Cultural Barriers to Mammography, Clinical Breast Exam, and Breast Self-exam Among Chinese-American Women 60 and Older

Background: This study examined screening utilization at least once and regular adherence to mammography, clinical breast exam, and breast self-exam among older Chinese-American women.

Method: One hundred women were recruited from senior centers in two metropolitan cities. Participants completed a questionnaire that included sections on demographics, health history, health insurance coverage, breast cancer screening, common and cultural barriers to screening, and acculturation.

Results: Logistic regression models found insurance coverage for mammography and acculturation to be significant predictors of having had a mammogram at least once. Low perceived need/lack of physician recommendation and recency of physical examination were significant predictors of having had a mammogram in the past year. Acculturation and modesty were significant predictors of having had a clinical breast exam at least once, while recency of physical examination was a significant predictor of having had a clinical breast exam in the past year. Reliance on medial professionals for screening and forgetting were significant predictors of having performed breast self-exam at least once, and forgetting was a significant predictor of regular performance of breast self-exam.

Conclusions: These findings suggest that both common and cultural barriers play a role in breast cancer screening among older Chinese-American women, with cultural factors being more influential in the initiation of cancer screening behavior.