Cervical cancer among Hmong women in California, 1988 to 2000.
BACKGROUND
The Hmong immigrated to the United States from Laos after the Vietnam conflict ended. Hmong encounter numerous readjustment issues, including health care. Traditional Hmong health beliefs and practices encompass more spiritual than biological etiologies. Hmong usually seek the first course of treatment from traditional healers, as they had in Laos. This practice delays early diagnosis and treatment of disease because biomedicine is used only as a last resort. This study examined cervical cancer incidence, mortality, and other tumor characteristics in the Hmong female population of California between 1988 and 2000.


METHODS
Data from the California Cancer Registry were used to calculate annual average incidence, mortality, and age-specific rates for Hmong women diagnosed with cervical cancer. The population at risk was estimated with linear interpolation using data from the 1990 and 2000 censuses.


RESULTS
Hmong women experienced incidence and mortality rates three and four times higher than Asian/Pacific Islander and non-Hispanic white women, respectively. Fifty-one percent of Hmong women chose no treatment, compared to 5.8% for Asian/Pacific Islander women and 4.8% for non-Hispanic white women. Hmong women aged >/= 40 years carried an unequal burden of cervical cancer. They were more likely to be diagnosed with cervical cancer at later stages and poorer histologic grades, and had a lower survival rate than younger Hmong females.


CONCLUSIONS
Cervical cancer is clearly a public health issue that threatens the health and well-being of Hmong women. Culturally sensitive screening and prevention programs need to be developed to target older Hmong women using bilingual and bicultural Hmong women health educators using verbal communication.
Yang
Richard C
RC
Public Health Institute, Fresno, California, USA. rcyang@sbcglobal.net
Mills
Paul K
PK
Riordan
Deborah G
DG
D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007812:Laos / Q000208:ethnology; D008875:Middle Aged; D012042:Registries; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology