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What factors explain disparities in mammography rates among Asian-American immigrant women? A population-based study in California

TitleWhat factors explain disparities in mammography rates among Asian-American immigrant women? A population-based study in California
Publication TypeJournal Article
Year of Publication2013
AuthorsRyu, SY, Crespi, CM, Maxwell, AE
JournalWomens Health IssuesWomens Health Issues
Volume23
Paginatione403-10
Date PublishedNov-Dec
ISBN Number1878-4321 (Electronic)<br/>1049-3867 (Linking)
Accession Number24183415
KeywordsAcculturation, Aged, Aged, 80 and Over, Asian Americans/ethnology/ statistics & numerical data, Breast Neoplasms/diagnosis/ethnology/ prevention & control, California/epidemiology, Emigrants and Immigrants/psychology/ statistics & numerical data, Female, Health Care Surveys, Healthcare Disparities, Humans, Incidence, Interviews as Topic, Logistic Models, Mammography/ statistics & numerical data/utilization, Mass Screening/statistics & numerical data, Middle Aged, Patient Acceptance of Health Care, Risk Factors, Socioeconomic Factors
AbstractBACKGROUND: The purpose of this study was to compare rates of screening mammography among immigrant women in five Asian-American ethnic groups in California, and ascertain the extent to which differences in mammography rates among these groups are attributable to differences in known correlates of cancer screening. METHODS: Using 2009 data from the California Health Interview Survey, we compared the rates of mammography among Chinese, Filipino, Japanese, Korean, and Vietnamese immigrants 40 years and older. To assess the impact of Asian ethnicity on participation in screening, we performed multiple logistic regression analysis with models that progressively adjusted for acculturation, sociodemographic characteristics, access to health care, and breast cancer risk factors, and examined the predicted probabilities of screening after adjusting for these factors. FINDINGS: Participation in screening mammography differed according to ethnicity, with Filipina and Vietnamese Americans having the highest rates and Korean Americans having the lowest rates of lifetime and recent (past 2 years) screening. These differences decreased substantially after adjusting for acculturation, sociodemographic factors, and risk factors of breast cancer, but differences remained, most notably for Korean Americans, who continued to have the lowest predicted probability of screening even after adjustment for these factors. CONCLUSIONS: This analysis draws attention to low mammography screening rates among Asian-American immigrants, especially recent immigrants who lack health insurance. Given that their breast cancer incidence is rising with length of stay in the United States, it is important to increase regular mammography screening in these groups.