Skip to main content
SpringerLink
Log in

Screening Mammography Among Chinese Canadian Women

  • Published:
Canadian Journal of Public Health Aims and scope Submit manuscript

Abstract

Background

Though breast cancer is the most common malignancy among Chinese women, screening mammography is underutilized. This study examined barriers and facilitators of screening mammography among Chinese Canadian women.

Methods

Using community-based sampling, Chinese women in British Columbia were interviewed in 1999 about multiple preventive health behaviours. We included 213 women in the mammography analysis; main outcome measures were ever having a mammogram and routine mammography.

Results

Seventy-five percent of women 50 to 79 years old reported ever having had a mammogram, and 53% had two or more mammograms within the last five years. Receiving a recommendation for a mammogram from medical personnel or from a family member, and believing that cancer cannot be prevented by faith were independently associated with both screening outcomes.

Conclusions

A multifaceted approach to screening mammography promotion in Chinese Canadian women is suggested. Interventions that include education of and by medical providers and family members should be considered.

Résumé

Contexte

Le cancer du sein est la tumeur maligne la plus répandue chez les Chinoises, mais la mammographie de dépistage est sous-utilisée. L’étude porte sur les obstacles et les facteurs facilitants de cet outil de dépistage chez les Canadiennes d’origine chinoise.

Méthode

Par échantillonnage à L’échelon de la collectivité, nous avons interviewé des Chinoises de Colombie-Britannique en 1999 au sujet de divers comportements préventifs liés à la santé. L’analyse des données sur la mammographie portait sur 213 femmes; nos principaux indicateurs de résultats étaient le fait d’avoir déjà eu une mammographie et le fait d’en avoir périodiquement.

Résultats

Soixante-quinze p. cent des femmes de 50 à 79 ans ont dit avoir déjà eu une mammographie, et 53 % en avaient eu deux ou plus au cours des cinq années précédentes. Les deux indicateurs étaient indépendamment associés au fait qu’un membre du personnel médical ou de la famille ait recommandé une mammographie et à la conviction que la foi ne peut prévenir le cancer.

Conclusion

Nous suggérons une approche multidimensionnelle pour la promotion de la mammographie de dépistage auprès des Canadiennes d’origine chinoise. Il faudrait envisager des mesures comme la sensibilisation des dispensateurs de soins médicaux et des membres de la famille.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Miller B, Kolonel L, Bernstein L, Young JL, Swanson GM, West CR, et al. Racial/Ethnic Patterns of Cancer in the United States 1988–1992. Bethesda, MD: National Cancer Institute, 1996.

    Google Scholar 

  2. Li FP, Pawlish K. Cancers in Asian Americans and Pacific Islanders: Migrant studies. Asian Am Pac Isl J Health 1998;6(2):123–29.

    CAS  PubMed  Google Scholar 

  3. Wu AH, Ziegler RG, Horn-Ross PL, Nomura AM, West DW, Kolonel LN, et al. Tofu and risk of breast cancer in Asian-Americans. Cancer Epidemiol Biomarkers Prev 1996;5(11):901–6.

    CAS  PubMed  Google Scholar 

  4. Yu H, Harris RE, Gao YT, Gao R, Wynder EL. Comparative epidemiology of cancers of the colon, rectum, prostate and breast in Shanghai, China versus the United States. Int J Epidemiol 1991;20(1):76–81.

    Article  CAS  PubMed  Google Scholar 

  5. Ziegler RG, Hoover RN, Pike MC, Hildesheim A, Nomura AM, West DW, et al. Migration patterns and breast cancer risk in Asian-American women. J Natl Cancer Inst 1993;85(22):1819–27.

    Article  CAS  PubMed  Google Scholar 

  6. Stanford JL, Herrinton LJ, Schwartz SM, Weiss NS. Breast cancer incidence in Asian migrants to the United States and their descendants. Epidemiology 1995;6(2):181–83.

    Article  CAS  PubMed  Google Scholar 

  7. Koh HK, Sun T, Zhang YQ. Cancer in Asian Americans and Pacific Islander Populations. Asian Am Pac Isl J Health 1996;4(1-3):121-24.

    Google Scholar 

  8. Yu MY, Seetoo AD, Tsai CK, Sun C. Sociodemographic predictors of Papanicolaou smear test and mammography use among women of Chinese descent in southeastern Michigan. Womens Health Issues 1998;8(6):372–81.

    Article  CAS  PubMed  Google Scholar 

  9. Lee M, Lee F, Stewart S. Pathways to Early Breast and Cervical Detection for Chinese American Women. Health Educ Q Suppl 1996;23:S77–S88.

