DOI QR코드

DOI QR Code

Attitudes of South Asian Women to Breast Health and Breast Cancer Screening: Findings from a Community Based Sample in the United States

  • Poonawalla, Insiya B. (Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health) ;
  • Goyal, Sharad (Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey) ;
  • Mehrotra, Naveen (Rutgers School of Public Health) ;
  • Allicock, Marlyn (Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health) ;
  • Balasubramanian, Bijal A. (Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health)
  • Published : 2014.11.06

Abstract

Background: Breast cancer incidence is increasing among South Asian migrants to the United States (US). However, their utilization of cancer screening services is poor. This study characterizes attitudes of South Asians towards breast health and screening in a community sample. Materials and Methods: A cross-sectional survey based on the Health Belief Model (HBM) was conducted among South Asians (n=124) in New Jersey and Chicago. The following beliefs and attitudes towards breast cancer screening were assessed-health motivation, breast self-examination confidence, breast cancer susceptibility and fear, and mammogram benefits and barriers. Descriptive statistics and Spearman rank correlation coefficients were computed for HBM subscales. Findings: Mean age of participants was 36 years with an average 10 years stay in the US. Most women strived to care for their health ($3.82{\pm}1.18$) and perceived high benefits of screening mammography ($3.94{\pm}0.95$). However, they perceived lower susceptibility to breast cancer in the future ($2.30{\pm}0.94$). Conclusions: Increasing awareness of breast cancer risk for South Asian women may have a beneficial effect on cancer incidence because of their positive attitudes towards health and breast cancer screening. This is especially relevant because South Asians now constitute one of the largest minority populations in the US and their incidence of breast cancer is steadily increasing.

Keywords

Breast cancer screening;South Asians;minority groups;attitudes;health belief model

