Journal of Community Health

, Volume 29, Issue 6, pp 437–450 | Cite as

Pap Testing Among Vietnamese Women: Health Care System and Physician Factors

  • Victoria M. Taylor
  • Stephen M. Schwartz
  • Yutaka Yasui
  • Nancy Burke
  • Jianfen Shu
  • D. Hien Lam
  • J. Carey Jackson


Cervical cancer occurs more frequently among Vietnamese Americans than women of any other race/ethnicity. In addition, previous studies in California have documented low Papanicolaou (Pap) testing rates in Vietnamese communities. This study focused on health care system factors and physician characteristics associated with recent cervical cancer screening among Vietnamese women. A population-based survey was conducted in Seattle during 2002. In-person interviews were conducted by bilingual, bicultural female survey workers. The survey response rate was 82% and 518 women were included in the analysis. Seventy-four percent of the respondents reported having been screened for cervical cancer on at least one occasion, and 64% reported a Pap smear within the previous 2 years. Women with a regular doctor were more likely to have been recently screened than those without a regular doctor (OR=2.33, 95% CI=1.45–3.74). Among those with a regular doctor, having a male physician, receiving care at a private doctor's office (rather than a community, hospital, or multi-specialty clinic), and concern about the cost of health care were independently associated with lower screening rates. Physician ethnicity was not associated with recent Pap smear receipt. The findings support targeted interventions for Vietnamese women without a regular physician and private doctors' offices that serve Vietnamese Americans. The availability of low cost screening services should be publicized in Vietnamese communities.

