Skip to main content

Advertisement

SpringerLink
Log in

Determinants of Cancer Screening Disparities Among Asian Americans: A Systematic Review of Public Health Surveys

  • Published:
Journal of Cancer Education Aims and scope Submit manuscript

Abstract

We conducted a systematic analysis of 24 peer-reviewed literary works that examined Asian Americans’ breast, cervical, and colon cancer screening, focusing on empirical findings from large-scale public health surveys (i.e., NHIS, CHIS, HINTS, BRFSS). We provide an overview of relevant research in terms of study characteristics, samples, predictor/covariate of cancer screenings, and key findings. Our analysis indicates that Asian Americans’ cancer screening rates are lower than for non-Hispanic Whites for all cancer types in four large-scale public health surveys throughout 17 study years. Acculturation and healthcare access were two significant factors in explaining Asian Americans’ cancer screening rates. Cancer fatalism and family cancer history emerged as potential factors that may account for more variances. However, the screening disparities between Asian Americans and whites persist even after adjusting all covariates, including SES, acculturation, healthcare access, health status, and health perception/literacy. More individual and cultural factors should be identified to address these disparities.

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. Alba I, Hubbell A, McMullin J, Sweningson J, Saitz R (2005) Impact of US citizenship status on cancer screening among immigrant women. J Gen Intern Med 20(3):290–296. doi:10.1111/j.1525-1497.2005.40158.x

    Article  PubMed  PubMed Central  Google Scholar 

  2. Breen N, Gentleman J, Schiller J (2011) Update on mammography trends: comparisons of rates in 2000, 2005, and 2008. Cancer 117(10):2209–2218. doi:10.1002/cncr.25679

    Article  PubMed  Google Scholar 

  3. Breen N, Cronin K, Tiro J, Meissner H, McNeel T, Sabatino S, Taplin S (2011) Was the drop in mammography rates in 2005 associated with the drop in hormone therapy use? Cancer 117(24):5450–5460

  4. CDC (2010) NCHS, NVSS, mortality data, deaths, final data for 2010. Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/minorityhealth/populations/REMP/asian.html#Demographics

  5. CDC (2013) REACH Publications by Racial/Ethnic Group. Retrieved from http://www.cdc.gov/nccdphp/dch/programs/reach/publications/racial_ethnic_group.htm

  6. CDC (2015) African American Women and Mass Media (AAMM) Campaign. Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/cancer/breast/what_cdc_is_doing/aamm.htm

  7. Coughlin S & Uhler R (2000) Breast and cervical cancer screening practices among Asian and Pacific Islander women in the United States, 1994-1997. Cancer Epidemiol Biomark Prev 9(6):597–603

  8. Chawla N, Breen N, Liu B, Lee R, Kagawa-Singer M (2015) Asian American women in California: a pooled analysis of predictors for breast and cervical cancer screening. Am J Public Health 105(2):e98–e109. doi:10.2105/AJPH.2014.302250

    Article  PubMed  PubMed Central  Google Scholar 

  9. Crawford J, Ahmad F, Beaton D, Bierman AS (2016) Cancer screening behaviours among South Asian immigrants in the UK, US and Canada: a scoping study. Health and Social Care in the Community 24(2):123–153. doi:10.1111/hsc.12208

    Article  PubMed  Google Scholar 

  10. Eun Y, Lee E, Kim M, Fogg L (2009) Breast cancer screening beliefs among older Korean American women. Journal of Geontological Nursing 35(9):40–50. doi:10.3928/00989134-20090731-09

    Article  Google Scholar 

  11. Field A (2009) Discovering statistics using SPSS, 3rd edn. SAGE, London

    Google Scholar 

  12. Goel M, Wee C, McCarthy E, Davis R, Ngo-Metzger Q, Phillips R (2003) Racial and ethnic disparities in cancer screening: the importance of foreign birth as a barrier to care. J Gen Intern Med 18(12):1028–1035. doi:10.1111/j.1525-1497.2003.20807.x

    Article  PubMed  PubMed Central  Google Scholar 

  13. Gomez S, Tan S, Keegan T, Clarke C (2007) Disparities in mammographic screening for Asian women in California: a cross-sectional analysis to identify meaningful groups for targeted intervention. BMC Cancer 7(1):201. doi:10.1186/1471-2407-7-201