References

  1. Althuis MD, Dozier JM, Anderson WF, Devesa SS, Brinton LA (2005). Global trends in breast cancer incidence and mortality 1973-1997. Int J Epidemiol, 34, 405-12. https://doi.org/10.1093/ije/dyh414
  2. Bottorff JL, Johnson JL, Bhagat R, et al (1998). Beliefs related to breast health practices: the perceptions of South Asian women living in Canada. Soc Sci Med, 47, 2075-85. https://doi.org/10.1016/S0277-9536(98)00346-3
  3. Anagnostopoulos F, Dimitrakaki C, Niakas D, Tountas Y (2012). Validity and reliability assessment of health belief scales for mammography screening in Greek asymptomatic women. Psychooncology, 22, 1912-7.
  4. Bharmal N, Chaudhry S (2012). Preventive health services delivery to South Asians in the United States. J Immigr Minor Health, 14, 797-802. https://doi.org/10.1007/s10903-012-9610-x
  5. Bhatt VR, Wetz RV, Shrestha R, et al (2011). Breast cancer knowledge, attitudes and practices among Nepalese women. Eur J Cancer Care, 20, 810-7. https://doi.org/10.1111/j.1365-2354.2011.01272.x
  6. Bray F, McCarron P, Parkin DM (2004). The changing global patterns of female breast cancer incidence and mortality. Breast Cancer Res, 6, 229-39. https://doi.org/10.1186/bcr932
  7. Champion VL (1999). Revised susceptibility, benefits, and barriers scale for mammography screening. Res Nurs Health, 22, 341-8. https://doi.org/10.1002/(SICI)1098-240X(199908)22:4<341::AID-NUR8>3.0.CO;2-P
  8. Champion VL, Monahan PO, Springston JK, et al (2008). Measuring mammography and breast cancer beliefs in African American women. J Health Psychol, 13, 827-37. https://doi.org/10.1177/1359105308093867
  9. D'Souza ND, Murthy NS, Aras RY (2013). Projection of burden of cancer mortality for India, 2011-2026. Asian Pac J Cancer Prev, 14, 4387-92. https://doi.org/10.7314/APJCP.2013.14.7.4387
  10. Elixhauser A (1991). Costs of breast cancer and the costeffectiveness of breast cancer screening. Int J Technol Assess Health Care, 7, 604-15. https://doi.org/10.1017/S0266462300007169
  11. Ersin F, Bahar Z (2011). Effect of health belief model and health promotion model on breast cancer early diagnosis behavior: a systematic review. Asian Pac J Cancer Prev, 12, 2555-62.
  12. Guvenc I, Guvenc G, Tastan S, Akyuz A (2012). Identifying women's knowledge about risk factors of breast cancer and reasons for having mammography. Asian Pac J Cancer Prev, 13, 4191-7. https://doi.org/10.7314/APJCP.2012.13.8.4191
  13. Fouladi N, Pourfarzi F, Mazaheri E, et al (2013). Beliefs and behaviors of breast cancer screening in women referring to health care centers in northwest Iran according to the champion health belief model scale. Asian Pac J Cancer Prev, 14, 6857-62. https://doi.org/10.7314/APJCP.2013.14.11.6857
  14. Ghumare SS, Cunningham JE (2007). Breast cancer trends in Indian residents and emigrants portend an emerging epidemic for India. Asian Pac J Cancer Prev, 8, 507-12.
  15. Glenn BA, Chawla N, Surani Z, Bastani R (2009). Rates and sociodemographic correlates of cancer screening among South Asians. J Community Health, 34, 113-21. https://doi.org/10.1007/s10900-008-9129-1
  16. Grosse Frie K, Ramadas K, Anju GA, et al (2013). Determinants of participation in a breast cancer screening trial in Trivandrum district, India. Asian Pac J Cancer Prev, 14, 7301-7. https://doi.org/10.7314/APJCP.2013.14.12.7301
  17. Hoeffel EM, Rastogi S, Kim MO, Shahid H (2012). The Asian population: 2010. United States census bureau. (Accessed on May 13, 2013). Available at: http://www.census.gov/prod/cen2010/briefs/c2010br-11.pdf.
  18. Islam N, Kwon SC, Senie R, Kathuria N (2006). Breast and cervical cancer screening among South Asian women in New York City. J Immigr Minor Health, 8, 211-21. https://doi.org/10.1007/s10903-006-9325-y
  19. John EM, Phipps AI, Davis A, Koo J (2005). Migration history, acculturation, and breast cancer risk in Hispanic women. Cancer Epidemiol Biomarkers Prev, 14, 2905-13. https://doi.org/10.1158/1055-9965.EPI-05-0483
  20. Karbani G, Lim JN, Hewison J, et al (2011). Culture, attitude and knowledge about breast cancer and preventive measures: a qualitative study of South Asian breast cancer patients in the UK. Asian Pac J Cancer Prev, 12, 1619-26.
  21. Kishore J, Ahmad I, Kaur R, P K M (2008). Beliefs and perceptions about cancers among patients attending radiotherapy OPD in Delhi, India. Asian Pac J Cancer Prev, 9, 155-8.
  22. Kaur JS (2000). Migration patterns and breast carcinoma. Cancer, 88, 1203-6. https://doi.org/10.1002/(SICI)1097-0142(20000301)88:5+<1203::AID-CNCR4>3.0.CO;2-#
  23. Khokhar A (2012a). Breast cancer in India: Where do we stand and where do we go? Asian Pac J Cancer Prev, 13, 4861-6. https://doi.org/10.7314/APJCP.2012.13.10.4861
  24. Khokhar A (2012b). Effect of a training programme on knowledge of nurses from a missionary hospital in India regarding breast cancer and its screening. Asian Pac J Cancer Prev, 13, 5985-7. https://doi.org/10.7314/APJCP.2012.13.12.5985
  25. Lee HY, Ju E, Vang PD, Lundquist M (2010). Breast and cervical cancer screening disparity among Asian American women: does race/ethnicity matter [corrected]? J Womens Health (Larchmt), 19, 1877-84. https://doi.org/10.1089/jwh.2009.1783
  26. Maciosek MV, Coffield AB, Flottemesch TJ, Edwards NM, Solberg LI (2010). Greater use of preventive services in U.S. health care could save lives at little or no cost. Health Aff (Milwood), 29, 1656-60. https://doi.org/10.1377/hlthaff.2008.0701
  27. Maqsood B, Zeeshan MM, Rehman F, et al (2009). Breast cancer screening practices and awareness in women admitted to a tertiary care hospital of Lahore, Pakistan. J Pak Med Assoc, 59, 418-21.
  28. Meana M, Bunston T, George U, Wells L, Rosser W (2001). Influences on breast cancer screening behaviors in Tamil immigrant women 50 years old and over. Ethn Health, 6, 179-88. https://doi.org/10.1080/13557850120078107
