Asian American and Pacific Islander breast and cervical carcinoma screening rates and healthy people 2000 objectives

BACKGROUND. Breast carcinoma is the number one cause of cancer-related mort ality among Asian American and Pacific Islander (AAPI) women, and for certa in subgroups cervical carcinoma is among the top three causes. Yet AAPI wom en have the lowest cancer screening and early detection rates of all ethnic groups. The practice of merging AAPI data hides significant variation amon g AAPI groups, and the groups at highest risk for late presentation of dise ase become invisible. To the authors' knowledge, this study is the first re port of disaggregated national data for breast and cervical carcinoma scree ning in AAPI subpopulations. The authors used data from the National Health Interview Survey (NHIS 1993 and 1994) and evaluated major socioeconomic an d access variables associated with screening practices. METHODS. Healthy People 2000 (HP2000) criteria were used to evaluate the mo st recent NHIS screening rates for AAPIs as one group and for six distinct subgroups compared with HP2000 criteria. The sample included 2756 non-Hispa nic AAPI and 64,196 non-Hispanic white women age Is years or older in the 1 993 and 1994 NI-BS. The effects of socioeconomic and access-to-care indicat ors on screening were explored. RESULTS. Breast and cervical carcinoma screening rates for AAPIs were below those for white women and well below national goals and guidelines. Lack o f insurance, low income, and lack of a usual source of care had a significa ntly greater negative impact on AAPIs than on white women, indicating that AAPIs may be more vulnerable to structural barriers to cancer control effor ts. CONCLUSIONS. AAPI women have very low rates of breast and cervical screenin g, which increases their chances of later stage disease presentation. To re ach the Healthy People 2000 objectives, targeted efforts are needed to incr ease cancer screening among MPI women overall and specific subgroups in par ticular. (C) 2000 American Cancer Society.