BERKELEY, CA (UroToday.com) - Prostate cancer screening methods that involve radiation exposure have been criticized for their effectiveness. Despite the controversies surrounding the effectiveness of the Prostate Specific Antigen (PSA) test, the disease remains a major cancer that causes many deaths among American males. Those with certain racial backgrounds might be more vulnerable to mortality from prostate cancer. Furthermore, a strong racial disparity in prostate cancer screening rates exists. For example, Korean American males have shown lower rates of cancer screening compared to other Asian American immigrant groups with a longer immigration history, yet this group remains significantly under-researched and medically underserved.
Recently, scholars have suggested that specific aspects of Asian culture might shape Asian American immigrants’ health beliefs and might play a substantial role in understanding cancer screening behaviors of Asian immigrants. In particular, cultural beliefs such as modesty around sexual organs and the body, a crisis versus prevention orientation toward health care, and utilization of Eastern over Western medicine are known to influence Asian Americans’ decision to undergo cancer screening.
We investigated how these cultural factors might influence prostate cancer screening adherence among Korean American immigrant males residing in New York City. Our study is the first to focus on this group. In the study, we determined that cultural beliefs appear to have a greater influence on the likelihood of PSA testing than socio-economic and immigration-related factors such as education, income, and years in the U.S. Specifically, a crisis-oriented approach toward health care was associated with a substantially reduced likelihood of recent screening: those with a stronger crisis-oriented approach were substantially less likely to have had a PSA test in the past 12 months than those with a more prevention-oriented approach. That is, the culturally-rooted idea that a doctor visit or medical treatment is necessary only when a symptom is present might deter Korean American males from taking a prostate cancer screening test.
Our study revealed another interesting finding: the association between PSA screening and inclination toward Eastern medicine over Western medicine was conditioned by age. Korean American males in their 50s and 60s, with a greater inclination toward Eastern medicine over Western medicine, were associated with a decreased likelihood of a PSA test. In contrast, Korean American males inclined toward Eastern Medicine, but who were older than 70, were more likely to have had a PSA test. Such a finding might appear surprising at first. Yet we believe that health care concerns among older adults are higher in general, thus leading them to a more nuanced approach to Westernized health care as they age. If use of Eastern medicine is associated with perceived control over one’s ability to care for one’s health and is seen as proactive behavior in dealing with health problems in old age, the positive association between use of Eastern medicine and cancer screening is plausible given that such screening reflects a proactive mindset, as well.
Our findings highlight the need for culturally competent health care for Asian American immigrant populations. Age can play a significant role in beliefs about health and preventive care, which in turn might influence actual health care practice for older Asian American immigrants. Further studies should examine if other cognitive factors regarding health and health care service utilization contribute to prostate cancer screening behavior. Clinical practitioners in the field of medicine and health care services should be aware of the potential role of cultural beliefs in impacting patients’ health care service use.
Written by:
Yunkyung Jung, PhDa and Hee Yun Lee, PhDb as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
aGraduate School of Social Welfare, The University of Suwon, Hwaseong, South Korea
bSchool of Social Work, University of Minnesota, Twin Cities,105 Peters Hall, 1404 Gortner Avenue, St. Paul, MN, 55108, USA
Older Korean American men's prostate cancer screening behavior: The prime role of culture - Abstract
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