Mammography and pap testing screening among first generation Chinese Americans

Despite the widespread availability of cancer screening, disparities in breast and cervical cancer rates persist among Asian American women. Breast cancer is the most commonly diagnosed cancer among Asian American women in the United States (U.S.). Asian American women still have higher incidence and death rates for cervical cancer than U.S. Caucasian women despite an overall decline in cervical cancer deaths in the U.S. This study examined the perceptions and beliefs about breast and cervical cancer, mammography, and Pap smear practices among Chinese American women (CAW), the largest Asian female population in the U.S. The Health Belief Model guided this cross-sectional, descriptive study. Three questionnaires were combined, modified, translated, and pretested for this study. A study sample of 100 CAW, ages 40 and older, was recruited from Portland, Oregon. Only 48.5% of the participants reported a mammogram within the last year. Having a mammogram within the last year was strongly associated with having an immediate family member diagnosed with breast cancer, followed by having insurance that covered a mammogram and lower perceived barriers to obtaining a mammogram. Respondents had a low knowledge level about breast cancer and mammography screening guidelines, and perceived low susceptibility to breast cancer. Only 68% of respondents reported that their last Pap was within the past 3 years. Pap screening was strongly associated with younger age, having insurance coverage and having a regular health care provider (HCP). Women who had a HCP were approximately five times more likely to report having a Pap smear within the last three years when compared to women without a HCP. Women with health insurance were four times more likely to report having a pap smear than those women without insurance. Findings of this study underscore both the value of a recommendation from a regular HCP to obtain screening and having adequate insurance coverage to pay for cancer screening. Primary HCPs should be reminded of their powerful role in increasing cancer screening adherence. Further health policy action is necessary to extend screening coverage to first generation CAW who do not have adequate health insurance.