186201 Understanding Filipina women's orientation toward colorectal cancer screening

Monday, October 27, 2008

Aimee Afable-Munsuz, PhD , Department of Medicine, University of California, San Francisco, San Francisco, CA
Eliseo J. Perez-Stable, MD , Department of Internal Medicine, University of California, San Francisco, San Francisco, CA
Background: Filipina women, especially recent immigrants, have lower rates of colorectal cancer (CRC) screening than Whites.

Methods: To characterize Filipinas' orientation toward CRC screening and the context of their medical decisions, we conducted 24 in-depth individual interviews with women 50-65 years old from the San Francisco Bay Area. Respondents were recruited from community based agencies, utilizing direct approach, referral and snowball sampling strategies; and were stratified by age at migration in order to characterize “acculturation” differences.

Results: Of the 24 women, the mean age was 57, 20 reported having some or completed college education, and 10 had private insurance. Of the 12 “recent” immigrants, mean age at migration was 46. Of the other 12, 3 were U.S. born and “tenured” immigrants migrated at the mean age of 14. Among all women, 22 reported having heard of an endoscopic procedure, but only 9 reported use. Both groups of women expressed the importance of CRC screening, but did not assign it high priority because their perceived risk of colon cancer was low, they feared discomfort, or had other competing health concerns. Family history of cancer, a “well-balanced” lifestyle and the ability to “cleanse” one's system were major influences on women's perceived risk. A notable difference, however, was that tenured immigrants expressed a willingness to insist on screening if physicians/clinicians do not take initiative; recent immigrants expressed reluctance in being assertive.

Significance: An understanding of the context of Filipina women's medical decisions will inform the development of effective CRC screening interventions.

Learning Objectives:
1) Articulate the importance of understanding the context in which immigrant women make decisions about colorectal cancer screening. 2) Discuss facilitators and/or barriers to colorectal cancer screening relevant to Filipina women.

Keywords: Cancer Screening, Immigrant Women

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a population health researcher focusing on racial/ethnic disparities in health. Broadly, my research focuses on understanding the social mechanisms that mediate racial/ethnic disparities in health. I am interested in a range of social mechanisms including cultural differences in childbearing and how they mediate disparities in unintended pregnancy; cultural variation in sense of personal control and implications for health services utilization; and how an immigrant’s social context might explain acculturation’s influence on health. More recently, my research examines how acculturation following arrival in the U.S. influences potentially modifiable cancer related behaviors such as cancer screening, alcohol use and physical activity among the country’s major immigrant groups – Mexicans, Chinese and Filipinos.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.