Primary Care Physicians' Cancer Screening Recommendation Practices and Perceptions of Cancer Risk of Asian Americans

  • Kwon, Harry T. (Department of Public and Community Health, University of Maryland) ;
  • Ma, Grace X. (Department of Public Health/Center for Asian Health, Temple University) ;
  • Gold, Robert S. (Department of Public and Community Health, University of Maryland) ;
  • Atkinson, Nancy L. (Department of Public and Community Health, University of Maryland) ;
  • Wang, Min Qi (Department of Public and Community Health, University of Maryland)
  • Published : 2013.03.30


Asian Americans experience disproportionate incidence and mortality rates of certain cancers, compared to other racial/ethnic groups. Primary care physicians are a critical source for cancer screening recommendations and play a significant role in increasing cancer screening of their patients. This study assessed primary care physicians' perceptions of cancer risk in Asians and screening recommendation practices. Primary care physicians practicing in New Jersey and New York City (n=100) completed a 30-question survey on medical practice characteristics, Asian patient communication, cancer screening guidelines, and Asian cancer risk. Liver cancer and stomach cancer were perceived as higher cancer risks among Asian Americans than among the general population, and breast and prostate cancer were perceived as lower risks. Physicians are integral public health liaisons who can be both influential and resourceful toward educating Asian Americans about specific cancer awareness and screening information.



  1. American Cancer Society (2012). Cancer Facts and Figures 2012. Atlanta, GA: Author.
  2. American Cancer Society (2011). Stomach Cancer. Retrieved July 24, 2012, Available at:
  3. Asch DA, Jedrziewski MK, Christakis NA, et al (1997). Conducting physician mail surveys on a limited budget: A randomized trial comparing $2 bill versus $5 bill incentives. J Clin Epidemiol, 50, 1129-36.
  4. Bodle EE, Islam N, Kwon SC, et al (2008). Cancer screening practices of Asian American physicians in New York City. J Immigr Minor Health, 10, 239-46.
  5. Chakrabarti S (2005). Philadelphia physicians' perceived cultural barriers to cancer screening of their Asian American patients. Unpublished Master's Thesis, Temple University, Philadelphia, PA.
  6. Cummings SM, Savitz LA, Konrad TR (2001). Reported response rates to mailed physician questionnaires. Health Serv Res, 35, 1347-55.
  7. Ferketich A, Wewers ME, Kwong K (2004). Smoking cessation interventions among Chinese Americans: the role of families, physicians, and the media. Nicotine Tob Res, 6, 241-8.
  8. Han P, Klabunde CN, Breen N, et al (2011). Multiple clinical practice guidelines for breast and cervical cancer screening: Perceptions of US primary care physicians. Med Care, 49, 139-48.
  9. Holland-Barkis P, Forjuoh SN, Couchman GR, et al (2006). Primary care physicians' awareness and adherence to cervical cancer screening guidelines in Texas. Prev Med, 42, 140-5.
  10. Howlader N, Noone AM, Krapcho M, et al (2012). SEER Cancer Statistics Review, 1975-2009 (Vintage 2009 Populations), National Cancer Institute. Bethesda, MD. Retrieved July 24, 2012, Available at:
  11. Keegan THM, Gomez SL, Clarke CA, et al (2007). Recent trends in breast cancer incidence among 6 Asian groups in the greater bay area of northern California. Int J Cancer, 120, 1324-9.
  12. Lee MM, Lee F, Stewart S, McPhee S (1999). Cancer screening practices among primary care physicians serving Chinese Americans in San Francisco. West J Med, 170, 148-55.
  13. Lubetkin EI, Santana A, Tso A, Jia H (2008). Predictors of cancer screening among low-income primary care patients. J Health Care Poor Underserved, 19, 135-48.
  14. Meissner HI, Klabunde CN, Han PK, et al (2011). Breast cancer screening beliefs, recommendations, and practices. Cancer, 117, 3101-11.
  15. Miller BA, Chu KC, Hankey BF, Ries LAG (2008). Cancer incidence and mortality patterns among specific Asian and Pacific Islander populations in the U.S. Cancer Causes Control, 19, 227-56.
  16. National Cancer Institute (2012). Stomach (Gastric cancer) Screening (PDQ): Patient version. Retrieved July 25, 2012, Available at:
  17. Nguyen TT, McPhee SJ, Stewart S, et al (2010). Factors associated with hepatitis B testing among Vietnamese Americans. J Gen Intern Med, 25, 694-700.
  18. O'Malley AS, Renteria-Weitzman R, Huerta EE, et al (2002). Patient and provider priorities for cancer prevention and control: a qualitative study in mid-Atlantic Latinos. Ethn Dis, 12, 383-91.
  19. Shieh K, Gao F, Ristvedt S, et al (2005). The impact of physicians' health beliefs on colorectal cancer screening practices. Dig Dis Sci, 50, 809-14.
  20. Strong C, Lee S, Tanaka M, Juon HS (2012). Ethnic differences in prevalence and barriers of HBV screening and vaccination among Asian Americans. J Community Health, 37, 1071-80.
  21. Su X, Ma GX, Seals B, et al (2006). Breast cancer early detection among Chinese women in the Philadelphia area. J Womens Health, 15, 507-19.
  22. Taylor VM, Yasui Y, Burke N, et al (2004). Pap testing adherence among Vietnamese American women. Cancer Epidemiol Biomarkers Prev, 13, 613-19.
  23. Tsui T, Tanjasiri SP (2008). Cervical cancer screening among Thai women in Northern California. J Womens Health, 17, 393-401.
  24. Tu SP, Yasui Y, Kuniyuki AA, et al (2003). Mammography screening among Chinese-American women. Cancer, 97, 1293-302.
  25. Yabroff KR, Saraiya M, Meissner HI, et al (2009). Specialty differences in primary care physician reports of Papanicolaou test screening practices: A national survey, 2006 to 2007. Ann Intern Med, 151, 1602-11.

