Acculturation and Cervical Cancer: Knowledge, Beliefs, and Behaviors of Hispanic Women

Abstract

In a community-based sample of Hispanic women, this study examines differences in relation to level of acculturation in knowledge about the Pap examination, fear/fatalism towards cancer, and cervical cancer screening behaviors. Respondents were randomly chosen from 11 churches in the Phoenix metropolitan area (n = 566) and were categorized into three acculturation levels: low (35.2%), bicultural (26.3%), and high (38.5%). Interviews focused on family history of cancer as well as knowledge about cancer and utilization of screening techniques for breast and cervical cancers. OLS regression and probit analyses were conducted to examine the role of acculturation in differentiating. Hispanic subgroups in relation to knowledge, beliefs, and behaviors regarding cervical cancer. Findings of the present study indicate that Hispanic women in the Phoenix metropolitan area are utilizing cervical cancer screening services with over 90 percent of women in all three acculturation groups ever having had a Pap exam and more than 50 percent having had the examination during the past year. However, results also indicate that of the Hispanic subgroups examined, lower acculturated Hispanic women have less knowledge about Pap smears and exhibit lower utilization rates for cervical cancer screening. These results suggest that lower-acculturated Hispanic women comprise the subgroup of Hispanics that is at greatest risk of presenting with advanced stages of cervical cancer. Results have implications for cancer screening and education programs for Hispanic women as well as implications for health care professionals who serve this population.

ACCULTURATION AND LATINO HEALTH IN THE UNITED STATES: A Review of the Literature and its Sociopolitical Context

“…Finally, acculturation is associated with higher use of some preventive services by women, including screening for breast cancer and pap smears (13, 44,59,68,96,107,114,115,133). Borrayo et al (13) found that 58.2% of U.S.-born women of Mexican descent had received a mammogram in the past year, compared with 48.6% of Mexico-born women.…”

Cervical screening in migrants to Australia

“…13 In the United States, compared with white women, Hispanic women have a higher risk of never having had a Pap test, 27 and lower screening rates, 28 particularly with lower levels of acculturation, 29 partly due to lack of knowledge and "cancer fatalism". 29,30 Furthermore, in a US national interview survey, women from areas with high proportions of Hispanic women were more likely to report never having had a Pap test. 31 Pap screening has been shown to be relatively low in rural African-American women, 32 and also in African-American women living in low SES urban areas.…”

Fatalism or Destiny? A Qualitative Study and Interpretative Framework on Dominican Women’s Breast Cancer Beliefs

“…An insufficient amount of attention has been devoted to establishing the construct validity of cancer fatalism. Some measures of cancer fatalism, for example, include items tapping other constructs, such as fear [15,16] and religious attributions concerning cancer as God's punishment [17], precluding any conclusion about the specific effects of fatalism on screening. Fourth, despite evidence that Latinos simultaneously hold fatalistic and optimistic beliefs about cancer screening and survival [10,11,[18][19][20] almost no research explores alternative, culturally-based belief systems that might explain these findings.…”