Understanding Breast Cancer Screening in Filipino Women

Institution: University of California, Los Angeles
Investigator(s): Annette Maxwell, DrPH -
Award Cycle: 1995 (Cycle I) Grant #: 1IB-0110 Award: $50,057
Award Type: IDEA
Research Priorities
Detection, Prognosis and Treatment>Imaging, Biomarkers, and Molecular Pathology: improving detection and diagnosis

Initial Award Abstract (1995)
A recent case control study suggests that the risk of breast cancer among Asian women (including Filipino women) may be as high as or even higher than that of White women (Ziegler, Hoover, Pike et al., 1993). Asian women frequently have been excluded from breast cancer research, and the few studies that have included Asian-American women show that they have the lowest screening rates among all ethnic groups. These considerations, coupled with the fact that Asians are the fastest growing ethnic group in California, create an urgent need for interventions to increase screening. However, at the present time, any intervention efforts will certainly be hampered by a woefully inadequate understanding of breast cancer screening behaviors among Asian-American women. The proposed study attempts to provide this information for women of Filipino descent as a first step in the design of an effective, culturally appropriate intervention program.

The purpose of this proposal is to gather detailed information on factors that affect breast cancer screening in Filipino women 50 years of age and older residing in Los Angeles County. Information will be obtained from focus groups and face-to-face interviews with women of this target group. This study will: 1) conduct semi-structured interviews with key informants in Asian American communities in Los Angeles County regarding breast cancer screening among women of Filipino descent; 2) conduct focus groups with Filipino women to explore attitudes and beliefs regarding breast cancer screening, barriers to screening and how to successfully overcome these barriers; 3) develop, translate and pilot test a survey to collect detailed information on breast cancer screening and correlates in Filipino women; and 4) administer the survey to 200 women 50 years of age and older residing in Los Angeles County.

Results of this study will be used to formulate recommendations for strategies to increase breast cancer screening among Filipino women 50 years of age and older.

Final Report (1997)
The purpose of this study was to assess breast cancer screening rates among Filipino-American women among whom breast cancer ranks as the number one cause of cancer mortality. Another purpose was to identify the knowledge, attitudes and barriers related to screening which may assist in the development of effective intervention strategies, and to determine the type of interventions that Filipino-American women might see as helpful for obtaining a mammogram. Thus, this study is relevant to the early detection of breast cancer among underserved populations.

Based on opinions voiced by key informants and focus group participants and a theoretical model of health behavior, a survey was developed in English and Tagalog. Two female bilingual interviewers conducted face-to-face interviews, which lasted on average one hour, with a convenience sample of 218 Filipino women residing in Los Angeles County. Half of the interviews were conducted in Tagalog.

In our sample of predominantly low-income women (average age 65 years), 66% had ever had a screening mammogram, 42% had had one in the past 12 months, and 54% in the past two years. These rates are about 20% lower than those found among African-American and white women in the 1994 California Behavioral Risk Factor Survey. Women who had received a doctor's recommendation to obtain a mammogram, women stating that they were very likely to obtain a mammogram if a physician recommended it, and women who felt very comfortable requesting a mammogram from a physician were more likely to have been screened. Women who had friends and relatives who had obtained mammograms, those stating that their friends and relatives would be very supportive of their getting a mammogram, and those who felt that it was very worthwhile to obtain a mammogram were also more likely to have been screened.

Women who had concerns such as the attitude that mammograms are only needed in the presence of symptoms, the perceived inconvenience of taking the time, concern over cost, difficulties getting to the mammography facility, and embarrassment were more likely to never have had a mammogram. The only demographic variables positively related to ever having had a mammogram were having health insurance and longer duration of U. S. residency. Survey findings also suggested that a single-session small discussion group intervention led by a Filipino-American female health professional will be acceptable to older Filipino-American women and has the potential to increase breast cancer screening. Funding for developing and testing such an intervention has been obtained from the National Cancer Institute.

Breast cancer screening and related attitudes among Filipino-American women
Periodical:Cancer Epidemiology Biomarkers and Prevention
Index Medicus: Cancer Epidemiol Biomarkers Prev
Authors: Maxwell AE, Bastani R, and Warda US
Yr: 1997 Vol: 6 Nbr: 9 Abs: Pg:719-26

Misconceptions and mammography use among Filipino- and Korean-American women
Periodical:Ethnicity and Disease
Index Medicus: Ethn Dis
Authors: Maxwell AI, Bastani R, Warda US
Yr: 1998 Vol: 8 Nbr: Abs: Pg:377-384

Demographic predictors of cancer screening among Filipino and Korean Immigrants in the United States
Periodical:American Journal of Preventative Medicine
Index Medicus:
Authors: Maxwell AI, Bastani R, Warda US
Yr: 2000 Vol: 18 Nbr: Abs: Pg:62-68