Cited by

  1. Acute Normovolemic Hemodilution Effects on Perioperative Coagulation in Elderly Patients Undergoing Hepatic Carcinectomy vol.14, pp.8, 2013,
  2. N-Acetyltransferase 2 Gene Polymorphisms are Associated with Susceptibility to Cancer: a Meta-analysis vol.15, pp.14, 2014,
  3. Cumulative Probability of Prostate Cancer Detection Using the International Prostate Symptom Score in a Prostate-specific Antigen-based Population Screening Program in Japan vol.15, pp.17, 2014,
  4. Perception of Breast Cancer Screening among Iranian Women without Experience of Mammography: A Qualitative Study vol.15, pp.9, 2014,
  5. Variation in Womenʼs Understanding of Prenatal Testing vol.125, pp.6, 2015,
  6. Gastric Cancer in Asian American Populations: a Neglected Health Disparity vol.15, pp.24, 2015,
  7. Determinants of cancer screening in Asian-Americans vol.27, pp.8, 2016,
  8. Racial/Ethnic Differences in the Use of Primary Care Providers and Preventive Health Services at a Midwestern University vol.3, pp.2, 2016,
  9. “A Word can become a Seed”: A Lesson Learned about Cultural Humility vol.31, pp.4, 2016,
  10. Hepatitis B and Hepatocellular Carcinoma Screening Practices in Chinese and African Immigrant-Rich Neighborhoods in New York City vol.4, pp.5, 2017,
  11. Facilitators of and Barriers to Gastric Cancer Screening Among Korean Americans vol.40, pp.4, 2017,
  12. Feasibility of a Multicomponent Breast Health Education Intervention for Vietnamese American Immigrant Women vol.44, pp.5, 2017,
  13. Cancer/health communication and breast/cervical cancer screening among Asian Americans and five Asian ethnic groups pp.1465-3419, 2018,