Asian American and Pacific Islander breast and cervical carcinoma screening rates and Healthy People 2000 objectives

• Published in: Cancer Vol. 89; no. 3; pp. 696 - 705
• Main Authors: Kagawa‐Singer, Marjorie, Pourat, Nadereh
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 01.08.2000; Wiley-Liss
• Subjects: Adult; Asian Americans; Asian Americans - statistics & numerical data; Biological and medical sciences; breast carcinoma screening; Breast Neoplasms - epidemiology; Breast Neoplasms - ethnology; Breast Neoplasms - prevention & control; cancer screening guidelines; cervical carcinoma screening; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Health Services Accessibility; Health Surveys; Humans; Incidence; Mammary gland diseases; Mammography - statistics & numerical data; Mass Screening - statistics & numerical data; Medical sciences; Socioeconomic Factors; Tumors; United States - epidemiology; Uterine Cervical Neoplasms - epidemiology; Uterine Cervical Neoplasms - ethnology; Uterine Cervical Neoplasms - prevention & control; Vaginal Smears - statistics & numerical data; women; Pacific Islands Us; United States; North America; America; Oceania; Human; Asiatic; Carcinoma; Socioeconomic status; Accessibility; Malignant tumor; Uterine cervix; Medical screening; Care; Female genital diseases; Mammary gland diseases; Mammary gland; Uterine cervix diseases; Public health
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(20000801)89:3<696::AID-CNCR27>3.0.CO;2-7

BACKGROUND Breast carcinoma is the number one cause of cancer‐related mortality among Asian American and Pacific Islander (AAPI) women, and for certain subgroups cervical carcinoma is among the top three causes. Yet AAPI women have the lowest cancer screening and early detection rates of all ethnic groups. The practice of merging AAPI data hides significant variation among AAPI groups, and the groups at highest risk for late presentation of disease become invisible. To the authors' knowledge, this study is the first report of disaggregated national data for breast and cervical carcinoma screening in AAPI subpopulations. The authors used data from the National Health Interview Survey (NHIS 1993 and 1994) and evaluated major socioeconomic and access variables associated with screening practices. METHODS Healthy People 2000 (HP2000) criteria were used to evaluate the most recent NHIS screening rates for AAPIs as one group and for six distinct subgroups compared with HP2000 criteria. The sample included 2756 non‐Hispanic AAPI and 64,196 non‐Hispanic white women age 18 years or older in the 1993 and 1994 NHIS. The effects of socioeconomic and access‐to‐care indicators on screening were explored. RESULTS Breast and cervical carcinoma screening rates for AAPIs were below those for white women and well below national goals and guidelines. Lack of insurance, low income, and lack of a usual source of care had a significantly greater negative impact on AAPIs than on white women, indicating that AAPIs may be more vulnerable to structural barriers to cancer control efforts. CONCLUSIONS AAPI women have very low rates of breast and cervical screening, which increases their chances of later stage disease presentation. To reach the Healthy People 2000 objectives, targeted efforts are needed to increase cancer screening among AAPI women overall and specific subgroups in particular. Cancer 2000;89:696–705. © 2000 American Cancer Society. Breast carcinoma is the number one cause of cancer‐related mortality among Asian American and Pacific Islander (AAPI) women, and certain subgroups have the highest cervical carcinoma rates of all ethnic groups. Yet, of all ethnic groups, AAPIs have the lowest screening and early detection rates. To the authors' knowledge, this is the first report of disaggregated statistics for cancer screening rates for AAPI women, and it supports the need for targeted screening efforts in AAPI populations.