cervical cancer immigrants Pap testing Vietnamese 


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  1. 1.
    US Census Bureau. US Summary: 2000. Washington, DC: Department of Commerce, 2002, p. 9.Google Scholar
  2. 2.
    McPhee SJ, Stewart S, Brock KC, Bird JA, Jenkins CNH, Pham GQ. Factors associated with breast and cervical cancer screening practices among Vietnamese American women. Cancer Detect Prev 1997; 21:510–521.PubMedGoogle Scholar
  3. 3.
    National Cancer Institute. Racial/Ethnic Patterns of Cancer in the United States, 1988–1992. Bethesda: National Institutes of Health, 1996, p. 37.Google Scholar
  4. 4.
    Hiatt RA, Pasick RJ, Pe´rez-Stable EJ, et al. Pathways to early cancer detection in the multiethnic population of the San Francisco Bay Area. Health Educ Q 1996; 23:10–27.Google Scholar
  5. 5.
    McPhee SJ, Nguyen TT. Cancer, cancer risk factors, and community-based cancer control trials in Vietnamese Americans. Asian Am Pac Isl J Health 2000; 8:18–31.PubMedGoogle Scholar
  6. 6.
    Nguyen T, McPhee S, Lam T, Mock J. Predictors of cervical Pap smear screening awareness, intention, and receipt among Vietnamese-American women. Am J Prev Med 2002; 23:207–214.PubMedGoogle Scholar
  7. 7.
    Department of Commerce. 1990 Census of Population and Housing: Population and Housing Characteristics for Census Tracts and Block Numbering Areas-Seattle, WA PMSA. Washington DC: Department of Commerce, 1993, pp. 161–222.Google Scholar
  8. 8.
    McPhee SJ. Promoting breast and cervical cancer screening among Vietnamese American women: two interventions. Asian Am Pac Isl J Health 1998; 6:344–350.PubMedGoogle Scholar
  9. 9.
    Eyton J, Neuwirth G. Cross-cultural validity: ethnocentrism in health studies with special reference to the Vietnamese. Soc Sci Med 1984; 18:447–453.PubMedGoogle Scholar
  10. 10.
    US Preventive Services Task Force. Guide to Clinical Preventive Services. Baltimore: Williams and Wilkins, 1996, pp. 269–276.Google Scholar
  11. 11.
    Saslow D, Runowicz CD, Solomon D, et al. American Cancer Society guideline for the early detection of cervical neoplasia and cancer. CA Cancer J Clin 2002; 52:342–362.PubMedGoogle Scholar
  12. 12.
    Anderson J, Moeschberger M, Chen MS, Jr., Kunn P, Wewers ME, Guthrie R. An acculturation scale for Southeast Asians. Soc Psychiatry Psychiatr Epidemiol 1993; 28:134–141.PubMedGoogle Scholar
  13. 13.
    Rosner B. Fundamentals of Biostatistics. Boston: Duxbury, 2000, pp. 302–367.Google Scholar
  14. 14.
    Breslow NS, Day NE. Statistical Methods in Cancer Research. Volume 1: The Analysis of Case–Control Studies. Lyon: International Agency for Research on Cancer, 1980, pp. 192–246.Google Scholar
  15. 15.
    Department of Health and Human Services. Healthy People 2010. Washington DC: US Government Printing Office, 2000, pp. 323–324.Google Scholar
  16. 16.
    Taylor VM, Schwartz SM, Jackson JC, et al. Cervical cancer screening among Cambodian-American women. Cancer Epidemiol Biomarkers Prev 1999; 8:541–546.PubMedGoogle Scholar
  17. 17.
    Yi JK. Factors associated with cervical cancer screening behavior among Vietnamese women. J Community Health 1994; 19:189–200.PubMedGoogle Scholar
  18. 18.
    Yi JK. Acculturation and Pap smear screening practices among college-aged Vietnamese women in the United States. Cancer Nurs 1998; 21:335–341.PubMedGoogle Scholar
  19. 19.
    Mandelblatt JS, Gold K, O'Malley AS, et al. Breast and cervix cancer screening among multiethnic women: role of age, health, and source of care. Prev Med 1999; 28:418–425.PubMedGoogle Scholar
  20. 20.
    Taylor VM, Jackson JC, Tu SP, et al. Cervical cancer screening among Chinese Americans. Cancer Detect Prev 2002; 26:139–145.PubMedGoogle Scholar
  21. 21.
    McPhee SJ, Bird JA, Davis T, Ha NT, Jenkins CN, Le B. Barriers to breast and cervical cancer screening among Vietnamese-American women. Am J Prev Med 1997; 13:205–213.PubMedGoogle Scholar
  22. 22.
    Mayer WJ, Beardall RW. Translating science into practice: cancer prevention in primary care medicine. In P Greenwald, BS Kramer and DL Weed (Eds.), Cancer Prevention and Control. New York: Marcell Dekker, 1995, pp. 411–433.Google Scholar
  23. 23.
    Jacobs EA, Lauderdale DS, Meltzer D, Shorey JM, Levinson W, Thisted RA. Impact of interpreter services on delivery of health care to limited-English-proficient patients. J Gen Intern Med 2001; 16:468–474.PubMedGoogle Scholar
  24. 24.
    Frey JH. Survey Research by Telephone. Newbury Park: Sage Publications, 1989, pp. 10–12.Google Scholar
  25. 25.
    Wilcox JB. The interaction of refusal and not-at-home sources of non-response bias. J Market Res 1977; XIV:592–597.Google Scholar
  26. 26.
    McPhee SJ, Nguyen TT, Shema SJ, et al. Validation of recall of breast and cervical cancer screening by women in an ethnically diverse population. Prev Med 2002; 35:463–473.PubMedGoogle Scholar
  27. 27.
    Pasick RJ, Stewart SL, Bird JA, D'Onofrio CN. Quality of data in multiethnic health surveys. Public Health Rep 2001; 116:223–243.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2004

Authors and Affiliations

  • Victoria M. Taylor
    • 1
  • Stephen M. Schwartz
    • 1
  • Yutaka Yasui
    • 1
  • Nancy Burke
    • 2
  • Jianfen Shu
    • 3
  • D. Hien Lam
    • 4
  • J. Carey Jackson
    • 4
  1. 1.Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleUSA
  2. 2.Comprehensive Cancer CenterUniversity of CaliforniaSan FranciscoUSA
  3. 3.Department of Health Evaluation SciencesUniversity of VirginiaCharlottesvilleUSA
  4. 4.Department of MedicineUniversity of WashingtonSeattleUSA

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