Cultural barriers to mammography, clinical breast exam, and breast self-exam among Chinese-American women 60 and older

Background: This study examined screening utilization at least once and reg ular adherence to mammography, clinical breast exam, and breast self-exam a mong older Chinese-American women. Method: One hundred women were recruited from senior centers in two metropo litan cities. Participants completed a questionnaire that included sections on demographics, health history, health insurance coverage, breast cancer screening, common and cultural barriers to screening, and acculturation. Results: Logistic regression models found insurance coverage for mammograph y and acculturation to be significant predictors of having had a mammogram at least once. Low perceived need/lack of physician recommendation and rece ncy of physical examination were significant predictors of having had a mam mogram in the past year. Acculturation and modesty were significant predict ors of having had a clinical breast exam at least once, while recency of ph ysical examination was a significant predictor of having had a clinical bre ast exam in the past year. Reliance on medial professionals for screening a nd forgetting were significant predictors of having performed breast self-e xam at least once, and forgetting was a significant predictor of regular pe rformance of breast self-exam. Conclusions: These findings suggest that both common and cultural barriers play a role in breast cancer screening among older Chinese-American women, with cultural factors being more influential in the initiation of cancer sc reening behavior. (C) 2000 American Health Foundation and Academic Press.