    Article  PubMed  PubMed Central  Google Scholar 

  14. HAF (2016) Together we can defeat cancer project. Hispanic Access Foundation. Retrieved from https://hispanicaccess.org/our-projects/health

  15. Hamman MK, Kapinos KA (2015) Mandated coverage of preventive care and reduction in disparities: evidence from colorectal cancer screening. Am J Public Health 105(S3):S508–S516. doi:10.2105/AJPH.2015.302578

    Article  PubMed  PubMed Central  Google Scholar 

  16. Han H, Song Y, Kim M, Hedlin H, Kim K, Lee H, Roter D (2017) Breast and cervical cancer screening literacy among Korean American women: a community health worker–led intervention. Am J Public Health 107(1):159–165. doi:10.2105/AJPH.2016.303522

    Article  PubMed  PubMed Central  Google Scholar 

  17. Hoeffel E, Rastogi S, Kim M, and Shahid H (2012) The Asian population 2010. Retrieved April 7, 2016, from https://www.census.gov/prod/cen2010/briefs/c2010br-11.pdf

  18. Jun J, Oh K (2013) Asian and Hispanic Americans’ cancer fatalism and colon cancer screening. Am J Health Behav 37(2):145–154. doi:10.5993/AJHB.37.2.1

    Article  PubMed  Google Scholar 

  19. Kagawa-Singer M, Pourat N (2000) Asian American and Pacific Islander breast and cervical carcinoma screening rates and healthy people 2000 objectives. Cancer 89(3):696–705. doi:10.1002/1097-0142(20000801)89:3<696

    Article  PubMed  CAS  Google Scholar 

  20. Kagawa-Singer M, Pourat N, Breen N, Coughlin S, Abend McLean T, McNeel T, Ponce N (2007) Breast and cervical cancer screening rates of subgroups of Asian American women in California. Med Care Res Rev 64(6):706–730. doi:10.1177/1077558707304638

    Article  PubMed  Google Scholar 

  21. Kandula N, Wen M, Jacobs E, Lauderdale D (2009) Association between neighborhood context and smoking prevalence among Asian Americans. Am J Public Health 99(5):885–892. doi:10.2105/AJPH.2007.131854

    Article  PubMed  PubMed Central  Google Scholar 

  22. Lai Y, Wang C, Civan J, Palazzo J, Ye Z, Hyslop T et al (2016) Effects of cancer stage and treatment differences on racial disparities in survival from colon cancer: a United States population-based study. Gastroenterology 150(5):1135–1146. doi:10.1053/j.gastro.2016.01.030

    Article  PubMed  PubMed Central  Google Scholar 

  23. Lee S (2015) Cultural factors associated with breast and cervical cancer screening in Korean American women in the US: an integrative literature review. Asian Nursing Research 9(2):81–90. doi:10.1016/j.anr.2015.05.003

    Article  PubMed  Google Scholar 

  24. Lee H, Vang S (2010) Barriers to cancer screening in Hmong Americans: the influence of health care accessibility, culture, and cancer literacy. J Community Health 35:302–314. doi:10.1007/s10900-010-9228-7

    Article  PubMed  Google Scholar 

  25. Lee H, Ju E, Vang P, Lundquist M (2010) Breast and cervical cancer screening disparity among Asian American women: does race/ethnicity matter? J Women’s Health 19(10):1877–1884. doi:10.1089/jwh.2009.1783

    Article  Google Scholar 

  26. Lee H, Lundquist M, Ju E, Luo X, & Townsend A (2011) Colorectal cancer screening disparities in Asian Americans and Pacific Islanders: Which groups are most vulnerable? Ethn Health 16(6):501–518. doi:10.1080/13557858.2011.575219

  27. Li C, Malone K, Daling J (2003) Differences in breast cancer stage, treatment, and survival by race and ethnicity. Arch Intern Med 163(1):49–56. doi:10.1001/archinte.163.1.49

    Article  PubMed  Google Scholar 

  28. Lim J (2010) Linguistic and ethnic disparities in breast and cervical cancer screening and health risk behaviors among Latina and Asian American women. Journal of Women’s Health (2002) 19(6):1097–1107. doi:10.1089/jwh.2009.1614

