Skip to main content

Advertisement

SpringerLink
Log in

Breast Cancer Screening Among Korean Americans: A Systematic Review

  • Original Paper
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

Cancer is the leading cause of death for Korean Americans (KAs). Breast cancer (BC) is the most commonly occurring cancer among KA women, and its rate has been rapidly increasing. Low BC screening rates for KAs puts them at greater risk for late-stage breast cancer. We conducted a systematic review of the published literature on cancer screening among KAs, and identified 38 eligible studies. Despite significant increases in mammogram utilization over the past two decades, KAs have consistently lower rates of mammogram screening than other American populations. KA women also report lower rates of clinical breast examination and breast self-examination. Screening rates are higher among adults with higher socioeconomic status, greater acculturation to the United States, more cancer knowledge, higher perceived susceptibility to BC, more social support, and better access to health services. However, fear of finding something wrong, fear of embarrassment or lack of modesty, not knowing where to go for screening, believing that mammography is only necessary when symptoms are present, and perceived time and cost difficulties in accessing mammography were reported as barriers to mammogram screening. Coordinated efforts from clinicians, public health workers, KA cultural and religious organizations, and the broader breast cancer advocacy and awareness community are necessary for improving BC screening among KAs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. U.S. Census Bureau. (2012). The Asian Population: 2010, 2010 Census Briefs. Retrieved 28 June, 2016, from https://www.census.gov/prod/cen2010/briefs/c2010br-11.pdf.

  2. American Fact Finder, U.S. Census Bureau. (2010). Race Reporting for the Asian Population by Selected Categories: 2010. Retrieved 28 June, 2016, from http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk.

  3. Terrazas, A., Batog, C. (2010). Migration Information Source—Korean Immigrants in the United States. Migration Policy Institute. Retrieved 10 May, 2016, from http://www.migrationpolicy.org/article/korean-immigrants-united-states-0.

  4. Chen, G. A., Lephuoc, P., Guzmán, M. R., Rude, S. S., & Dodd, B. G. (2006). Exploring Asian American racial identity. Cultural Diversity & Ethnic Minority Psychology, 12, 461–476.

    Article  Google Scholar 

  5. Heron, M. (2012). Deaths: Leading causes for 2008. National Vital Statistics Reports, 60, 1–94.

    PubMed  Google Scholar 

  6. Chen, M. S. Jr. (2005). Cancer health disparities among Asian Americans: What we do and what we need to do. Cancer, 104(12 Suppl), 2895–2902.

    Article  PubMed  Google Scholar 

  7. McCracken, M., Olsen, M., Chen, M. S. Jr., Jemal, A., Thun, M., Cokkinides, V., et al. (2007). Cancer incidence, mortality, and associated risk factors among Asian Americans of Chinese, Filipino, Vietnamese, Korean, and Japanese ethnicities. CA: A Cancer Journal for Clinicians, 57, 190–205.

    Google Scholar 

  8. Miller, B. A., Chu, K. C., Hankey, B. F., & Ries, L. A. G. (2008). Cancer incidence and mortality patterns among specific Asian and Pacific Islander populations in the U.S. Cancer Causes & Control, 19, 227–256.

    Article  Google Scholar 

  9. Gomez, S. L., Noone, A. M., Lichtensztajn, D. Y., Scoppa, S., Gibson, J. T., Liu, L., et al. (2013). Cancer incidence trends among Asian American populations in the United States, 1990–2008. Journal of the National Cancer Institute, 105, 1096–1110.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Miller, B. A., Hankey, B. F., & Thomas, T. L. (2002). Impact of sociodemographic factors, hormone receptor status, and tumor grade on ethnic differences in tumor stage and size for breast cancer in U.S. women. American Journal of Epidemiology, 155, 534–545.

    Article  PubMed  Google Scholar 

  11. Tabár, L., Fagerberg, C. J., Gad, A., Baldetorp, L., Holmberg, L. H., Gröntoft, O., et al. (1985). Reduction in mortality from breast cancer after mass screening with mammography: Randomized trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare. Lancet, 325, 829–832.

    Article  Google Scholar 

  12. Kerlikowske, K., Grady, D., Rubin, S. M., Sandrock, C., & Ernster, V. L. (1995). Efficacy of screening mammography: A meta-analysis. Journal of the American Medical Association, 273, 149–154.

