Disaggregating data on Asian and Pacific Islander women to assess cancer screening

Background: Although incidence of cancer is increasing among Asian-American and Pacific-Islander (AAPI) women, their low cancer screening rates are inadequately addressed. Furthermore, the traditional approach of studying the diverse AAPI nationalities as one group hides important intra- and inter-group ethnic differences in cancer screening, as well as lack of representativeness because the surveys are not administered in any AAPI language. To address these problems, this study compared cancer screening rates among particular AAPI groups and non-AAPIs living in an ethnically diverse region. Methods: This study was conducted in 2001-2002 using data from the 1999-2000 Los Angeles County Health Survey, a population-based telephone survey that relied on random-digit-dialing techniques. Cervical and breast cancer-screening rates were measured, and key determinants of screening using bivariate analyses and multivariate logistic regression were assessed. Results: AAPIs had lower screening rates than whites, with significant variation among AAPI subgroups. Moreover, AAPI women were less likely to have undergone cervical cancer screening compared to white women, independent of major demographic, socioeconomic, and health status factors. Determinants for receipt of cancer screening differed for AAPIs and whites. Immigration factors were significant barriers to cancer screening for AAPIs. Conclusions: These findings support the evidence of disparities in receipt of cancer screening services among subgroups of AAPI women. Additionally, these findings highlight the importance of disaggregating the heterogeneous AAPI population to identify higher-risk subgroups and facilitate development of effective targeted interventions. (C) 2004 American journal of Preventive Medicine