58.7%) were unemployed. Only 85 participants (22.5%) had ever undergone breast imaging, 64 (16.9%) had undergone a Papanicolaou test, 274 (72.5%) rarely or never examined their breasts, and 135 (35.7%) ignored observed breast changes. Knowledge gaps were prominent, with 348 (92.1%) having a low awareness of HPV and only 4 (1.1%) correctly identifying age as an important risk factor for breast cancer. Higher educational attainment was significantly associated with improved screening rates and knowledge of breast and cervical cancer (χ23 = 11.661; P = .009), whereas financial status showed no association. Conclusions and Relevance: These findings suggest that displaced women during humanitarian crises may face substantial breast and cervical cancer screening barriers, underscoring the need for crisis-responsive health care.
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