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Immigrants are likely to underreport a family history of cancer
People who have immigrated to the United States are a third less likely to report a family history of cancer to their clinicians, a study finds. Heather Orom, Ph.D., of Wayne State University, and colleagues used data collected by telephone for the 2005 Health Information Trends Survey to compare country of birth with variables typically associated with an individual knowing his or her family health history. For instance, married people are more likely to spend time with their family and know their health history and people with health insurance may be more aware of their family risk of cancer. Additional variables associated with reporting a family history of cancer were also considered, including race, age, gender, and education level. Of the 5,010 people who were surveyed, those born in foreign countries were a third as likely as U.S.-born respondents to report a family history of cancer.
Even immigrants who acculturated to the United States were not likely to report a family history of cancer. The authors suggest that under-reporting may occur because immigrants are separated from relatives and are unaware of their family's health history. If the individual's birth country is a developing nation, cancers simply may go undiagnosed and medical encounters are unlikely to emphasize a family cancer link. Finally, cultural beliefs that deem cancer as shameful or a punishment may also contribute to secrecy and underreporting in immigrants.
Clinicians caring for foreign-born patients should consider the possibility that their patients may not report a family history of cancer yet should be still be screened, the authors suggest. Not doing so could contribute to the disparities reported in cancer screening for minorities. This study was funded in part by the Agency for Healthcare Research and Quality (HS13819).
See "Family history of cancer: Is it an accurate indicator of cancer risk in the immigrant population?" by Dr. Orom, Michele L. Cote, Ph.D., Hector M. Gonzalez, Ph.D., and others in the January 15, 2008, Cancer 112(2), pp. 399-406.
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