    Article  CAS  PubMed  Google Scholar 

  13. USPSTF (2016). Final Update Summary: Breast Cancer: Screening—US Preventive Services Task Force. Retrieved 10 February, 2016, from http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening1.

  14. American Cancer Society. (2016). American Cancer Society Guidelines for the Early Detection of Cancer. Retrieved 28 June, 2016, from http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer.

  15. Centers for Disease Control and Prevention. (2013). The State of Aging and Health in America. Retrieved 9 June, 2016, from http://www.cdc.gov/aging/pdf/state-aging-health-in-america-2013.pdf.

  16. Choi, K. S., Lee, S., Park, E., Kwak, M. S., Spring, B. J., & Juon, H. S. (2010). Comparison of breast cancer screening rates between Korean women in America versus Korea. Journal of Women’s Health, 19, 1089–1096.

    Article  PubMed  Google Scholar 

  17. Juon, H. S., Kim, M., Shankar, S., & Han, W. (2004). Predictors of adherence to screening mammography among Korean American women. Preventive Medicine, 39, 474–481.

    Article  PubMed  Google Scholar 

  18. Kagawa-Singer, M., Pourat, N., Breen, N., Coughlin, S., Abend McLean, T., McNeel, T. S., & Ponce, N. A. (2007). Breast and cervical cancer screening rates of subgroups of Asian American women in California. Medical Care Research and Review, 64, 706–730.

    Article  PubMed  Google Scholar 

  19. Lee, H., Kim, J., & Han, H. R. (2009). Do cultural factors predict mammography behaviour among Korean immigrants in the USA? Journal of Advanced Nursing, 65, 2574–2584.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Maxwell, A. E., Crespi, C. M., Antonio, C. M., & Lu, P. (2010). Explaining disparities in colorectal cancer screening among five Asian ethnic groups: A population-based study in California. BMC Cancer, 10, 214.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Moskowitz, J. M., Kazinets, G., Wong, J. M., & Tager, I. B. (2007). “Health is strength”: A community health education program to improve breast and cervical cancer screening among Korean American Women in Alameda County, California. Cancer Detection and Prevention, 31, 173–183.

    Article  PubMed  Google Scholar 

  22. Pourat, N., Kagawa-Singer, M., Breen, N., & Sripipatana, A. (2010). Access versus acculturation: Identifying modifiable factors to promote cancer screening among Asian American women. Medical Care, 48, 1088–1096.

    PubMed  Google Scholar 

  23. U.S. Department of Health and Human Services. (2016). Healthy People 2020 topics and objectives: Cancer. Retrieved 9 June, 2016, from https://www.healthypeople.gov/2020/topics-objectives/topic/cancer.

  24. Lee, H. Y., Ju, E., Vang, P. D., & Lundquist, M. (2010). Breast and cervical cancer screening among Asian American women: Does race/ethnicity matter? Journal of Women’s Health, 19, 1877–1884.

    Article  PubMed  Google Scholar 

  25. Kim, K., Yu E. S. H., Chen, E. H., Kim, J., Kaufman, M., & Purkiss, J. (1999). Cervical cancer screening knowledge and practices among Korean-American women. Cancer Nursing, 22, 297–302.

    Article  CAS  PubMed  Google Scholar 

  26. Oh, K. M., Kreps, G., Jun, J., & Ramsey, L. (2011). Cancer information seeking and awareness of cancer information sources among Korean Americans. Journal of Cancer Education, 26, 355–364.

    Article  PubMed  Google Scholar 

  27. Oh, K. M., Kreps, G. L., & Jun, J. (2013). Colorectal cancer screening knowledge, beliefs, and practices of Korean Americans. American Journal of Health Behavior, 37, 381–394.

    Article  PubMed  Google Scholar 

  28. Oh, K. M., Jun, J., Zhao, X., Kreps, G. L., & Lee, E. E. (2015). Cancer information seeking behaviors of Korean American women: A mixed methods study using surveys and focus group interviews. Journal of Health Communication, 20, 1143–1154.

    Article  PubMed  Google Scholar 

  29. Asian Pacific Islander American Health Forum (APIAHF). (2006). APIAHF Health Brief: Koreans in the United States. Retrieved 21 April, 2016, from http://www.apiahf.org/sites/default/files/APIAHF_Healthbrief08e_2006.pdf.

