Grant: Fellowship: Bisby (Prize)

Breast and colorectal cancer are two of the leading causes of cancer death among Chinese American women. In fact, incidence of invasive breast cancer has declined among all US women from 2000-2007 except Asian American women; incidence for this group increased. Early detection through regular screening increases survival rates. Compared to non-Hispanic whites, older Chinese American women have lower rates of breast and colorectal cancer screening participation and received fewer FOBT screening recommendations. Physician recommendation is the primary factor for participation in cancer screening. Yet, older women who speak English-as-a-second language are more likely to experience language and literacy barriers to patient-physician communication. Physicians who perceive communication barriers (e.g., health literacy, English language proficiency (ELP), cultural or gender based barriers) to engaging in productive conversations about the risks and benefits of preventive cancer screening may be less likely to initiate these conversations in order to focus on more pressing medical issues. While much is known about cancer screening and treatment disparities among minorities in Canada and the USA, little research has focused specifically on disparities experienced among Asian populations. Using physician interviews, this research will explore physician self-reported approaches and perceived barriers to communicating with patients about cancer screening and seek to understand whether perceptions of patient characteristics such as health literacy, ELP, culture or gender influence the initiation of cancer screening conversations or recommendations. Understanding the barriers obstructing physician recommendation for cancer screening is the first step to ensuring equitable and timely access to important preventive cancer screening for all women.