Immigrant patients less likely to report
family history of cancer
Immigrants in the United States may be less
likely to report a family history of cancer,
which may lead to inadequate screening and
cancer prevention strategies according to a
new study.
Dr. Heather Orom of the Barbara Ann Karmanos
Cancer Institute in Detroit and colleagues
argue that as a result of being less likely
to report a family history, family history
may not be as strong a predictor of cancer
risk in immigrant populations. The study is
published in the January 15, 2008 issue of
CANCER, a peer-reviewed journal of the
American Cancer Society.
Cancer prevention guidelines recommend
earlier and more frequent screening for
individuals with a family history of certain
cancers. Therefore, knowledge and timely
reporting of cancer history can impact
access to cancer prevention and screening
services.
Previous research has identified lower rates
of reporting cancer family history among
African Americans, Hispanics, and Asian
Americans than among Whites in the U.S.
However, the current study is the first to
examine whether an individual’s immigrant
status, in conjunction with race/ethnicity,
plays a role in this under-reporting.
Dr. Orom and co-investigators studied data
from 5,010 respondents to the 2005 Health
Information Trends Survey. After controlling
for race/ethnicity, other sociodemographic
variables, and cancer knowledge,
foreign-born respondents were about
one-third as likely to report a family
history of cancer as US-born respondents.
The authors found that those who were
single, male, or without health coverage
were also less likely to report a family
history of cancer.
The low rate of cancer history reporting did
not change as immigrants became more
integrated into American culture with time.
The authors suggest that this may be due to
fewer opportunities to learn about family
health histories afforded to immigrants due
to separation from relatives, as well as
cultural norms that inhibit family
communication about cancer diagnoses.
The investigators conclude that information
regarding family history of cancer may not
be as accurate an indicator of risk for
foreign-born patients as it is for US-born
patients. Dr. Orom suggests, “that some
immigrants might not have a family history
of cancer even though they have a genetic
disposition for cancer, in part, because
they are from countries in which people are
more likely to die at a relatively young age
of causes other than cancer, and are not
exposed to the same degree of behavioral and
environmental risk for the disease. \
"In
addition, due to under-diagnosis of cancer
in many immigrants’ countries of origin,
lack of awareness of familial risk, and
communication barriers in families,
foreign-born patients may not be aware of
their true family history of cancer.”
The authors note that failing to take into
account that immigrants may have genetic
risk without family history could lead to
insufficiencies in cancer screening and
prevention for immigrants and ethnic
minorities.