  30. Shin H. B., Kominski, R. A. (2010). Language Use in the United States: 2007, American Community Survey Reports, ACS-12. Retrieved 21 April, 2016, from https://www.census.gov/prod/2010pubs/acs-12.pdf.

  31. New California Media. (2003). Bridging language barriers in health care: Public opinion survey of California immigrants from Latin America, Asia and the Middle East. Woodland Hills, CA: The California Endowment.

    Google Scholar 

  32. Oh, K. M., Kreps, G. L., Jun, J., Chong, E., & Ramsey, L. (2012). Examining the health information-seeking behaviors of Korean Americans. Journal of Health Communication, 17, 779–801.

    Article  PubMed  Google Scholar 

  33. Kim, M. J., Cho, H. I., Cheon-Klessig, Y. S., Gerace, L. M., & Camilleri, D. D. (2002). Primary health care for Korean immigrants: Sustaining a culturally sensitive model. Public Health Nursing .19, 191–200.

    Article  PubMed  Google Scholar 

  34. Oh, K. M., & Jacobsen, K. H. (2013). Colorectal cancer screening among Korean Americans: A systematic review. Journal of Community Health, 39, 193–200.

    Article  Google Scholar 

  35. Yoo G. J., Kim B. W. (2008). Korean immigrants and health care access: Implications for the uninsured and underinsured. Research in the Sociology of Health Care, 25:77–94.

    Article  Google Scholar 

  36. National Center for Health Statistics. (2011). Products—NHIS Early Release—Health Insurance—2010. Retrieved 10 May, 2012, from http://www.cdc.gov/nchs/nhis.htm.

  37. NCAPIP (National Council of Asian Pacific Islander Physicians. (2015). The Impact of the Affordable Care Act on Asian Indian, Chinese, Filipino, Korean, Pakistani, and Vietnamese Americans. Retrieved 21 April, 2016, from http://files.ctctcdn.com/0b5c58ed001/7f8bfeb4-ba4d-4b55-9628-ea34fc4e4438.pdf.

  38. Asia Matters for America, East-West Center. (2016). Korean-American Population Data. Retrieved 9 June, 2016 from http://www.asiamattersforamerica.org/southkorea/data/koreanamericanpopulation.

  39. Eun, Y., Lee, E. E., Kim, M. J., & Fogg, L. (2009). Breast cancer screening beliefs among older Korean American women. Journal of Gerontological Nursing, 35, 40–50.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Han, H. R., Lee, H., Kim, M. T., & Kim, K. B. (2009). Tailored lay health worker intervention improves breast cancer screening outcomes in non-adherent Korean-American women. Health Education Research, 24, 318–329.

    Article  PubMed  Google Scholar 

  41. Han, Y., Williams, R. D., & Harrison, R. A. (1999). Breast self examination (BSE) among Korean American women: Knowledge, attitudes and behaviors. Journal of Cultural Diversity, 6, 115–123.

    Google Scholar 

  42. Han, Y., Williams, R. D., & Harrison, R. A. (2000). Breast cancer screening knowledge, attitudes, and practices among Korean American women. Oncology Nursing Forum, 27, 1585–1591.

    CAS  PubMed  Google Scholar 

  43. Juon, H. S., Choi, Y., & Kim, M. T. (2000). Cancer screening behaviors among Korean-American women. Cancer Detection and Prevention, 24, 589–601.

    CAS  PubMed  Google Scholar 

  44. Juon, H., Seo, Y., & Kim, M. (2002). Breast and cervical cancer screening among Korean American elderly women. European Journal of Oncology Nursing, 6, 228–235.

    Article  PubMed  Google Scholar 

  45. Kim, J. K. (2014). Effects of acculturation on mammography utilization among Korean American women. Dissertation, University of San Diego.

  46. Kim, J. H., & Menon, U. (2009). Pre- and postintervention differences in acculturation, knowledge, beliefs, and stages of readiness for mammograms among Korean American women. Oncology Nursing Forum, 36, E80–E92.

    Article  PubMed  Google Scholar 

  47. Kim, Y. H., & Sarna, L. (2004). An intervention to increase mammography use by Korean American women. Oncology Nursing Forum, 31, 105–110.

    Article  PubMed  Google Scholar 

  48. Kim, K., Yu E. S., Chen, E. H., Kim, J. K., & Brintnall, R. A. (1998). Breast cancer screening knowledge and practices among Korean American women. Asian American and Pacific Islander Journal of Health, 6, 263–275.

    CAS  PubMed  Google Scholar 

  49. Kim, J. H., Menon, U., Wang, E., & Szalacha, L. (2010). Assess the effects of culturally relevant intervention on breast cancer knowledge, beliefs, and mammography use among Korean American women. Journal of Immigrant and Minority Health, 12, 586–597.

    Article  PubMed  Google Scholar 

  50. Lee, E. E., Nandy, K., Szalacha, L., Park, H., Oh, K. M., Lee, J., & Menon, U. (2016). Korean American women and mammogram uptake. Journal of Immigrant and Minority Health, 18, 179–186.

    Article  PubMed  Google Scholar 

  51. Lee, E., Menon, U., Nandy, K., Szalacha, L., Kviz, F., Cho, Y., Miller, A., & Park, H. (2014). The effect of a couples intervention to increase breast cancer screening among Korean Americans. Oncology Nursing Forum, 41, E185–E193.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Lee, E. E., Brecht, M.-L., Park, H., Lee, J., & Oh, K. M. (2016). Web-based study for improving mammography among Korean American women. Journal of Cancer Education. doi:10.1007/s13187-015-0920-2.

    PubMed Central  Google Scholar 

  53. Lee, E. E., Tripp-Reimer, T., Miller, A. M., Sadler, G. R., & Lee, S. Y. (2007). Korean American women’s beliefs about breast and cervical cancer and associated symbolic meanings. Oncology Nursing Forum, 34, 713–720.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Lee, Y. S., Hofstetter, C. R., Irvin, V. L., Kang, S., Chhay, D., Reyes, W. D., & Hovell, M. F. (2012). Korean American women’s preventive health care practices: Stratified samples in California, USA. Health Care for Women International, 33, 422–439.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Lee, E., Fogg, L., & Sadler, G. (2006). Factors of breast cancer screening among Korean immigrants in the United States. Journal of Immigrant and Minority Health , 8, 223–233.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Lee, H. Y., Stange, M. J., & Ahluwalia, J. S. (2015). Breast cancer screening behaviors among Korean American immigrant women: Findings from the Health Belief Model. Journal of Transcultural Nursing, 26, 450–457.

    Article  PubMed  Google Scholar 

  57. Lew, A. A., Moskowitz, J. M., Ngo, L., Wismer, B. A., Wong, J. M., Ahn, Y., & Tager, I. B. (2003). Effect of provider status on preventive screening among Korean-American women in Alameda County, California. Preventive Medicine, 36, 141–149.

    Article  PubMed  Google Scholar 

  58. Ma, G. X., Shive, S. E., Wang, M. Q., & Tan, Y. (2009). Cancer screening behaviors and barriers in Asian Americans. American Journal of Health Behavior, 33, 650–660.

    Article  PubMed  Google Scholar 

  59. Maxwell, A. E., Jo, A. M., Chin, S. Y., Lee, K. S., & Bastani, R. (2008). Impact of a print intervention to increase annual mammography screening among Korean American women enrolled in the National Breast and Cervical Cancer Early Detection Program. Cancer Detection and Prevention, 32, 229–235.

    Article  PubMed  Google Scholar 

  60. Maxwell, A. E., Bastani, R., & Warda, U. S. (1998). Mammography utilization and related attitudes among Korean-American women. Women and Health, 27, 89–107.

    Article  CAS  PubMed  Google Scholar 

  61. Maxwell, A. E., Bastani, R., & Warda, U. S. (1998). Misconceptions and mammography use among Filipino- and Korean-American women. Ethnicity and Disease, 8, 377–384.

    CAS  PubMed  Google Scholar 

  62. Park, S. (2000). The factors influencing the practice of breast cancer screening among Korean-American women. Dissertation, Virginia Commonwealth University.

