Cervical Cancer Screening and Chinese Women: Insights from Focus Groups

Abstract

Objective: Despite extensive efforts to raise awareness, Papanicolaou (Pap) testing rates among Chinese women living in North America remain low compared with Euro-American women. Although the lower Pap testing rate and ensuing health repercussions among Chinese women are well characterized, mechanisms underlying such health disparities are not. The aim of this study was to use a qualitative approach to delineate such mechanisms. Qualitative approaches to understand constructs within the domain of sexual and reproductive health have been shown to be particularly appropriate, and offer a nuanced view of sexuality that is not afforded by traditional quantitative methods.Method: We carried out two focus groups aimed at exploring how Mandarin-speaking and English-speaking Chinese women experience Pap testing (N = 12). The women were invited to partake in the focus groups from having participated in a large-scale quantitative study. Participants were all first-generation immigrants and their average age was 53-years-old. We used content analyses to analyze transcripts and extract themes.Results and Discussion: The women heavily endorsed traditional Chinese medicine philosophy, conceptualizing physical health holistically, and valuing preventative measures over screening and interceptive measures. Pap testing was described as qualitatively different from other screening procedures, such that women assigned a sexually charged meaning to Pap testing, often discussing it in relation to sexual activity and promiscuity. Women expressed their preference for the compulsory and depersonalized manner that Pap tests are performed in their home country of China, as this lessens the embarrassment associated with undergoing Pap testing.Conclusion: Three mechanisms may contribute to lower Pap testing among middle-aged first-generation Chinese immigrants: preference for Chinese medicine philosophy, perceived sexualization of Pap testing, and the institutionalization of medical care. Implications for improving the reproductive health of Chinese women are discussed.

Barriers to cervical cancer screening faced by immigrant women in Canada: a systematic scoping review

“…Some immigrant women identified differences between the Canadian healthcare system and that of their home country [31.40]. For example, screening is a matter of personal choice in Canada, while it is compulsory and anonymous in China [ 40 ], and the healthcare system in India is more focused on curative services, as opposed to the more preventive and health-promoting system in Canada [ 31 ]. Preference for the compulsory and anonymous screening services, as well as unfamiliarity with preventive health services in Canada, acted as barriers to screening for these immigrant women.…”

Long non-coding RNA DSCAM-AS1 contributes to the tumorigenesis of cervical cancer by targeting miR-877-5p/ATXN7L3 axis

“…CC is considered the second most commonly diagnosed cancer and the third prevailing cause of cancer deaths across female group, specifically with a high occurrence in developing countries [13,14]. So far, numerous lncRNAs have been believed to have the role of promoting the growth of CC.…”

“I want to save my life”: Conceptions of cervical and breast cancer screening among urban immigrant women of South Asian and Chinese origin

“…In some cases, Chinese women preferred depersonalized, ‘third party’ Pap tests, carried out in large hospitals or mobile health units organized by their employer. Chang et al postulate that anonymity with Pap testing may also lessen the embarrassment and sexuality attached to getting a Pap test and thus encourage its usage among Chinese women [ 33 ]. Mammograms were not overtly shameful, but a source of pain and discomfort which women were mostly willing to endure if their physicians or family recommended it, a finding echoed in the literature [ 49 ].…”