Cultural views and cervical cancer screening behavior in Chinese American women

Background: Previous literature suggests that cultural views affect Chinese American women's participation in cervical cancer screening. However, few researchers have used a comprehensive measure of cultural views to examine its impact on screening behavior.

Objective: To investigate the association between cultural view and cervical cancer screening with the consideration of other important factors such as cancer worry, healthcare coverage, physician recommendation, and access barriers.

Methods: We drew data from the baseline assessment of a large randomized controlled trial designed to improve cancer screening rates in older Chinese American women. The study sample consisted of 473 asymptomatic participants aged 50 and older recruited from Chinese American community organizations. The main outcome was women's self-report of having received a pap-smear test in the past two years (regular vs. irregular). Cultural views were measured by 30 items addressed beliefs such as balance of Yin -Yang, fatalism, and self-care. Socio-demographics, physician recommendation, health insurance, cancer worry, and access barriers were included as covariates in multiple logistic regression models.

Results: After controlling for covariate variables, participants who held traditional Chinese cultural views had 38% less odds of having regular Pap tests as those having western culture views (OR= .62, 95% CI=.397-.968, p<.05). In addition, younger age, less cancer worry and physician recommendation also significantly predicted regular screening behavior.

Conclusions: Older Chinese American women who held traditional Chinese culture were less likely to receive regular Pap tests. Future research is needed to design and identify cultural specific intervention programs to promote regular cervical cancer screening.