Breast Cancer Knowledge/Attitudes: California Pacific Islanders

Sora Park Tanjasiri, Dr. P.H.
University of California, Irvine

Initial Award Abstract

California represents the major gateway for immigration of Asian and Pacific Islander Americans (APIA) into the United States. While breast cancer remains the most common cancer site for Asian American women, information on the incidence and prevalence among Pacific Islander women is nearly nonexistent. Despite the lack of systematic epidemiological data on Pacific Islander Americans, they possess risk factors for the development of breast cancer. Finally, utilization of breast cancer screening services is predicted to be low among Pacific Islander American women.

This two-year study will attempt to assess and analyze the breast cancer knowledge, attitude and screening behaviors of women aged 40 years and older in two Pacific Islander populations (Tongan and Chamorro, the latter of which are indigenous Guamanians) of Los Angeles, Orange, and San Diego Counties. Given the dearth of epidemiological and behavioral data on breast cancer among Pacific Islanders, the proposed research will be exploratory in nature. The major research question of the proposed project will be: What are the differences between Tongans and Chamorros in breast cancer knowledge, attitude and screening behavior? What are the predictors (e.g., age, year of immigration, ethnic identity) of Tongan and Chamorro women’s knowledge, attitude and behavior related to screening and breast cancer?

Baseline behavioral data on breast cancer knowledge, attitudes and screening behavior will be collected from a minimum of 600 Tongan and Chamorro women aged 40 years and older. A provider survey will also be conducted in each community to identify culturally relevant providers of breast cancer information and screening services.

Final Report (1999)

California represents a major gateway for Pacific Islanders into the United States. According to the 1990 census, California's populations of Guamanians (25,059) and Tongans (7,919) are the largest outside of these islands. Data from the California Cancer Registry show breast cancer is the most common cancer site for these Pacific Islander American women. This two-year study examined the breast cancer knowledge, attitudes and screening behaviors of two groups of Pacific Islander women -- Chamorros (indigenous Guamanians) and Tongans -- aged 40 and older in Los Angeles and Orange County.

A core philosophy of this study was its partnership with community-based organizations in each of the collaborating communities. Together with the Guam Communications Network, Inc. and the Tongan Community Service Center, this project identified community-relevant and culturally-appropriate strategies for survey design, informant identification, survey administration and analyses. Between November 1997 and June 1998, 530 women (227 Chamorros and 303 Tongans) completed the surveys. Regarding ever having received a breast cancer screening, among Tongans 25.7% ever had a clincal breast exam, 25.1% ever had a mammogram, and only 40.4% ever performed a breast self examination. Among Chamorros, 92.8% ever had a clinical breast examination, 76.8% ever had a mammogram, and 37.3% ever performed BSE. According to the American Cancer Society's guidelines for yearly CBE and mammograms, for Tongans only 12.9% had yearly CBE's and 10.2% had yearly mammograms. For Chamorros, while 66.2% had yearly CBE's only 25.3% had yearly mammograms. Many barriers to screening were identified, including cost, language, and lack of knowledge for both populations.