  29. Mehrotra N, Gaur S, Petrova A (2012). Health care practices of the foreign born Asian Indians in the U.S. A community based survey. J Community Health, 37, 328-34. https://doi.org/10.1007/s10900-011-9449-4
  30. Menon U, Szalacha LA, Prabhughate A (2012). Breast and cervical cancer screening among South Asian immigrants in the United States. Cancer Nurs, 35, 278-87. https://doi.org/10.1097/NCC.0b013e31822fcab4
  31. Peltzer K, Phaswana-Mafuya N (2014). Breast and cervical cancer screening and associated factors among older adult women in South Africa. Asian Pac J Cancer Prev, 15, 2473-6. https://doi.org/10.7314/APJCP.2014.15.6.2473
  32. Miller BA, Kolonel LN, Bernstein L, et al (1996). Racial/ethnic patterns of cancer in the U.S. 1988-1992. national cancer institute. NIH pub. no. 96-4104. Bethesda, MD. (Accessed on May 10, 2013). Available at: http://seer.cancer.gov/publications/ethnicity.
  33. National cancer institute, Surveillance epidemiology and end results program (2003). Cancer incidence in U.S. immigrant populations-Landmark studies. (Accessed on July 15, 2013). Available at: http://seer.cancer.gov/archive/studies/surveillance/study5.html.
  34. Parsa P, Kandiah M, Mohd Nasir MT, Hejar AR, Nor Afiah MZ (2008). Reliability and validity of champion's health belief model scale for breast cancer screening among Malaysian women. Singapore Med J, 49, 897-903.
  35. Price CL, Szczepura AK, Gumber AK, Patnick J (2010). Comparison of breast and bowel cancer screening uptake patterns in a common cohort of South Asian women in England. BMC Health Serv Res, 10, 103. https://doi.org/10.1186/1472-6963-10-103
  36. Rajan SS, Lim JN, Haq A (2011). Late presentation and management of South Asian breast cancer patients in West Yorkshire, U.K. Asian Pac J Cancer Prev, 12, 1615-8.
  37. Rakowski W, Wyn R, Breen N, Meissner H, Clark MA (2010). Prevalence and correlates of recent and repeat mammography among California women ages 55-79. Cancer Epidemiol, 34, 168-77. https://doi.org/10.1016/j.canep.2010.02.005
  38. Rastogi T, Devesa S, Mangtani P, et al (2008). Cancer incidence rates among South Asians in four geographic regions: India, Singapore, UK and US. Int J Epidemiol, 37, 147-60. https://doi.org/10.1093/ije/dym219
  39. Rubin DB (1987). Multiple Imputation for nonresponse in surveys. John Wiley & Sons, Inc., Hoboken, NJ, USA.
  40. Subramanian P, Oranye NO, Masri AM, Taib NA, Ahmad N (2013). Breast cancer knowledge and screening behaviour among women with a positive family history: a cross sectional study. Asian Pac J Cancer Prev, 14, 6783-90. https://doi.org/10.7314/APJCP.2013.14.11.6783
  41. Schafer JL (1999). Multiple imputation: a primer. Stat Methods Med Res, 8, 3-15. https://doi.org/10.1191/096228099671525676
  42. Sokal R (2010). A critical review of the literature on the uptake of cervical and breast screening in British South Asian women. Qual Prim Care, 18, 251-61.
  43. Stanford JL, Herrinton LJ, Schwartz SM, Weiss NS (1995). Breast cancer incidence in Asian migrants to the U.S. and their descendants. Epidemiology, 6, 181-3. https://doi.org/10.1097/00001648-199503000-00017
  44. Sutton GC, Storer A, Rowe K (2001). Cancer screening coverage of south Asian women in Wakefield. J Med Screen, 8, 183-6. https://doi.org/10.1136/jms.8.4.183
  45. Szczepura A, Price C, Gumber A (2008). Breast and bowel cancer screening uptake patterns over 15 years for UK south Asian ethnic minority populations, corrected for differences in socio-demographic characteristics. BMC Public Health, 8, 346. https://doi.org/10.1186/1471-2458-8-346
  46. Tsangari H, Petro-Nustas W (2012). The psychometric properties of the greek version of champion's health belief model scale. J Nurs Meas, 20, 244-57. https://doi.org/10.1891/1061-3749.20.3.244
  47. Tsunematsu M, Kawasaki H, Masuoka Y, Kakehashi M (2013). Factors affecting breast cancer screening behavior in Japan--assessment using the health belief model and conjoint analysis. Asian Pac J Cancer Prev, 14, 6041-8. https://doi.org/10.7314/APJCP.2013.14.10.6041
  48. Wang HH, Chung YC, Sun JL (2012). The effects of education program on knowledge and intention of breast cancer screening in Taiwan. Asian Pac J Cancer Prev, 13, 5545-9. https://doi.org/10.7314/APJCP.2012.13.11.5545
  49. Wu TY, West B, Chen YW, Hergert C (2006). Health beliefs and practices related to breast cancer screening in Filipino, Chinese and Asian-Indian women. Cancer Detect Prev, 30, 58-66. https://doi.org/10.1016/j.cdp.2005.06.013
  50. Ziegler RG, Hoover RN, Pike MC, et al (1993). Migration patterns and breast cancer risk in Asian-American women. J Natl Cancer Inst, 85, 1819-27. https://doi.org/10.1093/jnci/85.22.1819

Cited by

  1. Cancer screening behaviours among South Asian immigrants in the UK, US and Canada: a scoping study vol.24, pp.2, 2015, https://doi.org/10.1111/hsc.12208
  2. Heart disease and breast cancer perceptions: Ethnic differences and relationship to attentional bias vol.3, pp.2, 2016, https://doi.org/10.1177/2055102916657673
  3. Psychometric Properties of the Breast Cancer Screening Beliefs Questionnaire Among Women of Indian Ethnicity Living in Australia vol.39, pp.4, 2016, https://doi.org/10.1097/NCC.0000000000000294
  4. Cultural Beliefs and Attitudes About Breast Cancer and Screening Practices Among Arabic Women in Australia vol.39, pp.5, 2016, https://doi.org/10.1097/NCC.0000000000000325
  5. Applying the Health Belief Model and an Integrated Behavioral Model to Promote Breast Tissue Donation Among Asian Americans pp.1532-7027, 2017, https://doi.org/10.1080/10410236.2017.1315678
  6. A Theory-Based and Culturally Aligned Training Program on Breast and Cervical Cancer Prevention for South Asian Community Health Workers vol.42, pp.2, 2019, https://doi.org/10.1097/NCC.0000000000000543