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What Stops Chinese Elderly From Using Preventive Care and Personalized Treatments for Cancer?

Stephanie Bergren
Chinese Health, Aging, and Policy Program
Institute for Health, Health Care Policy, and Aging Research
Rutgers University
[email protected]

Chicago, IL, June 26—Cancer is one of the leading causes of death in the U.S., claiming the lives of more than half a million Americans each year. Previous studies have shown that preventive care services and personalized cancer treatments, or precision medicine, can improve survival rates for cancer. However, barriers may exist for the Chinese aging populations in the United States.

Compared with other populations, Chinese older adults have lower rates of cancer screening and are less likely to participate in biospecimen collection, which is critical for the development of personalized cancer treatments. Researchers are trying to identify the characteristics and barriers within the Chinese community that may contribute to low utilization of preventive health care services and low participation in biospecimen research for precision medicine. These research efforts are crucial for a population that may be at risk of certain kinds of cancer, such as lung cancer, breast cancer, colon cancer, and cervical cancer.

Dr. Melissa Simon from Northwestern University Feinberg School of Medicine, and Drs. XinQi Dong, and Chien-Ching Li from Rush University Medical Center, utilized data from the PINE study, a population-based longitudinal study investigating over 3,000 Chinese older adults, to examine eligibility for lung cancer screening and population characteristics associated with utilization of cancer screening. The main findings include:

  • Two-thirds of older Chinese men were at risk of lung cancer due to a history of smoking. Approximately 18% and 22% of older Chinese men were eligible for low-dose computed tomography (LDCT) lung cancer screening based on Center of Medicare and Medicaid Services (CMS) and U.S. Preventive Services Task Force (USPSTF) recommendations, respectively.
  • Higher overall social support was associated with cancer screening utilization. In particular, higher levels of social support from family members and friends were associated with breast cancer screening utilization while higher level of social support from a spouse was associated with colon cancer screening utilization.

Additionally, researchers conducted qualitative interviews with 47 older Chinese women to obtain a better understanding about the beliefs and barriers to breast cancer screening and participation in biospecimen research. Main findings include:

  • Language, time, not wanting to burden their adult children, transportation, and perceptions of stigma and the value of screening may be key barriers to breast cancer screening among older Chinese women.
  • Most participants had positive attitudes toward biospecimen research, but barriers to participating in biospecimen research included cultural beliefs of the body, concerns about physical and privacy risks, and perceptions about old age.

These studies shed light on the beliefs and patterns of health care use and research participation among the Chinese aging population in the U.S.

“Chinese populations in the U.S. are significantly undeserved with respect to cancer screening and care access.” Dr. Simon said, “Based on our research, tailored interventions are needed to optimize elder Chinese populations’ knowledge of and attitudes towards cancer screening and access to cancer care.”

Note: Articles are published in The Journal of Gerontology: Medical Sciences Volume 72: S1.