Purpose/Objectives: To investigate whether differences in age and death rates exist between hospitalized Asian/Pacific Islander American (APIA) women and women of other racial groups.
Design: Secondary data analysis of a national data set.
Setting: The Healthcare Cost and Utilization Project Nationwide Inpatient Sample, Release 6, was used to obtain hospitalization data on women with breast cancer based on racial status. A total of 20,507 hospitalization records met the study criteria.
Sample: All women who were hospitalized with a primary diagnosis of breast cancer, were older than 18, and did not die during hospitalization, plus all women who met the criteria stated above but died during hospitalization.
Methods: Secondary data analysis. Post hoc analysis was used to identify significant differences among racial groups.
Findings: Significant differences were found between APIA and Caucasian and Latino women. Significant differences based on race were found between subjects who had died during hospitalization. On average, APIA women were the youngest to die.
Conclusions: APIA women with breast cancer were among the youngest women being hospitalized and the youngest to die during hospitalization.
Implications for Nursing: Cultural awareness by nurses is critical when discussing methods for prevention and early detection of breast cancer with minority women. Targeting new immigrants is a priority for those who screen and educate women about detection and treatment of breast cancer.
Agency for Healthcare Research and Quality. (1997). Healthcare cost and utilization project (HCUP): A federal-state-industry partnership in health data. Washington, DC: Author.
Ayanian, J.Z., Kohler, B.A., Abe, T., & Epstein, A.M. (1993). The relation between health insurance coverage and clinical outcomes among women with breast cancer. New England Journal of Medicine, 329, 326-331.
Bottorff, J.L., Johnson, J.L., Bhagat, R., Grewal, S., Balneaves, L.G., Hilton, B.A., et al. (1999). Breast health practices and South Asian women. Canadian Nurse, 95(9), 24-27.
Breen, N., Kessler, L.G., & Brown, M.L. (1996). Breast cancer control among the underserved—An overview. Breast Cancer Research and Treatment, 40(1), 105-15.
Clegg, L.X., Li, F.P., Hankey, B.F., Chu, K., & Edwards, B.K. (2002). Cancer survival among US whites and minorities: A SEER (Surveillance, Epidemiology, and End Results) program population-based study. Archives of Internal Medicine, 162, 1985-1993.
Deapen, D., Liu, L., Perkins, C., Bernstein, L., & Ross, R.K. (2002). Rapidly rising breast cancer incidence rates among Asian-American women. International Journal of Cancer, 99, 747-750.
Edge, S.B., Gold, K., Berg, C.D., Meropol, N.J., Tsangaris, T.N., Gray, L., et al. (2002). Patient and provider characteristics that affect the use of axillary dissection in older women with stage I-II breast carcinoma. Cancer, 94, 2534-2541.
Eggers, P.W., & Greenberg, L.G. (2000). Racial and ethnic differences in hospitalization rates among aged Medicare beneficiaries, 1998. Healthcare Financing Review, 21(4), 1-15.
Facione, N.C., Giancarlo, C., & Chan, L. (2000). Perceived risk and help-seeking behavior for breast cancer: A Chinese-American perspective. Cancer Nursing, 23, 258-267.
Facione, N.C., & Katapodi, M. (2000). Culture as an influence on breast cancer screening and early detection. Seminars in Oncology Nursing, 16, 238-247.
Gullatte, M.M. (1999). Breast health and culture: Issues for nursing practice. Georgia Nursing, 59(1), 18-19.
Guy, H.V. (2000). Uninsured minorities: Who goes without and why? Retrieved November 7, 2003, from http://finance.pro2net.com/x19733.xml
Health Care Information. (1999). 1999 annual report: Patient sex and race. Retrieved November 6, 2003, from: http://www.health.state.ok.us/program/hci/discharge/Annual/racesex.html
Hedeen, A.N., & White, E. (1999). Ethnicity and birthplace in relation to tumor size and stage in Asian American women with breast cancer. American Journal of Public Health, 89, 1248-1252.
Intercultural Cancer Council. (2001). Asian Americans and cancer. Retrieved November 6, 2003, from http://iccnetwork.org/cancerfacts/cfs3.htm
Jemal, A., Tiwari, R., Murray, T., Ghafoor, A., Samuels, A., Ward, E., et al. (2004). Cancer statistics, 2004. CA: A Cancer Journal for Clinicans, 54(1), 8-29.
Joslyn, S.A. (2002). Racial differences in treatment and survival from early-stage breast carcinoma. Cancer, 95, 1759-1766.
Joslyn, S.A., & West, M.M. (2000). Racial differences in breast carcinoma survival. Cancer, 88, 114-123.
Kagawa-Singer, M. (1995). Socioeconomic and cultural influences on cancer care of women. Seminars in Oncology Nursing, 11, 109-119.
