Correlates of Breast Cancer Screening Among Asian Americans Enrolled in ENCORE plus

  • Cindy A. Leong-Wu
  • Maria E. Fernandez
Asians and Asian Americans


This study examines the correlates of mammogram utilization among predominantly low income Asian American women using cross sectional data of women recruited through the ENCORE plus program (n = 1695) between July 1996 and June 1998. Logistic regression was used to examine the independent effect of variables corresponding to Andersen’s behavioral model of health services utilization on mammography screening behavior. Foreign-born women living in the U.S. < 5 years and between 5 and 10 years were significantly less likely to have ever had a mammogram than women who were born in the U.S. (OR 0.22; CI 0.12, 0.40 and OR 0.48; CI 0.27, 0.86, respectively). Women 40–49 years old were half as likely to adhere to mammography screening recommendations as women 50–64 years (CI 0.33, 0.76). Health insurance was positively associated with adherence to mammography screening guidelines (OR 1.59; CI 1.02, 2.48). The results of this study highlight the need for health education about breast cancer and mammography among Asian American women. Policy work also needs to be directed toward improving access to health care in this community.


breast cancer cancer screening immigrants Asian Americans 


  1. 1.
    U.S. Bureau of the Census. Population Profile of the United States: 1997. Series P23-194. 1998. Washington, DC, U.S. Government Printing Office. Current Population Reports Google Scholar
  2. 2.
    Greenlee RT, Murray T, Bolden S, Wingo PA: Cancer Statistics, 2000. CA Cancer J Clin 2000; 50:7–33PubMedGoogle Scholar
  3. 3.
    Goodman MJ: Breast cancer in multi-ethnic populations: The Hawaii perspective. Breast Cancer Res Treat 1991; 18:S5–S9PubMedGoogle Scholar
  4. 4.
    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):181–183PubMedGoogle Scholar
  5. 5.
    Ziegler RG, Hoover RN, Pike MC, Hildesheim A, Nomura AM, West DW, Wu-Williams AH, Kolonel LN, Horn-Ross PL, Rosenthal JF: Migration patterns and breast cancer risk in Asian-American women. J Natl Cancer Inst 1993; 85(22):1819–1827PubMedGoogle Scholar
  6. 6.
    U.S. Department of Health and Human Services. The National Breast and Cervical Cancer Early Detection Program At-A-Glance 2000. 2000Google Scholar
  7. 7.
    Parker SL, Davis KJ, Wingo PA, Ries LAG, Heath CW: Cancer statistics by race and ethnicity. CA Cancer J Clin 1998; 48:31–48PubMedGoogle Scholar
  8. 8.
    Wismer BA, Moskowitz JM, Chen AM, Kang SH, Novotny TE, Min K, Lew R, Tager IB: Mammography and clinical breast examination among Korean American women in two California counties. Prev Med 1998; 27(1):144–151PubMedCrossRefGoogle Scholar
  9. 9.
    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):55–61PubMedCrossRefGoogle Scholar
  10. 10.
    McPhee SJ, Bird JA, Davis T, Ha N-T, Jenkins CNH, Le B: Barriers to breast and cervical cancer screening among Vietnamese-American women. Am J Prev Med 1997; 13(3):205–213PubMedGoogle Scholar
  11. 11.
    Pham CT, McPhee SJ: Knowledge, attitudes, and practices of breast and cervical cancer screening among Vietnamese women. J Cancer Educ 1992; 7(4):305–310PubMedCrossRefGoogle Scholar
  12. 12.
    Maxwell AE, Bastani R, Warda US: Breast cancer screening and related attitudes among Filipino-American women. Cancer Epidemiol Biomarkers Prev 1997; 6(9):719–726PubMedGoogle Scholar
  13. 13.
    McPhee SJ, Jenkins CN, Hung S, Nguyen KP, Ha NT, Fordham DC, Jang VL, Gelbard N, Folkers LF: Behavioral Risk Factor Survey of Vietnamese—California, 1991. MMWR Wkly 1992; 41(05):69–72Google Scholar
  14. 14.
    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):372–381PubMedCrossRefGoogle Scholar
  15. 15.
    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):510–521PubMedGoogle Scholar
  16. 16.
    Aday LA, Awe WC: Health Services Utilization Models. In: Gochman DS, ed. Handbook of Health Behavior Research I: Personal and Social Determinants. New York: Plenum Press; 1997. p 153–172Google Scholar
  17. 17.
    University of Texas-Houston School of Public Health CHPRD, YWCA of the U.S.A. Office of Women’s Health Initiatives. YWCA of the USA ENCOREplus Annual Report: July 1996 to June 1997, National Program Year 3. Houston, Texas: 1998Google Scholar
  18. 18.
    Chen A, Lew R, Thai V, Ko KL, Okahara L, Hirota S, Chan S, Wong WF, Saika G, Folkers LF, Marquez B: Behavioral risk factor survey of Chinese—California, 1989. MMWR Wkly 1992; 41(16):266–270Google Scholar
  19. 19.
    Coughlin SS, Uhler RJ: Breast and cervical cancer screening practices amng asian and pacific islander women in the United States, 1994–1997. Cancer Epidemiol Biomarkers Prev 2000; 9:597–603PubMedGoogle Scholar
  20. 20.
    Serxner S, Chung CS: Trend analysis of social and economic indicators of mammography use in Hawaii. Am J Prev Med 1992; 8(5):303–308PubMedGoogle Scholar
  21. 21.
    Zapka JG, Bigelow C, Hurley T, Durland L, Egelhofer J, Cloud WM, Sachsse E: Mammography use among sociodemographically diverse women: The accuracy of self-report. Am J Public Health 1996; 86(7):1016–1021Google Scholar
  22. 22.
    McGovern PG, Lurie N, Margolis KL, Slater J: Accuracy of self-report of mammography and pap smear in a low-income urban population. Am J Prev Med 1998; 14(3):201–208Google Scholar
  23. 23.
    Day JC: Population projections of the United States by age, sex, race, and hispanic origin: 1995–2050. U.S. Government Printing Office, Washington, DC: U.S. Bureau of the Census; 14 Mar 1999. Report nr P25-1130Google Scholar

Copyright information

© Springer Science + Business Media, LLC 2006

Authors and Affiliations

  1. 1.Center for Health Promotion and Prevention ResearchThe University of Texas-Houston School of Public HealthHouston
  2. 2.UT-Houston School of Public HealthHouston

Personalised recommendations