    Google Scholar 

  10. Yu ESH, Kim KK, Chen EH, Brintnall RA. Breast and Cervical Cancer Screening among Chinese American Women. Cancer Pract 2001;9(2):81–91.

    Article  CAS  PubMed  Google Scholar 

  11. Kagawa-Singer M, Pourat N. Asian American and Pacific Islander breast and cervical carcinoma screening rates and healthy people 2000 objectives. Cancer 2000;89(3):696–705.

    Article  CAS  PubMed  Google Scholar 

  12. Tang TS, Solomon LJ, McCracken LM. Cultural barriers to mammography, clinical breast exam, and breast self-exam among Chinese-American women 60 and older. Prev Med 2000;31(5):575–83.

    Article  CAS  PubMed  Google Scholar 

  13. Tu SP, Yasui Y, Kuniyuki AA, Schwartz SM, Jackson JC, Hislop TG, et al. Mammography screening among Chinese American women. Cancer 2003;97(5):1293–302.

    Article  PubMed  Google Scholar 

  14. Hiatt RA, Pasick RJ, Perez-Stable E, McPhee SJ, Engelstad L, Lee M, et al. Pathways to early detection in the multiethnic population of the San Francisco Bay area. Health Educ Q Suppl 1996;23:S10–S27.

    Article  Google Scholar 

  15. Tu SP, Taplin SH, Barlow WE, Boyko EJ. Breast cancer screening by Asian-American women in a managed care environment. Am J Prev Med 1999;17(1):55–61.

    Article  CAS  PubMed  Google Scholar 

  16. Statistics Canada. Census Recensement 96. 1996. Available on-line at https://doi.org/www.statcan.ca/eng-lish/census96/feb17/vmbc.htm

  17. Hislop TG, Schwartz SM, Taylor V, Jackson JC, Tu SP. Identification of Chinese Subjects for Etiological and Cancer Control Research: Description of Sampling Methods Based Upon Surnames. New Orleans: North American Association of Central Cancer Registries Annual Meeting, 2000;87.

    Google Scholar 

  18. Eyton J, Neuwirth G. Cross-cultural validity: Ethnocentrism in health studies with special reference to the Vietnamese. Soc Sci Med 1984;18(5):447–53.

    Article  CAS  PubMed  Google Scholar 

  19. McPhee SJ, Bird JA, Ha NT, Jenkins C, Fordham D, Le B. Pathways to early cancer detection for Vietnamese women: Suc Khoe La Vang! (Health is Gold!) Health Educ Q Suppl 1996;23:S60–S75.

    Article  Google Scholar 

  20. Curry SJ, Emmons K. Theoretical models for predicting and improving compliance with breast cancer screening. Ann Behav Med 1994;16:302–16.

    Google Scholar 

  21. Green L, Krueler M. Applications of PRECEDE-PROCEED in Community Settings. Health Promotion Planning: An Educational and Environmental Approach. Palo Alto: Mayfield, 1991.

    Google Scholar 

  22. Jackson JC, Do H, Chitnarong K, Tu SP, Marchand A, Hislop TG, et al. Development of cervical cancer control interventions for Chinese immigrants. J Immigrant Health 2002;4(3):147–57.

    Article  Google Scholar 

  23. Screening Mammography Program of British Columbia. Information about screening mam-mogram for women in their 50s, 60s and 70s. Vancouver: SMPBC, 2001.

    Google Scholar 

  24. Rosner B. Fundamentals of Biostatistics, Fifth ed. Boston: Duxbury, 2000.

    Google Scholar 

  25. Kleinbaum DG. Logistic Regression: A Self-learning Text. New York: Springer-Verlag, 1994.

    Book  Google Scholar 

  26. Katz SJ, Larson EB, LoGerfo JP. Trends in the utilization of mammography in Washington State and British Columbia: Relation to stage of diagnosis and mortality. Med Care 1992;30(4):320–28.

    Article  CAS  PubMed  Google Scholar 

  27. Katz SJ, Hislop TG, Thomas DB, Larson EB. Delay from symptom to diagnosis and treatment of breast cancer in Washington State and British Columbia. Med Care 1993;31(3):264–68.

    Article  CAS  PubMed  Google Scholar 

  28. Katz SJ, Hofer TP. Socioeconomic disparities in preventive care persist despite universal coverage. Breast and cervical cancer screening in Ontario and the United States. JAMA 1994;272(7):530–34.

    Article  CAS  PubMed  Google Scholar 

  29. Katz SJ, Zemencuk JK, Hofer TP. Breast cancer screening in the United States and Canada, 1994: Socioeconomic gradients persist. Am J Public Health 2000;90(5):799–803.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Mandelblatt JS, Gold K, O’Malley AS, Taylor K, Cagney K, Hopkins JS, et al. Breast and cervix cancer screening among multiethnic women: Role of age, health, and source of care. Prev Med 1999;28(4):418–25.

