Liang Wenchi, Wang Judy H, Chen Mei-Yuh, Mandelblatt Jeanne S
Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA.
J Womens Health (Larchmt). 2009 Feb;18(2):201-7. doi: 10.1089/jwh.2007.0709.
Cancer screening rates are low among Chinese American women, a mostly immigrant minority population. This is possibly because they do not receive cancer screening recommendations from their physicians. The objective of this study was to determine if the rate at which physicians recommend cancer screening to older Chinese American women differs according to the language used during visits.
Data for the cross-sectional study were collected from a telephone survey of older Chinese American women residing in the Washington, DC, area. A total of 507 asymptomatic Chinese American women aged > or =50 who had a regular physician participated in this study. The main outcome was women's self-reported perception of having received a recommendation from their physician for mammography, Pap tests, or colorectal cancer screening in the past 2 years. The main independent variable was the language used during visits (English vs. Chinese). Patient age, educational level, employment status, cultural views, physician specialty, physician gender, and length of relationship with the physician were included in the multiple logistic regression analyses.
Chinese women who communicated with their physicians in English were 1.71 (95% CI 1.00-2.96) and 1.73 (95% CI 1.00-3.00) times more likely to report having received mammography and colorectal cancer screening recommendations, respectively (p < 0.05). Physicians in family medicine or general practice were 2.11 (95% CI 1.31-3.40) and 1.70 (95% CI 1.06-2.48) times more likely to recommend cancer screening than those in other specialties.
Chinese American women who conversed with their physicians in Chinese were less likely to perceive receiving cancer screening recommendations. Future research is needed to identify physician-specific knowledge, attitude, and cultural barriers to recommending cancer screening.
美籍华裔女性(主要是移民少数族裔群体)的癌症筛查率较低。这可能是因为她们没有从医生那里获得癌症筛查建议。本研究的目的是确定医生向老年美籍华裔女性推荐癌症筛查的比率是否因就诊时使用的语言而异。
横断面研究的数据来自对居住在华盛顿特区地区的老年美籍华裔女性的电话调查。共有507名年龄≥50岁、有固定医生的无症状美籍华裔女性参与了本研究。主要结果是女性自我报告在过去两年中是否从医生那里获得了乳腺钼靶检查、巴氏试验或结直肠癌筛查的建议。主要自变量是就诊时使用的语言(英语与中文)。患者年龄、教育水平、就业状况、文化观念、医生专业、医生性别以及与医生的关系时长被纳入多元逻辑回归分析。
与医生用英语交流的华裔女性报告收到乳腺钼靶检查和结直肠癌筛查建议的可能性分别是用中文交流的华裔女性的1.71倍(95%置信区间1.00 - 2.96)和1.73倍(95%置信区间1.00 - 3.00)(p < 0.05)。家庭医学或全科医生推荐癌症筛查的可能性分别是其他专科医生的2.11倍(95%置信区间1.31 - 3.40)和1.70倍(95%置信区间1.06 - 2.48)。
与医生用中文交流的美籍华裔女性感觉收到癌症筛查建议的可能性较小。未来需要开展研究,以确定医生在推荐癌症筛查方面特定的知识、态度和文化障碍。