Low breast cancer screening and survival rates for American Indian and Alaska Native women have more to do with cultural beliefs than with barriers such as access to health care, a UC Davis study has found.
Researchers with UC Davis and the Turtle Health Foundation, Inc. also found that more holistic educational interventions designed by American Indian and Alaska Native women prompted women in those communities to seek mammograms and to change unhealthy eating and sedentary lifestyles.
"The results highlight the significance of cultural beliefs and attitudes when designing effective cancer risk-reduction and cancer control interventions," says Marlene von Friederichs-Fitzwater, an oncology professor and director of the UC Davis Outreach and Education Program. "Access to mammography screening and quality follow-up care are critical, but we learned that access is not the only barrier to improving breast cancer screening rates among American Indian/Alaska Native women."
Breast cancer is now the second leading cause of cancer-related deaths among American Indian and Alaska Native women, with mortality rates that could be cut by more than 30 percent if screening were increased to recommended levels.
The UC Davis and community researchers identified several important cultural and tribal issues that affect cancer control strategies. For example, in some native languages, the literal translation for cancer is "the sore that never heals," reflecting a belief that cancer is incurable. Among some groups, cancer carries a stigma, which can impede the effectiveness of cancer screening educational programs and interventions to reduce risk.
"My experience with people who did not survive their cancer is that many of them didn't tell anyone except for those very, very close to them," says Linda Navarro, co-chair of the project and a member of the Torres Martinez Desert Cahuilla tribe. "One of the reasons is they didn't want to be a burden to anyone."
The study, funded with a grant from the California Breast Cancer Research Program, resulted in a more culturally appealing breast cancer morbidity and mortality reduction approach called the "Mother's Wisdom Breast Health Program." The program, delivered in a DVD format, was disseminated using traditional storytelling, talking circles and other Indian communication methods.
