October 5, 2001 UNT Inhouse publication: U.S. breast cancer screening messages not always effective for Mexican-born women

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U.S. breast cancer screening messages not always effective for Mexican-born women

Hispanic women who were born in Mexico but are now living in the United States are significantly less likely to use screening procedures for breast cancer than their U.S.-born peers, according to a UNT study.

Charles Guarnaccia, associate professor of psychology, and Evelinn A. Borrayo, who earned her master's and doctoral degrees from UNT, surveyed 179 women living in the Dallas-Fort Worth area who were all 50 years old or older. Seventy-six of the women had been born in Mexico, while 103 Mexican American women had been born in the United States. The U.S.-born women had slightly higher levels of education and income than the Mexican-born women.

Borrayo, who conducted the research for her master's thesis and expanded on it for her doctoral dissertation, says Guarnaccia had previously studied screening behaviors of Caucasian and African American women, but not Hispanic women.

"As a Latino myself, I decided to include Latino women," she says.

October is Breast Cancer Awareness Month Breast cancer is the most common cancer for Hispanic women in the United States, according to statistics from the American Cancer Society. Guarnaccia says that while Hispanic women don't have a higher risk of developing breast cancer than women of other racial and ethnic groups, they are at higher risk for late-stage diagnosis of the cancer and thus have a higher mortality rate from it than other women.

"Unfortunately, deaths from breast cancer result largely from the late-stage detection," he says. "Late staging and high mortality rates suggest that Hispanic women are not using important screening procedures. If this is the case, high mortality from breast cancer among Hispanic women could be substantially reduced if they would use screening procedures more regularly."

Guarnaccia and Borrayo found that the Mexican-born women were more likely than the U.S.-born Mexican American women to view breast cancer as a serious illness, and were more likely to believe that they were personally susceptible to breast cancer. However, the Mexican-born women were much less likely to perform breast self-exams and have mammograms to be screened for breast cancer.

While 76 percent of the Mexican-born women had been instructed about breast self-exams, only 45 percent had performed the exams during the previous month. In addition, while 70 percent said their physicians had recommended that they have mammograms, only 49 percent had had a mammogram during the past year.

Among the U.S.-born women, 92 percent had been instructed about breast self-exams and 62 percent had performed the exams during the past month. Seventy-five percent had received recommendations for mammograms and 58 percent had had a mammogram during the past year.

In addition, while 85 percent of the U.S.-born women had private health insurance or Medicare, only 40 percent of the Mexican-born women were insured.

Guarnaccia says differences in language and culture may make it more difficult for Mexican-born women to access services for breast cancer screening.

"Even though they have lived in the United States for a long time, many of these women live in predominantly Spanish-speaking communities and function quite well knowing only Spanish," he says. "Also, these women are older, and older women who have not worked outside the home are more isolated. They may not have learned English and may not be aware of health care services for that reason. Younger women find it easier to move into a new culture because they probably have to go out to work or to school, and therefore learn more English."

Borrayo adds that the women born in Mexico believed doing monthly breast self-exams and having mammograms will result in them worrying more about breast cancer than if they did not engage in these screening behaviors. The women also believed that screening behaviors increased the chances of requiring radical or disfiguring surgery, or even death, if breast cancer occurs.

"These women may not have as much health insurance or access to health care as other women, so it's realistic for them to think that they will die from breast cancer if they are diagnosed with it," she says. "They equate finding breast cancer with dying from breast cancer, so they would rather not find it."

Borrayo points out that the differences between U.S.-born and Mexican-born women show that health care professionals should not assume that all Hispanic women share the same view toward breast cancer screening behaviors.

"Failure to consider cultural factors is likely to render efforts to improve screening useless with this group of ethnic minority women," she says.

Borrayo points out that mainstream campaigns for breast cancer screening focus on finding the cancer on time and thus preventing death — messages that scare Mexican-born women away.

"A better message may focus on breast cancer screening as a healthy behavior for Mexican American women and their families, since their culture emphasizes family ties," says Borrayo, who recently received a grant from the Susan G. Komen Breast Cancer Foundation to develop culturally sensitive materials to promote breast cancer screening.

Borrayo and Guarnaccia's research was published in the International Journal of Clinical and Health Psychology and Health Care for Women International.