EXPLANATORY MODELS FOR CANCER AMONG AFRICAN-AMERICAN WOMEN AT 2 ATLANTA NEIGHBORHOOD HEALTH CENTERS - THE IMPLICATIONS FOR A CANCER SCREENING-PROGRAM

This paper examines cultural models for breast and cervical cancer amo ng low-income African-American women over 40, in order to better under stand how those models might affect cancer screening behavior. The stu dy is part of The Community-Based Cancer Screening Project, which is s ponsored by Emory University, Grady Memorial Hospital, and the America n Cancer Society. The Screening Project attempts to increase the use o f mammography, clinical and self-examination of the breast, and cervic al Pap smear among women aged 40 or older in a predominantly African-A merican, low-income, low educational level population that is currentl y underserved by any screening activities. The study of cultural model s of cancer within the project was prompted by the recognition that if screening programs targeted at specific, underserved, populations are to succeed, cultural as well as logistical barriers to screening must be overome. Patients and clinicians must each understand how the othe r perceives cancer, its prevention, and its treatment. Only with this mutual understanding as a foundation, can physicians and their clients cooperate to improve cancer screening rates. Our research results ind icate that the cancer models held by the patient population differ sig nificantly from those held by clinicians. Women attending the clinics endure cancer screening tests that to them seem to serve only as heral ds of a disease that will ultimately kill them. Most women doubt there is a cure for cancer, though some believe a person may live if the di sease is caught in time. Even then, though, catching cancer 'in time' may mean somehow discovering the disease before it can even be detecte d as a spot on a mammogram or as dysplastic cells from a pap smear. If the cancer is not caught in time, and a woman is diagnosed as having the disease, some argue that the knowledge that she has it may cause m ental deterioration and may speed her death. Even if her mind is unaff ected, according to many women interviewed, she still faces treatment choices that may make her poor and seem certain to erode her health ev en further. Her faith in God seems to be one of the few completely ben ign and truly powerful treatment alternatives available to her.