Kagawa-Singer, M., & Pourat, N. (2000). Asian American and Pacific Islander breast and cervical carcinoma screening rates and Healthy People 2000 objectives. Cancer, 89, 696-705.
Lannin, D.R., Mathews, H.F., Mitchell, J., Swanson, M.S., Swanson, F.H., & Edwards, M.S. (1998). Influence of socioeconomic and cultural factors on racial differences in late-stage presentation of breast cancer. JAMA, 279, 1801-1807.
Lee, M.M., Lin, S.S., Wrensch, M.R., Adler, S.R., & Eisenberg, D. (2000). Alternative therapies used by women with breast cancer in four ethnic populations. Journal of the National Cancer Institute, 92, 42-47.
Lin, S.S., Phan, J.C., & Lin, A.Y. (2002). Breast cancer characteristics of Vietnamese women in the Greater San Francisco Bay Area. Western Journal of Medicine, 176, 87-91.
Lu, Z.J. (1995). Variables associated with breast self-examination among Chinese women. Cancer Nursing, 18, 29-34.
Mandelblatt, J.S., Kerner, J.F., Hadley, J., Hwang, Y.T., Eggert, L., Johnson, L.E., et al. (2002). Variations in breast carcinoma treatment in older Medicare beneficiaries: Is it black or white. Cancer, 95, 1401-1414.
Maxwell, A.E., Bastani, R., & Warda, U.S. (1998). Mammography utilization and related attitudes among Korean-American women. Women and Health, 27(3), 89-107.
Mitchell, J.L. (1998). Cross-cultural issues in the disclosure of cancer. Cancer Practice, 6, 153-160.
Ortin, E.L. (1998). Cultural diversity: The Filipino client. Philippine Journal of Nursing, 69(1-2), 22-29.
Phipps, E., Cohen, M.H., Sorn, R., & Braitman, L.E. (1999). A pilot study of cancer knowledge and screening behaviors of Vietnamese and Cambodian women. Health Care for Women International, 20, 195-207.
Rajaram, S.S., & Rashidi, A. (1998). Minority women and breast cancer screening: The role of cultural explanatory models. Preventive Medicine, 27(5, Pt. 1), 757-764.
Rajaram, S.S., & Rashidi, A. (1999). Asian-Islamic women and breast cancer screening: A socio-cultural analysis. Women and Health, 28(3), 45-58.
Rashidi, A., & Rajaram, S.S. (2000). Middle Eastern Asian Islamic women and breast self-examination. Needs assessment. Cancer Nursing, 23, 64-70.
Rees, R.W., Feigel, I., Vickers, A., Zollman, C., McGurk, R., & Smith, C. (2000). Prevalence of complementary therapy use by women with breast cancer. A population-based survey. European Journal of Cancer, 36, 1359-1364.
San Francisco State University. (2001). Statewide conference on improving breast, cervical cancer awareness among Asian American, Pacific Islander women at S.F. State on Oct. 27. Retrieved November 6, 2003, from http://www.sfsu.edu/~news/prsrelea/fy01/038.htm
Snyder, R.E., Cunningham, W., Nakazono, T.T., & Hays, R.D. (2000). Access to medical care reported by Asians and Pacific Islanders in a West Coast physician group association. Medical Care Research and Review, 57, 196-215.
Strzelczyk, J.J., & Dignan, M.B. (2002). Disparities in adherence to recommended followup on screening mammography: Interaction of sociodemographic factors. Ethnicity and Disease, 12(1), 77-86.
Tabachnick, B., & Fidell, L. (2001). Using multivariate statistics (4th ed.). Boston: Allyn and Bacon.
Tang, T.S., Solomon, L.J., & McCracken, L.M. (2000). Cultural barriers to mammography, clinical breast exam, and breast self-exam among Chinese-American women 60 and older. Preventive Medicine, 31, 575-583.
U.S. Census Bureau. (2000). Census data 2000. Washington, DC: U.S. Department of Commerce.
U.S. Census Bureau. (2003). Health insurance coverage in the United States: 2002. Retrieved November 8, 2003, from http://www.census.gov/prod/2003pubs/p60-223.pdf
Yi, J.K. (1994). Breast cancer screening practices by Vietnamese women. Journal of Women's Health, 3, 205-213.
Yi, J.K., & Prows, S.L. (1996). Breast cancer screening practices among Cambodian women in Houston, Texas. Journal of Cancer Education, 11, 221-225.
Ziegler, R.G., Hoover, R.N., Pike, M.C., Hildesheim, A., Nomura, A.M., West, D.W., et al. (1993). Migration patterns and breast cancer risk in Asian-American women. Journal of the National Cancer Institute, 85, 1819-1827.