Monday, 8 June 2009

cancer screening for asian women

this little article on the stuff website talks about the low rates of cervical smears and breast cancer screening amongst asian women:

Partnership Health Canterbury ethnic liaison officer Wayne Reid said he was concerned about the low uptake of cancer screening among Asians.

Ministry statistics show that only 47 per cent of Asian women regularly have a cervical smear test.

Screening rates for Maori and Pacific women are 51 per cent and 54 per cent respectively, compared with 83 per cent for other New Zealanders....

Asian people in New Zealand suffered the "healthy migrant effect", where they would arrive healthy, but their health deteriorated because of stress and diet changes.

Reid said the ministry largely ignored Asian health needs, which were relegated to the "too-hard basket".

Auckland University of Technology Centre for Asian and Migrant Health senior research fellow Ruth DeSouza wrote a research paper last year showing Asian women were the least likely of all ethnic groups to have mammograms or smear tests, generally going to a doctor only if something was already wrong.

the headline to this piece was pretty awful "Asian women 'disadvantaged' in health". notice the brackets around "disadvantaged", which implies there is no real disadvantage and they're only pretending. on top of that, no-one quoted in the article even uses the word. grrr.

the main issue is the lower rates of screening for asian women, and the need to develop strategies to deal with that. the cause may be embarassment, a belief that they are less susceptible to these types of cancer or a lack of understanding of the importance of detecting these diseases early. in any case, it's an issue that needs some work by the "back-room" staff in the ministry, if we have any left.

14 comments:

katy said...

I was discussing a similar issue with my GP recently because east Asian people in general have a greater susceptibility to type-2 diabetes and stomach cancer than other groups. Public health campaigns in Japan, where I used to live, obviously ensure that there is high awareness around this and it is common for workers to have health checks every year that specifically focus on diseases that are associated with being overweight because the threshold is much lower than it is for other groups. Maybe I am just uninformed but it seems that Asian people in general are a bit invisible in terms of public health campaigns in NZ.

artandmylife said...

A couple of years ago i did some health research in the Porirua basin. There is a large "asian" popoulation in the southern area (Linden, Tawa etc). At the time, there appeared to be NO primary health initiatives aimed at or provided for the Asian population

stargazer said...

one of the main issues here is the collection of data. if you don't collect the ethnicity data, then investigate causes, then it's very difficult to organise strategies to solve the problem. the prevailing view seems to be that collection of ethnicity data is somehow a bad thing, which really doesn't help the situation.

katy said...

stargazer, that is interesting. I have seen those ads regarding cervicial screening that target Maori and Pacific Island, are these based on something different (ie, those communities requesting targeted advertising)? Or is ethnicity data collected in some circumstances? (sorry for lots of questions! I am just curious).

stargazer said...

unfortunately i don't have any specific answers. the person to speak to would be ruth desouza, a wonderful mental health researcher who is quoted in the article. my comments were more based on the furore about recording ethnicity data that happens regularly around census time. i'm sure that it affects attitudes to collecting ethnicity data in other areas as well.

Hugh said...

Stargazer, are you referring to the whole 'just put New Zealander' movement? Because I think that actually is unique to the census - presumably because the census is so high profile.

I think a lot of medical information is collected during the delivery of medical services, and the 'New Zealanders' haven't seen fit to move their lobbying to that area yet.

stargazer said...

yes, i know it's unique to the census, but it does have an effect on other areas. i can recall so many times hearing people complaining about having to put ethnicity data on forms, and the whole "why can't we all just be nz'ers" thing coming through. the debate may initially start with the census, but is very much more expanded in many people's mind. to the extent that it puts data collection in other areas such as health at risk.

Hugh said...
This comment has been removed by the author.
stargazer said...

wrong post! you want to cut & paste across to the other one?

Hugh said...

Sorry about that Stargazer, pasted and deleted.

Perhaps I'm being complacent, but I'm pretty sure this 'I'm just an NZ'er' thing is a flash in the pan, a product of where the socio-political environment was as of 2006. It may crop up at the next census, but I kind of doubt it. That's not say New Zealand nationalism won't find some other, equally ugly way to manifest itself.

Anonymous said...

So, approximately half of all Asians, and a similar number of Maori and Pacific women aren't having regular smears, and similarly nearly 20% of all other New Zealanders also aren't. Given the nature of the test, and also the violations of women's privacy that are the end result of the Botrill mess (the smear register now keeps data on every woman who has ever had a smear, whether or not her smear results are kept) I wonder if we should be supporting research into the privacy/modesty/cultural issues surrounding these things.

There are a number of approaches to this that are beginning to become available, including DIY sampling kits, and research into a "cervical specific antigen" blood test. I'm aware that access to health care generally is compromised for Asians, Maori, and Pacific peoples, but I can't help but think that tests that were less likely to place them (and indeed all women) in a culturally uncomfortable or unacceptable position, and particularly tests that could be performed without ever the need to see a doctor (as in the DIY kits) would be more likely to increase screening rates than any initiatives designed to overcome the cultural issues.

katy said...

Hi Anon, the points you raise are worth considering. I wonder though if it is about "modesty" as a cultural trait or about societies where there are more established practices around preventative medical testing.

katy said...

Though that wouldn't necessarily account for the discrepancy described in the article, that might be just about targeting. I know my own participation in such things is as a result of external reminders.

Wayne said...

Interesting comments in this blog which I have just come across in trying to locate data on Asian cervical screening. The MoH had little interest in collecting ethnicity data other than Maori, Pacific, European and other! Thus we see too many reports comparing (for example) Maori to non-Maori and Pacific to non-Pacific. This is like comparing an apple to an orange and wondering why it does not look like a banana. There are significant cultural issues at play however these can be overcome by using methods such as the recent TV campaign for Pacific women. This has been successful as it uses Pacific women to heighten awareness in Pacific women. The same campaign is needed for Asian peoples. Unfortunately also, The NZ thing referred to is not going to go away any time soon.Stats are struggling with this one. However ethnic data is available from GP level and is being reported to DHBs.