    Article  CAS  PubMed  Google Scholar 

  31. Hiatt RA, Pasick RJ, Stewart S, Bloom J, Davis P, Gardiner P, et al. Community-based cancer screening for underserved women: Design and baseline findings from the Breast and Cervical Cancer Intervention Study. Prev Med 2001;33(3):190–203.

    Article  CAS  PubMed  Google Scholar 

  32. O’Malley MS, Earp JA, Hawley ST, Schell MJ, Mathews HF, Mitchell J. The association of race/ethnicity, socioeconomic status, and physician recommendation for mammography: Who gets the message about breast cancer screening? Am J Public Health 2001;91(1):49–54.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Stein JA, Fox SA, Murata PJ. The influence of ethnicity, socioeconomic status, and psychological barriers on use of mammography. J Health Soc Behav 1991;32(2):101–13.

    Article  CAS  PubMed  Google Scholar 

  34. Grana G. Ethnic differences in mammography use among older women: Overcoming the barriers. Ann Intern Med 1998;128(9):773–75.

    Article  CAS  PubMed  Google Scholar 

  35. Qureshi M, Thacker HL, Litaker DG, Kippes C. Differences in breast cancer screening rates: An issue of ethnicity or socioeconomics? J Womens Health Gend Based Med 2000;9(9):1025–31.

    Article  CAS  PubMed  Google Scholar 

  36. Maxwell AE, Bastani R, Warda US. Mammography utilization and related attitudes among Korean-American women. Women Health 1998;27(3):89–107.

    Article  CAS  PubMed  Google Scholar 

  37. McPhee SJ, Stewart S, Brock KC, Bird JA, Jenkins CN, Pham GQ. Factors associated with breast and cervical cancer screening practices among Vietnamese American women. Cancer Detect Prev 1997;21(6):510–21.

    CAS  PubMed  Google Scholar 

  38. Pham CT, McPhee SJ. Knowledge, attitudes, and practices of breast and cervical cancer screening among Vietnamese women. J Cancer Educ 1992;7(4):305–10.

    Article  CAS  PubMed  Google Scholar 

  39. Mo B. Modesty, sexuality, and breast health in Chinese-American women. West J Med 1992;157(3):260–64.

    CAS  PubMed  PubMed Central  Google Scholar 

  40. Nguyen TT, McPhee SJ, Somkin CP, Vo P, Nguyen BH, Shema SJ. How valid are PAP smear and mammogram self-reports in a multiethnic population? J Gen Intern Med 2001;16(S1):160.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, University of Washington, 1825 N. 52nd Street, Seattle, WA, 98103, Canada

    Sara L. Jackson MD, MPH & J. Carey Jackson MD, MA, MPH

  2. Cancer Control Research, British Columbia Cancer Agency, Vancouver, BC, Canada

    T. Greg Hislop MD, MSc & Chong Teh PhD

  3. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, Canada

    Yutaka Yasui PhD, Shin-Ping Tu MD, MPH, Alan Kuniyuki MS & Vicky M. Taylor MD, MPH

  4. Department of Health Services, University of Washington, Seattle, WA, Canada

    Vicky M. Taylor MD, MPH

Authors
  1. Sara L. Jackson MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Greg Hislop MD, MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chong Teh PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yutaka Yasui PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shin-Ping Tu MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Alan Kuniyuki MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J. Carey Jackson MD, MA, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Vicky M. Taylor MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sara L. Jackson MD, MPH.

Additional information

Acknowledgements: Funded, in part, by grant CA74326 and cooperative agreement CA86322 from the National Cancer Institute of the United States. We thank the women who participated in these interviews; the interviewers: C. Chan, I. Chan, L. Hsu, A. Ko, S. Leung, M. Li, J. Ng, E. Ng, C. Pang, G. Troung; the community advisory coalition: I. Chan and L. Lai (Canadian Cancer Society), Dr. J. Ko (Taiwanese Canadian Cultural Society), G. Mumick (Vancouver-Richmond Health Board), S. Leung (SUCCESS), Dr. L. Sent (Asian Women’s Health Clinic), Dr. C. Wang (Chinese Canadian Medical Society), and Dr. M. Yu (Chinese Cultural Centre)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jackson, S.L., Hislop, T.G., Teh, C. et al. Screening Mammography Among Chinese Canadian Women. Can J Public Health 94, 275–280 (2003). https://doi.org/10.1007/BF03403605

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03403605

Search

Navigation