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Associations Between Religion-Related Factors and Cervical Cancer Screening Among Muslims in Greater Chicago

Padela, Aasim I. MD, MSc1,2,3,4; Peek, Monica MD, MPH3; Johnson-Agbakwu, Crista E. MD, MSc5,6; Hosseinian, Zahra MA1; Curlin, Farr MD3

Journal of Lower Genital Tract Disease: October 2014 - Volume 18 - Issue 4 - p 326–332
doi: 10.1097/LGT.0000000000000026
Original Articles

Objective This study aimed to assess rates of Papanicolaou (Pap) testing and associations between religion-related factors and these rates among a racially and ethnically diverse sample of American Muslim women.

Materials and Methods A community-based participatory research design was used in partnering with the Council of Islamic Organizations of Greater Chicago to recruit Muslim women attending mosque and community events. These participants self-administered surveys incorporating measures of fatalism, religiosity, perceived discrimination, Islamic modesty, and a marker of Pap test use.

Results A total of 254 survey respondents were collected with nearly equal numbers of Arabs, South Asians, and African American respondents. Of these respondents, 84% had obtained a Pap test in their lifetime, with individuals who interpret disease as a manifestation of God’s punishment having a lower odds of having had Pap testing after controlling for sociodemographic factors (odds ratio [OR] = 0.87, 95% CI = 0.77–1.0). In multivariate models, living in the United States for more than 20 years (OR = 4.7, 95% CI = 1.4–16) and having a primary care physician (OR = 7.7, 95% CI = 2.5–23.4) were positive predictors of having had a Pap test. Ethnicity, fatalistic beliefs, perceived discrimination, and modesty levels were not significantly associated with Pap testing rates.

Conclusions To our knowledge, this is the first study to assess Pap testing behaviors among a diverse sample of American Muslim women and to observe that negative religious coping (e.g., viewing health problems as a punishment from God) is associated with a lower odds of obtaining a Pap test. The relationship between religious coping and cancer screening behaviors deserves further study so that religious values can be appropriately addressed through cancer screening programs.

Of the 254 American Muslim women surveyed, 84% had undergone Pap testing, and individuals with negative religious coping mechanisms had a lower odds of being tested.

1Initiative on Islam and Medicine, Program on Medicine and Religion, 2Section of Emergency Medicine, and 3Section of General Internal Medicine, Department of Medicine, and 4Comprehensive Cancer Center, the University of Chicago, Chicago, IL; and 5Refugee Women’s Health Clinic, Maricopa Integrated Health System and 6Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ

Correspondence to: Aasim I. Padela, MD, MSc, The University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637. E-mail:

This project was supported by an Institutional Research Grant (no. 58-004) from the American Cancer Society and a Cancer Center Support Grant (no. P30 CA14599). Data warehousing was supported by the REDCap project at the University of Chicago, managed by the Center for Research Informatics, and funded by the Biological Sciences Division and the Institute for Translational Medicine CTSA Grant (UL1 RR024999).

The authors have declared they have no conflicts of interest.

Copyright © 2014 by the American Society for Colposcopy and Cervical Pathology