As the U.S. observes National Cancer Awareness Day on Sunday, difficult but pressing conversations surrounding the disease must be tackled by people who die from it in silence: Asian Americans.
The big picture: Cancer is the leading cause of death among Asian Americans, according to the Centers for Disease Control and Prevention (CDC). Data from 2017 reflect such a reality for both males (24.8%) and females (25.5%), which may be explained — at least in part — by the fact that some Asian Americans have greater exposure to certain carcinogens.
Improving screening: The journey to beating cancer begins with early detection. Liu, who survived her condition, is now speaking up and encouraging others to take charge of their health.
- Despite this outlook, studies show that Asian Americans have lower screening rates for some cancers than other racial groups. For one, only 52% of those aged 50 and above received recommended colorectal screening in 2013, compared to 61% of white people.
- Aside from lower screening rates, Asian Americans have lower odds of seeking cancer information than white people, research shows. Those who are younger and have higher levels of English fluency, socioeconomic status and health access are more likely to seek such information than their counterparts.
- Sociocultural beliefs — such as the idea that illnesses are born out of bad karma — are often blamed for the group’s hesitancy to seek help. In an article for NBC News, freelance writer Yvonne Liu shared her fight against breast cancer and her struggle to keep it a secret to save herself from being ostracized.
- “It’s a complicated problem, with complicated cultural roots, like the shame and fear that stems from thousand-year-old East Asian traditional beliefs,” Liu wrote. “I certainly felt that pressure. For 28 years, I kept my breast cancer a secret. I lived in fear that my Chinese American friends would shun me if I told them what I had endured.”
- One myth surrounding breast cancer associates it with immoral behavior, according to Cannas Kwok, a Sydney-based physician. Kwok lost her own mother to the disease in 1983. “Some women believe they will not get breast cancer if they are loyal to their husband. To a health care professional this is nonsense, but this mindset still impacts women’s screening behaviour,” she told the South China Morning Post in 2018.
- Early detection comes with factual information that guides patients in making sound choices, which consequently help improve prognosis. “Treating disease like it’s a curse has to stop,” Liu wrote.
- One study shows that when communication factors — namely cancer/health information seeking, patient-provider communication (PPC) and cancer screening information from providers — are controlled, the odds of Asian Americans going for screening increases. In the case of breast cancer, these odds became 1.4 times greater than white people.
- Researchers from the Cancer Prevention Institute of California found that breast cancer increased among Asian Americans between 1988 and 2013, most notably among Koreans and Southeast Asians. “Culturally-tailored efforts to increase awareness of and attention to breast cancer risk factors are needed,” they wrote.
- Still, healing does not end with pushing cancer out of one’s system. Greater self-stigma among survivors are associated with greater ambivalence toward emotional expression, which in turn is related to worse sleep quality, greater use of sleep aids and greater difficulty staying awake during the day, according to one study.
- Cancer researchers should also improve their collection and presentation of disaggregated data on Asian Americans. Knowing which cancer affects which ethnic group more or less will aid health care providers in recognizing disparities and rendering more culturally-competent interventions.