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Cancer prevention among American Samoans
– Reported, January19 2013
Unfortunately, little is known about the use of any cancer prevention services among American Samoans. The paucity of data has been due in part to the lack of a specific ethnic identifier. Until 1980, American Samoans were included in the broad category of Asian and Pacific Islanders and consequently, their unique problems were largely obscured. It is particularly important to learn more about the cervical cancer control needs of this population because the high site-specific rate of the disease, the potential for prevention of the disease, the rapid growth of the population, and the previous neglect by cancer researchers.
Most of the predictors of Pap smear screening, such as income levels, years of formal education, and health insurance status, were similar to those of other economically disadvantaged groups.Several additional factors may also contribute to the very low screening rates among American Samoans. On the islands, where screening rates were lowest, all residents are entitled medical care funded by the government; however, this care is mostly episodic with little emphasis on prevention. Moreover, Pap smear slides must be sent to Hawaii for interpretation. The inefficiency and cost of this referral program has not encouraged regular screening for cervical cancer. Adding to these practical problems, is the lack of culturally sensitive cancer prevention programs for American Samoans in any of the study sites. Indeed, prior to this study, few cancer education materials had even been translated into the Samoan language, the first language of the majority of American Samoans.
In summary, the rate of screening for cervical cancer among American Samoan women was very low. It is likely that the low screening rate explains, at least in part, the high site-specific incidence of cervical cancer in this population. Our research group is currently evaluating culturally appropriate educational programs designed to improve Pap smear screening rates. Others are studying the diagnostic accuracy of telepathology for the interpretation of Pap smears and the efficacy of visual inspection for cervical cancer screening, approaches that would address the lack of a cytopathologist in geographically isolated regions such as American Samoa. We believe that these approaches have the potential to decrease the cervical cancer burden among American Samoan women.
CREDITS:Shiraz I Mishra, Pat H Luce-Aoelua and F Allan Hubbell
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495219/