    Article  Google Scholar 

  29. Lin M, Moskowitz J, Kazinets G, Ivey S, Kim Y, McDonnell D (2009) Adherence to pap test guidelines: variation among Asians in California. Ethnicity and Disease 19(4):425–432

    PubMed  Google Scholar 

  30. Liss D, Baker D (2014) Understanding current racial/ethnic disparities in colorectal cancer screening in the United States. Am J Prev Med 46(3):228–236. doi:10.1016/j.amepre.2013.10.023

    Article  PubMed  Google Scholar 

  31. Lu M, Moritz S, Lorenzetti D, Sykes L, Straus S, Quan H (2012) A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women. BMC Public Health 12(1):413. doi:10.1186/1471-2458-12-413

    Article  PubMed  PubMed Central  Google Scholar 

  32. Maxwell A, Crespi C, Antonio C, Lu P (2010) Explaining disparities in colorectal cancer screening among five Asian ethnic groups: a population-based study in California. BMC Cancer 10:214–214. doi:10.1186/1471-2407-10-214

    Article  PubMed  PubMed Central  Google Scholar 

  33. Mead E, Doorenbos A, Javid S, Haozous E, Arviso Alvord L, Flum D, Morris A (2013) Shared decision-making for cancer care among racial and ethnic minorities: a systematic review. Am J Public Health 103(12):e15–e29. doi:10.2105/AJPH.2013.301631

    Article  PubMed  PubMed Central  Google Scholar 

  34. National Center for Health Statistics (2011) Health, United States, 2010: with special feature on death and dying. US Government Printing Office, Washington, DC

    Google Scholar 

  35. Nayak P, Paxton R, Holmes H, Nguyen T, Elting L (2015) Racial and ethnic differences in health behaviors among cancer survivors. Am J Prev Med 48(6):729–736. doi:10.1016/j.amepre.2014.12.015

    Article  PubMed  Google Scholar 

  36. NCI (2015) Disparities research. National Cancer Institute. Retrieved from https://www.cancer.gov/about-nci/organization/crchd/disparities-research

  37. NCI (2016a) Multicultural media outreach program. Retrieved from https://www.cancer.gov/news-events/media-resources/multicultural/lifelines

  38. NCI (2016b) Population-based cancer survival statistics. National Cancer Institute. Retrieved from https://surveillance.cancer.gov/survival/

  39. NCI (2016c) U.S. cancer mortality trends. Retrieved from https://www.cancer.gov/about-cancer/understanding/statistics

  40. New California Media (2003) Bridging language barriers in health care: public opinion survey of California immigrants from Latin America, Asia and the Middle East. New California Media. Retrieved from http://www.bendixenandassociates.com/studies/NCM%20Health%20Care%20Report%202003.pdf

  41. Nguyen A, Belgrave F (2012) Health sources of cancer screening knowledge for Vietnamese women. J Cancer Educ 27(2):320–326. doi:10.1007/s13187-011-0299-7

    Article  PubMed  Google Scholar 

  42. Oh K, Jacobsen K (2014) Colorectal cancer screening among Korean Americans: a systematic review. J Community Health 39(2):193–200. doi:10.1007/s10900-013-9758-x

    Article  PubMed  Google Scholar 

  43. Oh K, Kreps G, Jun J, Ramsey L (2011) Cancer information seeking and awareness of cancer information sources among Korean Americans. J Cancer Educ 26(2):355–364. doi:10.1007/s13187-010-0191-x

    Article  PubMed  Google Scholar 

  44. Oh K, Zhou Q, Kreps G, Ryu S (2012) Breast cancer screening practices among Asian Americans and Pacific Islanders. Am J Health Behav 36(5):711–722. doi:10.5993/AJHB.36.5.13

    Article  PubMed  Google Scholar 

  45. Oh K, Jun J, Zhao X, Kreps G, Lee E (2015) Cancer information seeking behaviors of Korean American women: a mixed-methods study using surveys and focus group interviews. J Health Commun 20(10):1143–1154. doi:10.1080/10810730.2015.1018578

