Predictors of never having a mammogram among Chinese, Vietnamese, and Korean immigrant women in the U.S.

En-Jung Shon,Aloen Louise Townsend,Yonglan Zheng

doi:10.1371/journal.pone.0224505

En-Jung Shon, Aloen Louise Townsend + Show 1 more

Open Access

https://doi.org/10.1371/journal.pone.0224505

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Journal: PloS one	Publication Date: Nov 6, 2019
Citations: 12	License type: CC BY 4.0

Affiliation: Miami University, Case Western Reserve University

Abstract

BackgroundBreast cancer is the most common cancer among Asian women in the U.S. The first objective was to investigate predictors (including ethnicity) of never having a mammogram in middle-aged and older Chinese, Vietnamese, and Korean immigrant women (main effects). The second objective was to explore whether relationships between predictors and never having a mammogram varied across the three groups (moderation effects of ethnicity).MethodsMerged (2005-2007-2009-2011) California Health Interview Survey data were utilized. Unweighted sample was 3,710 Asian women ages 40 years and older (Chinese = 1,389; Vietnamese = 1,094; Korean = 1,227). Replicate weighted total sample size was 1,710,233 (Chinese = 940,000; Vietnamese = 410,000; Korean = 360,000). Replicate-weighted multivariate logistic regression was applied. Interaction effects (moderator role of ethnicity) were also examined, using multivariate logistic regression, for the second objective.ResultsFor the first objective, odds of never having a mammogram were higher for women who were Korean (Ref = Vietnamese), unmarried, or a non-U.S. citizen. Odds were lower in women ages 50–59 or 60–69 (Ref = 70–85). Regarding the second objective, only for Chinese women, odds of never having a mammogram were lower as the number of physician visits got higher.ConclusionCulturally-sensitive outreach and services should be developed to target higher-risk groups. Patient-centered healthcare strategies tailored for the three groups could be effective. For Chinese women, in particular, regular information sessions or education programs could be provided for enhancing their physician visits.

Highlights

Breast cancer is the most common cancer among Asian women in the U.S [1, 2] From 2005 to 2014, Asian American women’s breast cancer incidence rate increased more steeply than other racial or ethnic groups [2]
Only for Chinese women, odds of never having a mammogram were lower as the number of physician visits got higher
For Chinese women, in particular, regular information sessions or education programs could be provided for enhancing their physician visits

Summary

Introduction

Breast cancer is the most common cancer among Asian women in the U.S [1, 2] From 2005 to 2014, Asian American women’s breast cancer incidence rate increased more steeply than other racial or ethnic groups [2]. According to the National Cancer Institute (2017), the decline in breast cancer death rate began a decade later among Asian American women than other racial and ethnic groups. These statistics highlight the greater vulnerability of Asian American women to breast cancer incidence or death [3]. Asian immigrant women (i.e., foreign born) have a consistently advanced breast cancer stage at diagnosis and, a lower survival rate than their U.S.-born counterparts [4]. Breast cancer is the most common cancer among Asian women in the U.S The first objective was to investigate predictors (including ethnicity) of never having a mammogram in middle-aged and older Chinese, Vietnamese, and Korean immigrant women (main effects). The second objective was to explore whether relationships between predictors and never having a mammogram varied across the three groups (moderation effects of ethnicity)

Methods

Discussion

Conclusion