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Reducing Breast Cancer Risk Among Latina Women: Myths and Misconceptions 2004 Minority Women’s Health Summit August 12-1 PowerPoint Presentation
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Reducing Breast Cancer Risk Among Latina Women: Myths and Misconceptions 2004 Minority Women’s Health Summit August 12-15, 2004. Amelie G. Ramírez, DrPH, Principal Investigator Baylor College of Medicine – San Antonio Cancer Institute Co-Principal Investigators

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Reducing Breast Cancer Risk Among Latina Women: Myths and Misconceptions2004 Minority Women’s Health SummitAugust 12-15, 2004

Amelie G. Ramírez, DrPH, Principal Investigator

Baylor College of Medicine – San Antonio Cancer Institute

Co-Principal Investigators

José R. Martí, MD Martha A. Medrano, MD, MPH

Columbia University U. of TX Health Science Ctr., S.A.

Edward J. Trapido, ScD Eliseo J. Pérez-Stable, MD

NCI U. of California, San Francisco

Frank J. Penedo, PhD Gregory A. Talavera, MD, MPH

U. of Miami San Diego State U.

Aida L. Giachello, PhD Elena Ríos, MD

U. of Illinois, Chicago National Hispanic Medical Assoc.

Roland Garcia, PhD, NCI Program Officer

Supported by NCI Grant No. UO 1 CA 86117-01

slide2

Selected Spanish Settlement Dates in the Americas:

Late 1400s - Late 1700s

Santa Fe

1609

San Diego

1768

Natchitoches 1713

St. Augustine

1565

Veracruz

1518

Baracoa 1511

San Juan

1521

Santo Domingo

1496

Spanish settlements

Santa Marta

1525

slide3

Hispanic Population: 1930-2050 (millions)

First year “Hispanic” used

Census

Projections

Source: U.S. Department of Commerce. (1993) We the American… Hispanic.

U.S. Census Bureau.(2000). Projections of the Resident Population by Age, Sex, Race, and Hispanic origin, 1999 to 2100.

slide4

Percent Distribution of Hispanics

by Type: 2002

Source: U.S. Census Bureau, Current Population Survey, March 2002

why it s important to study latinos and cancer
Why It’s Important to StudyLatinos and Cancer
  • Fastest growing U.S. population group
  • Cancer: 2nd leading cause of death
  • Breast cancer leading cause of death for Latinas
  • Higher incidence of:cervical, stomach, gallbladder and liver cancer
latino cultural values
Latino Cultural Values
  • Family emphasis
  • Religious/spiritual emphasis
  • Machismo attitudes
sociodemographic profile
Sociodemographic Profile
  • Poor access to health care
  • Poverty
  • Low educational attainment
  • Lack of health insurance
  • Strong family ties
  • Strong religious beliefs
  • Low levels of knowledge about breast cancer
  • Reliance on folk/alternative medicine
  • Lack of orientation toward preventative health behaviors
lack of latino health data
Lack of Latino Health Data
  • Lack of cancer reporting among groups otherthan African Americans
  • Hispanic origin not reported on all statedeath certificates as late as 1990
  • Gaps in SEER data collection
cancer in latinos at the crossroads
Cancer in Latinos:At the Crossroads
  • We should:
    • Research the impact of cancer on Latinos
    • Study factors that may provide protective effect
    • Plan for population growth, aging, acculturation
    • Encourage greater participation by Latinos in clinical trials
recent mammography by ethno regional group
Recent Mammography by Ethno-Regional Group

S. Francisco

Central Am.

Miami

Cuban Am.

New York

P. Ricans

San Diego

Mexican Am.

San Antonio

Mexican Am.

Houston

Mexican Am.

Brownsville

Mexican Am.

Laredo

Mexican Am.

Ramirez et al. Breast cancer screening in regional Hispanic populations. Health Education Research. 2000.

knowledge of screening guidelines women 40

Heard but no

Knowledge

Hispanic Group

Never Heard

Knowledge

Mamm.

Pap

Mamm.

Pap

Mamm.