    Article  PubMed  Google Scholar 

  46. Perencevich M, Ojha R, Steyerberg E, Syngal S (2013) Racial and ethnic variations in the effects of family history of colorectal cancer on screening compliance. Gastroenterology 145(4):775–781. doi:10.1053/j.gastro.2013.06.037

    Article  PubMed  PubMed Central  Google Scholar 

  47. Pew Research Center (2013) The rise of Asian Americans. Retrieved from http://www.pewsocialtrends.org/files/2013/04/Asian-Americans-new-full-report-04-2013.pdf

  48. Pourat N, Kagawa-Singer M, Breen N, Sripipatana A (2010) Access versus acculturation: identifying modifiable factors to promote cancer screening among Asian American women. Med Care 48(12):1088–1096. doi:10.1097/MLR.0b013e3181f53542

    Article  PubMed  Google Scholar 

  49. Sentell T, Braun K, Davis J, Davis T (2015) Health literacy and meeting breast and cervical cancer screening guidelines among Asians and whites in California. SpringerPlus 4(1):432–440. doi:10.1186/s40064-015-1225-y

    Article  PubMed  PubMed Central  Google Scholar 

  50. Shi L, Lebrun LA, Zhu J, Tsai J (2011) Cancer screening among racial/ethnic and insurance groups in the United States: a comparison of disparities in 2000 and 2008. J Health Care Poor Underserved 22(3):945–961. doi:10.1353/hpu.2011.0079

    Article  PubMed  Google Scholar 

  51. Smigal C, Jemal A, Ward E, Cokkinides V, Smith R, Howe HL, Thun M (2006) Trends in breast cancer by race and ethnicity: Update 2006. CA Cancer J Clin 56(3):168–183. doi:10.3322/canjclin.56.3.168

    Article  PubMed  Google Scholar 

  52. The Commenwealth Fund (2002) 2001 Health care quality survey. Retrieved from http://www.commonwealthfund.org/publications/surveys/2001/2001-health-care-quality-survey

  53. US Census (2016) Asian/Pacific American heritage month: May 2016. Retrieved from https://www.census.gov/newsroom/facts-for-features/2015/cb15-ff07.html

  54. USPSTF (2016) U.S. Preventive Services Task Force. Retrieved from http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=cancer

  55. Ward E, Jemal A, Cokkinides V, Singh G, Cardinez C, Ghafoor A, Thun M (2004) Cancer disparities by race/ethnicity and socioeconomic status. CA Cancer J Clin 54(2):78–93. doi:10.3322/canjclin.54.2.78

    Article  PubMed  Google Scholar 

  56. Williams A, Dabney K, Holmes L (2013) Health disparities in colorectal cancer screening in the United States: race/ethnicity or shifting paradigms? Journal of Health Disparities Research and Practice 6(2):107–123

    Google Scholar 

  57. Wong S, Gildengorin G, Nguyen T, Mock J (2005) Disparities in colorectal cancer screening rates among Asian Americans and non-Latino whites. Cancer 104(12 Suppl):2940–2947

    Article  PubMed  PubMed Central  Google Scholar 

  58. Wu T, Guthrie B, Bancroft J (2005) An integrative review on breast cancer screening practice and correlates among Chinese, Korean, Filipino, and Asian Indian American women. Health Care for Women International 26(3):225–246. doi:10.1080/07399330590917780

    Article  PubMed  CAS  Google Scholar 

  59. Yu T, Chou C, Johnson P, & Ward A (2010) Persistent disparities in Pap test use: Assessments and predictions for Asian Women in the U.S., 1982–2010. J Immigr Minor Health 12(4):445–453. doi:10.1007/s10903-009-9255-6

Download references

Author information

Authors and Affiliations

  1. The Department of Communication, University of Maryland, College Park, MD, USA

    Jungmi Jun & Xiaoli Nan

Authors
  1. Jungmi Jun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xiaoli Nan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jungmi Jun.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jun, J., Nan, X. Determinants of Cancer Screening Disparities Among Asian Americans: A Systematic Review of Public Health Surveys. J Canc Educ 33, 757–768 (2018). https://doi.org/10.1007/s13187-017-1211-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13187-017-1211-x

Keywords

Search

Navigation