Abstract
Introduction: Michigan is a diverse state and continues to experience notable disparities in cancer outcomes among its various racial/ethnic; geography specific; and socio-economic groups. A special population-based cancer survey was systematically conducted in 2008 in a representative sample of the state population and included for the first time an adequate over-sample of African American, American Indian, Hispanic, Arab American and Asian American Michigan residents.
Methods: The survey population consisted of men and women aged 40 years and older. This age group was chosen because it experiences the highest incidence and mortality rates for the most common cancer sites. Participation in regular cancer screening is also typically recommended for this age group. The data were collected using telephone surveillance methodology. This approach was modeled closely after the Centers for Disease Control (CDC) Behavioral Risk Factor Surveillance System. Data were weighted to adjust for the unequal probabilities of selection.
To ensure cultural sensitivity of the survey, consultants from within the American Indian, the Hispanic and the Arab American communities reviewed the interview instruments for wording or interpretations. The survey tools were translated to Spanish and Arabic and conducted by bilingual interviewers when needed.
Results: The response rate for the statewide sample was 51.1%. The final sample consisted of 3,414 White, 1,036 African Americans, 575 American Indians, 613 Hispanics, 582 Arab Americans, and 609 Asian Americans.
Selected results will be presented. Major findings indicated: 1) while African American women reported receiving age appropriate breast cancer screening (mammogram and clinical breast exam within the past two years) at a rate similar to the general population (≈75%), breast screening rates for each of the other minority groups were below the general rate with Hispanic women reporting the lowest rate at 49.9%. Whether or not a woman had health care coverage had a major impact on the two year breast cancer screening level for all women. The rate dropped from 77.5% for women with health care coverage to 43.9% for those without coverage. 2) Women of different racial/ethnic background reported having had a discussion with their provider about their family history of breast cancer at a lesser level. 3) appropriate colorectal screening rates were below the general population (60.8%)for each of the minority populations except Asian Americans , rates were exceptionally low for Hispanics (46.5%) and Arab Americans (45.6%). 4)with the exception of American Indians, minorities had lower levels of awareness of hospice and palliative care for cancer. 5) 19% of the general population age 40 or older had been Primary Caregiver for a terminally ill person within the past five years with this same rate as high as 33% for American Indians. It was striking to us that caregivers of persons who died from cancer rated the average pain experienced by their loved one in the last three months of their life 56.1% of the time as ‘severe to excruciating’ compared to 24.5% for persons who died from another cause.
Conclusion: The results of this survey provided a basis for evidence based strategic planning at the state level and many opportunities for targeted interventions which resulted in positive results. Examples of improved outcomes in areas of focused efforts will be offered.
Citation Format: May Darwish Yassine. Cancer screening and related behaviors in five minority and special populations of Michigan. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr A94.
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