Pap

Mexican American

4.8

11.7

36.9

35.8

58.3

52.5

Central American

1.7

8.6

33.9

43.7

64.4

47.7

Puerto Rican

2.1

17.8

31.8

41.1

66.1

41.1

Cuban

2.9

4.9

25.3

39.8

71.8

55.6

Knowledge of Screening Guidelines – Women 40+

Source: Ramirez et al. Hispanic Women’s Breast and Cervical Cancer Knowledge, Attitudes, and Screening Behaviors. Am J Health Promot. 2000; 14(5):292-300

attitudes toward cancer women 40

Cancer can be cured

Little I can do to prevent

How likely to get cancer

Hispanic Group

% Disagree

% Agree

% More likely

Mexican American

21.5

39.5

17.0

Central American

17.8

36.8

12.2

Puerto Rican

21.2

33.5

20.1

Cuban

15.2

34.3

11.6

Attitudes Toward Cancer – Women 40+

Source: Ramirez et al. Hispanic Women’s Breast and Cervical Cancer Knowledge, Attitudes, and Screening Behaviors. Am J Health Promot. 2000; 14(5):292-300

latina breast cancer facts
Latina Breast Cancer Facts
  • Third highest incidence rates among minorities
  • Third highest mortality rates among all groups
  • Mostly commonly diagnosed cancer
  • Leading cause of cancer death
  • Diagnosed at a more advanced stage of the disease
  • Uninsured 2.3 times more likely to be diagnosed at a later stage
  • Lower 5-year survival rate: 76% vs. 87%

Source: American College of Physicians 2000; Healthy People 2010, 1998

latina breast cancer myths
Latina Breast Cancer Myths
  • A bruise on the breast will lead to breast cancer.
  • If an incision is made during breast cancer surgery,the cancer will spread.
  • Getting too many mammograms leads tobreast cancer.
  • Mammograms are only used to evaluatebreast lumps.

Source: Ramirez et al, 2000 American Journal of Public Health

Familias en Acción/Familias in Action & Nuestras Historias/Our Stories

latina breast cancer myths1
Latina Breast Cancer Myths
  • Touching the breasts too often will lead to cancer
  • Talking about cancer causes cancer
  • Using illegal drugs causes cancer
  • Herbs cure breast cancer(uña de gato/cat’s claw)

Source: Ramirez et al, 2000 American Journal of Public Health

Familias en Acción/Familias in Action & Nuestras Historias/Our Stories

disparities in clinical trial participation
Disparities in Clinical TrialParticipation

NCI study participation:

  • Latinos and other minority groups: 3%
  • Non-Hispanic Whites: 88%
national psa campaign
National PSA Campaign
  • 4 PSAs (video and audio) produced in Spanish and English
  • >700 nationwide TV and radio stations receiving PSAs
  • 2 Telly Awards for PSA excellence
clinical trials outreach for hispanics
Clinical Trials Outreach for Hispanics
  • Purpose: Increase awarenessand intention to participatein clinical trials; coordinate withNCI Cancer Genetics Networkto offer enrollment
  • Methods: Clinical Trials Education Series presentation to Hispanic adults in existing groups
  • Results: 40 presentations, 1,000 people, 90% Hispanic, mostly female, desire more information
recommendations patient education
RecommendationsPatient Education
  • Increase breast cancer awareness
  • Work with community organizations to dispel myths and educate Latinas about breast cancer
  • Promote breast cancerscreening behavior(clinical breast exams,mammograms, and BSEs)
recommendations training
RecommendationsTraining
  • Encourage Latino and minoritystudents to enter health professions
  • Promote cultural competencein formal education curriculum
  • Provide professionals with continuing formal and informal cultural competence training
recommendations patient contact
RecommendationsPatient Contact
  • Promote cultural competence of office staff
  • Provide culturally appropriate educational materials
  • Ask open-ended questions and remain non-judgmental
recommendations research
RecommendationsResearch
  • Encourage research in Latinos and other minority populations, including immigrant and racial/ethnic groups
  • Study correlation between culturally competent communication and health outcomes
  • Fund technology use in cancer care communications among minority populations
mil gracias
Mil Gracias

For more information on cancer control

policy recommendations produced by

Redes En Acción, visit our web sites at

www.redesenaccion.org

or

www.saludenaccion.org

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