title: Cultural barriers to mammography, clinical breast exam, and breast self-exam among Chinese-American women 60 and older.
abstract: BACKGROUND
  This study examined screening utilization at least once and regular adherence to mammography, clinical breast exam, and breast self-exam among older Chinese-American women.
  
  
  METHODS
  One hundred women were recruited from senior centers in two metropolitan 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 mammography and acculturation to be significant predictors of having had a mammogram at least once. Low perceived need/lack of physician recommendation and recency of physical examination were significant predictors of having had a mammogram in the past year. Acculturation and modesty were significant predictors of having had a clinical breast exam at least once, while recency of physical examination was a significant predictor of having had a clinical breast exam in the past year. Reliance on medial professionals for screening and forgetting were significant predictors of having performed breast self-exam at least once, and forgetting was a significant predictor of regular performance 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 screening behavior.
authors.affiliation: Ruttenberg Cancer Center, Box 1130, Mount Sinai Medical Center, New York, New York 100029, USA.
authors.forename: T S
authors.initials: TS
authors.lastname: Tang
authors.forename: L J
authors.initials: LJ
authors.lastname: Solomon
authors.forename: L M
authors.initials: LM
authors.lastname: McCracken
mesh_terms: D000069:Acculturation; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000523:psychology / Q000706:statistics & numerical data*; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000175:diagnosis / Q000208:ethnology*; D016504:Breast Self-Examination / Q000706:statistics & numerical data*; D002681:China / Q000208:ethnology; D003469:Culture; D005260:Female; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D010808:Physical Examination / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires