Comparison of Breast Cancer Screening Practices Between Asians and Pacific Islanders

Monday, July 11, 2011: 2:05 PM

Kyeung Mi Oh, PhD, RN
Qiuping (Pearl) Zhou, RN, PhD
School of Nursing, George Mason University, Fairfax, VA

Learning Objective 1: The learner will be able to understand the differences between Asian and Pacific Islander women in breast cancer screening practices.

Learning Objective 2: The learner will be able to understand the contribibuting factors influencing breast cancer screening practices for Asian and Pacific Islander women.

Purpose: Mammography screening for Asian American women has been the lowest among all ethnic groups. Most national estimates used aggregated data of Asians and Pacific Islanders (API) and assumed that they are homogeneous. The purpose of this study explores within-group differences in breast cancer screening practices and related factors.

 Methods: Using 2008 Behavioral Risk Factor Surveillance System (BRFSS) data, mammogram and clinical breast exam (CBE) usage within the past year among women aged 40+ were explored. The analyses included 2,600 Asian women and 345 PI. Covariates include demographics, health perception, risk, and care access, and general health practice behavior.  Data were analyzed using descriptive statistics and logistic regressions.

Results: The mammogram screening rate was 70.3% for PI but 60.3% for Asian only. The rates for obtaining a CBE in the previous year was 70.0% for PI, but 57.5% for Asians only. The adjusted odd ratios of mammogram (OR: 1.62, 95% CI: 1.60-1.65) and CBE (OR:1.86, CI: 1.83-1.89) for Pacific Islanders were higher than that for Asian women after adjusting for covariates . Most of the contributing factors for Asians and Pacific Islanders were different in magnitude or in opposite directions, indicating different mechanisms for failing to obtain recommended screenings. For instance, Asian women with higher levels of education (≥HS graduate- OR: 1.62, CI:1.6-1.64), a positive health perception (OR: 1.06, CI: 1.05-1.07), and higher incomes (≥50,000 –OR: 1.34, CI: 1.32-1.35) were more likely to have a recent mammogram, but PI with higher levels of education (OR: 0.77, CI: 0.71-0.83), a positive health perception (OR: 0.49, CI: 0.47-0.51) and, higher incomes (OR: 0.9, CI: 0.89-0.98) were less likely to have a recent mammogram.

 Conclusion: Asian American women are less likely to obtain a mammogram and CBE than the Pacific Islanders. Combining the two populations would mask the significant differences and delay the development of effective interventions.