Hispanic Women's Breast and Cervical Cancer Knowledge, Attitudes, and Screening Behaviors

Purpose. This study examined breast and cervical cancer knowledge, attitudes, and screening behaviors among different Hispanic populations in the United States.

Design. Data were collected from a random digit dial telephone survey of 8903 Hispanic adults from eight U.S. sites. Across sites, the average response rate was 83%.

Setting. Data were collected as part of the baseline assessment in a national Hispanic cancer control and prevention intervention study.

Subjects. Analysis ivas restricted to 2239 Hispanic women age 40 and older who were self-identified as either Central American (n = 174), Cuban (n = 279), Mexican American (n = 1550), or Puerto Rican (n = 236).

Measures. A bilingual survey instrument was used to solicit information on age, education, income, health insurance coverage, language use, U.S.-born status, knowledge of screening guidelines, attitudes toward cancer, and screening participation. Differences in knowledge and attitudes across Hispanic groups were assessed by either chi-square tests or analysis of variance. Logistic regression models assessed the influence of knowledge and attitudes on screening participation.

Results. The level of knowledge of guidelines ranged from 58.3% (Mexican Americans) to 71.8% (Cubans) for mammography, and from 41.1% (Puerto Ricans) to 55.6% (Cubans) for Pap smear among the different Hispanic populations. Attitudes also varied, with Mexican Americans and Puerto Ricans having more negative or fatalistic views of cancer than Cuban or Central Americans. Knowledge was significantly related to age, education, income, language preference, and recent screening history. Overall, attitudes were not predictive of mammography and Pap smear behavior.

Conclusions. Factors related to mammography and Pap smear screening vary among the different Hispanic populations. Limitations include the cross-sectional nature of the study, self-reported measures of screening, and the limited assessment of attitudes. The data and diversity of Hispanic groups reinforce the position that ethno-regional characteristics should be clarified and addressed in cancer screening promotion efforts. The practical relationships among knowledge, attitudes, and cancer screening are not altogether clear and require further research.

Keywords: Cancer Screening, Mammography, Pap Smear, Hispanics, Cancer Screening Behaviors, Cancer Knowledge and Attitudes

Received: July 26, 1999; Revised: October 20, 1999; Accepted: March 21, 2000

Amelie G. Ramirez, DrPH, is Associate Professor of Medicine at Baylor College of Medicine, Deputy Director of the Chronic Disease Prevention and Control Research Center, and Associate Director for Community Research at the San Antonio Cancer Institute, San Antonio, Texas.

Lucina Suarez, PhD, is at the Associateship for Disease Control and Prevention for the Texas Department of Health, Austin, Texas.

Larry Laufman, EdD, is Associate Professor of Medicine, Cristina Barroso, MPH, is a Research Coordinator, and Patricia Chalela, MPH, is a Research Associate with the Chronic Disease Prevention and Control Research Center, Baylor College of Medicine, Houston, Texas.

Send reprint requests to Amelie G. Ramirez, DrPH, 8207 Callaghan Road, Suite 110, San Antonio, TX 78230.