A study recently published in the Asian Pacific Journal of Cancer Prevention reports that Chinese Americans are facing concerning cultural barriers that impede them from asking for cancer screenings. The study was led by professor and interim chair of the University of Central Florida's Health Management & Informatics Department, Su-I Hou, who says that it is more important than ever to incorporate cultural competency into healthcare settings in order to decrease disparities.
"We all need to work together to recognize the barriers to providing quality healthcare to all," she said. "This study is another example of the importance of understanding cultural norms as we provide care."
In conducting the study, Hou surveyed 372 Chinese adults who attended churches with services in Mandarin in the U.S. and Taiwan. She wanted to evaluate their knowledge of cancer risks and she was also interested in learning if the adults had asked their primary care providers about cancer screenings.
"Chinese culture and language difficulties are deterrents to open dialogue between these patients and their providers," she said. "The Chinese culture teaches respect to authority and in our culture, the doctor is the authority. To question a physician is seen as a sign of disrespect."
This dynamic showed up in Hou’s analysis, which showed that Chinese adults infrequently asked about cancer screenings. Even those adults with family cancer history only asked their PCPs about cancer screenings 32.2% of the time, while individuals with family cancer history asked a mere 21.5% of the time. Hou comments that older adults were less likely to ask about cancer screenings, holding with cultural norms of respect and authority figures.
Hou also analyzed the responses from Chinese adults who had personally been the caretakers of a cancer patient. While these adults showed a higher ask-rate, at 48.3% of the time, non-caregivers asked only 23.4% of the time. Her analysis showed to be statistically similar between Chinese adults living in Taiwan and those living in the US.
These findings are particularly alarming because cancer is the leading cause of death among Chinese Americans. Hou suggests that community spaces, such as the churches where she found her survey respondents, could play a role in advocating for cancer screenings amongst community members. Yet, she adds, it is also imperative that medical providers understand the cultural subtleties that their patients may show – or not show – in regards to advocating for their own health. She urges providers to mention cancer screening options to their patients, regardless of whether the patient has brought it up or not, saying that “Many of the survey participants said they did not ask about cancer screenings because their provider did not raise the subject.”
Sources: Asian Pacific Journal of Cancer Prevention, Eureka Alert