  63. Ryu, S. Y., Crespi, C. M., & Maxwell, A. E. (2013). What factors explain disparities in mammography rates among Asian-American immigrant women? A population-based study in California. Women’s Health Issues, 23, e403–e410.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Sadler, G. R., Ryujin, L. T., Ko, C. M., & Nguyen, E. (2001). Korean women: Breast cancer knowledge, attitudes and behaviors. BMC Public Health, 1, 7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Sarna, L., Tae, Y. S., Kim, Y. H., Brecht, M. L., & Maxwell, A. E. (2001). Cancer screening among Korean Americans. Cancer Practice, 9, 134–140.

    Article  CAS  PubMed  Google Scholar 

  66. Sohn, L., & Harada, N. D. (2005). Knowledge and use of preventive health practices among Korean women in Los Angeles county. Preventive Medicine, 41, 167–178.

    Article  PubMed  Google Scholar 

  67. Wismer, B. A., Moskowitz, J. M., Min, K., Chen, A. M., Ahn, Y., Cho, S., et al. (2001). Interim assessment of a community intervention to improve breast and cervical cancer screening among Korean American women. Journal of Public Health Management and Practice, 7, 61–70.

    Article  CAS  PubMed  Google Scholar 

  68. Wismer, B. A., Moskowitz, J. M., Chen, A. M., Kang, S. H., Novotny, T. E., Min, K., et al. (1998). Mammography and clinical breast examination among Korean American women in two California counties. Preventive Medicine, 27, 144–151.

    Article  CAS  PubMed  Google Scholar 

  69. Yu, M. Y., Hong, O. S., & Seetoo, A. D. (2003). Uncovering factors contributing to under-utilization of breast cancer screening by Chinese and Korean women living in the United States. Ethnicity and Disease, 13, 213–219.

    PubMed  Google Scholar 

  70. Centers for Disease Control and Prevention (2012). Cancer screening—United States, 2010. Morbidity and Mortality Weekly Report, 61, 41–45.

    Google Scholar 

  71. Sabatino, S. A., White, M. C., Thompson, T. D., & Klabunde, C. N. (2015). Cancer screening test use—United States, 2013. Morbidity and Mortality Weekly Report, 64, 464–468.

    PubMed  Google Scholar 

  72. Oh, K. M., Zhou, Q. P., Kreps, G. L., & Ryu, S. K. (2012). Breast cancer screening practices among Asian Americans and Pacific Islanders. American Journal of Health Behavior, 36, 711–722.

    Article  PubMed  Google Scholar 

  73. Rhodes, S. D., Song, E., Nam, S., Choi, S. J., & Choi, S. (2015). Identifying and intervening on barriers to healthcare access among members of a small Korean community in the southern USA. Patient Education and Counseling, 98, 484–491.

    Article  PubMed  Google Scholar 

  74. Centers for Disease Control and Prevention (2004). Breast- and cervical-cancer screening among Korean women—Santa Clara County, California, 1994 and 2002. Morbidity and Mortality Weekly Report, 53, 765–767.

    Google Scholar 

  75. Jo, A. M., Maxwell, A. E., Rick, A. J., Cha, J., & Bastani, R. (2009). Why are Korean American physicians reluctant to recommended colorectal cancer screening to Korean American patients? Exploratory interview findings. Journal of Immigrant and Minority Health, 11, 302–309.

    Article  PubMed  Google Scholar 

  76. Han, E., Song, H., & Kim, S. H. (1996). Doctor visits among Korean Americans in Los Angeles County. Asian American and Pacific Islander Journal of Health, 4, 146–148.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Nursing, George Mason University, 4400 University Drive 3C4, Fairfax, VA, 22030, USA

    Kyeung Mi Oh

  2. Department of Global and Community Health, George Mason University, 4400 University Drive 5B7, Fairfax, VA, 22030, USA

    Karen L. Taylor & Kathryn H. Jacobsen

Authors
  1. Kyeung Mi Oh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Karen L. Taylor
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kathryn H. Jacobsen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kyeung Mi Oh.

Ethics declarations

Conflict of Interest

None of the authors have conflicts of interest to disclose.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Oh, K.M., Taylor, K.L. & Jacobsen, K.H. Breast Cancer Screening Among Korean Americans: A Systematic Review. J Community Health 42, 324–332 (2017). https://doi.org/10.1007/s10900-016-0258-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-016-0258-7

Keywords

Search

Navigation