Knowledge of and attitudes about cancer among American Samoans

The objective of this study was to determine cancer-related knowledge and a ttitudes among American Samoans, a population seldom studied by cancer rese archers. Such information is necessary to develop culturally sensitive canc er control interventions. Specially trained personnel conducted face-to-fac e interviews with randomly selected respondents in the US Territory of Amer ican Samoa; Oahu, HI; and Los Angeles, CA, using a survey based on the Nati onal Health interview Survey Cancer Control Supplement and focus group find ings. The survey included questions concerning knowledge of risk: factors f or cancers (breast, cervical, colon, lung, stomach. and prostate), family r esources (health insurance coverage, employment status, and family income), and demographic characteristics. Participants could complete the sun;ey in English or Samoan. Analysis of data included the chi-squared test and logi stic regression analysis. Participants included 1,834 noninstitutionalized English- or Samoan-speaking women and men (609 from American Samoa, 610 fro m Hawaii, and 615 from Los Angeles). The majority of residents had some pos itive attitudes about cancer prevention and treatment but often also had mi sconceptions about risk factors for cancer. Logistic regression analysis re vealed that site of residence nas an important predictor of attitudes. For example, being residents of American Samoa or Hawaii predicted that the res pondents would rather not know that they had cancer (odds ratio [OR], 1.5, 2.1, respectively); that cancer can be caused by aitu, or spirits (OR, 1.9, 2.1, respectively); that cancer is a punishment from God (OR, 2.0, 2.2, re spectively): and that cancer can be cured by fofo, or traditional Samoan he alers (OR, 2.0, 3.1,respectively). This study documented cancer-related kno wledge and attitudes among American Samoans and set the stage for culturall y sensitive interventions aimed at improving cancer control in this populat ion. It also identified many issues that should be addressed in such interv entions.