American Samoan women's health: experiences and attitudes toward breast and cervical cancer screening.
BACKGROUND
Cancer is the second leading cause of death among Samoan women and, compared to women of other ethnicities in the United States, Samoan women present at earlier ages with advanced stages of both breast and cervical cancers. Our goal was to gain a better understanding of issues that may prevent women in American Samoa from using available cancer screening resources.


METHODS
Following approval from the Office of Samoan Affairs, we conducted four focus group sessions, in which a total of 55 women from urban and rural sites participated. Women were asked about their perceptions regarding barriers, knowledge, and past utilization of available cancer screening services.


RESULTS
Among the participants, professional women were more aware and had higher utilization rates of age-specific screening services. Barriers to health care services included lack of awareness and fears regarding poor confidentiality.


CONCLUSIONS
Our findings, which have been reviewed by participants, highlight the further need for outreach and education about female cancers. Screening rates could be increased and all services may benefit from increased collaboration between the American Samoa Department of Public Health and Lyndon B. Johnson (LBJ) Tropical Medical Center. Our findings underline a need for additional staff training in professionalism, particularly in the areas of confidentiality and respect for patients.
Department of Family Medicine and Community Health, John A Burns School of Medicine, University of Hawaii, Honolulu, Hawaii 96813, USA.
Lisa
L
Wu
Elaine
E
Colby
Alisi
A
Iongi-Filiaga
Gregory G
GG
Maskarinec
D000328:Adult; D000368:Aged; D018948:American Samoa; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000517:prevention & control / Q000523:psychology; D004522:Educational Status; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000706:statistics & numerical data*; D008519:Medicine, Traditional; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander; D012424:Rural Population; D013637:Tape Recording; D014481:United States; D014505:Urban Population; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000517:prevention & control / Q000523:psychology; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D016387:Women's Health; D055815:Young Adult