Elsevier

Women's Health Issues

Volume 25, Issue 5, September–October 2015, Pages 494-500
Women's Health Issues

Original article
Acculturation, Behavioral Factors, and Family History of Breast Cancer among Mexican and Mexican-American Women

https://doi.org/10.1016/j.whi.2015.05.011Get rights and content

Abstract

Background

Incidence rates for breast cancer are higher among Mexican-American (MA) women in the United States than women living in Mexico. Studies have shown higher prevalence of breast cancer risk factors in more acculturated than less acculturated Hispanic/Latinas in the United States. We compared the prevalence of behavioral risk factors and family history of breast cancer by level of acculturation and country of residence in women of Mexican descent.

Methods

Data were collected from 1,201 newly diagnosed breast cancer patients living in Mexico (n = 581) and MAs in the United States (n = 620). MA participants were categorized into three acculturation groups (Spanish dominant, bilingual, and English dominant); women living in Mexico were used as the referent group. The prevalence of behavioral risk factors and family history of breast cancer were assessed according to acculturation level, adjusting for age at diagnosis and education.

Results

In the adjusted models, bilingual and English-dominant MAs were significantly more likely to have a body mass index of 30 kg/m2 or greater, consume more than one alcoholic beverage a week, and report having a family history of breast cancer than women living in Mexico. All three U.S. acculturation groups were significantly more likely to have lower total energy expenditure (≤533 kcal/d) than women in Mexico. English-dominant women were significantly less likely to ever smoke cigarettes than the Mexican group.

Conclusions

Our findings add to the limited scientific literature on the relationships among acculturation, health behavior, and family history of breast cancer in Mexican and MA women.

Section snippets

Study Design and Participants

The data used in this study are part of the Ella Binational Breast Cancer study, a collaborative effort among three sites in Mexico and two in the United States. Detailed methods for the Ella Study have been previously published (Martínez et al., 2010). Briefly, eligible participants were female, 18 years of age or older, self-identified as being of Mexican descent (U.S. participants), and diagnosed with invasive breast cancer 24 months before study enrollment. Participants with in situ and/or

Results

Distributions of behavioral factors and family history by country of residence and U.S. MA level of acculturation are shown in Table 1. Mexican women had the oldest mean age at diagnosis (54.5 years) and Spanish-dominant patients had the lowest. Mexican and Spanish-dominant MA women had the lowest level of education. Obesity increased while prevalence of high waist circumference decreased across level of acculturation. Self-reported family history of breast cancer was least among Mexican women

Discussion

In this study, we observed differences in behavioral risk factors and family history of breast cancer by language acculturation and country of residence. Results showed that, after adjusting for age and education, level of acculturation was associated significantly with several factors, including obesity, ever smoking cigarettes, alcohol consumption, physical inactivity, and family history of breast cancer. Few studies have reported comparisons for breast cancer risk factors by level of

Implications for Practice and/or Policy

Our results add to the existing literature on the relationship between the process of acculturation and behavioral risk factors and family history of breast cancer. Findings show that acculturation has both positive and negative effects on these risk factors in women of Mexican descent. Interventions and public health policies may benefit from considering the increase in risk factors occurring with acculturation among U.S. MA women as well as those in Mexico. Interventions and policies that

Conclusions

We found differences in certain behavioral risk factors and family history of cancer by language acculturation and country of residence which were independent of educational level. Findings from this and our prior research underscore the complexity of culture and its impact on cancer-related risk factors.

Acknowledgments

The authors are indebted to Erin Ashbeck, Rachel Garcia, and Fang Wang for their contribution as well as Malaika Tobias for help with manuscript preparation.

Jesse N. Nodora, DrPH, is Assistant Professor in the Department of Family Medicine and Public Health and Moores UC San Diego Cancer Center. His research focus is in informed decision-making, patient-provider communication, health literacy, and systems interventions among poor and underserved populations.

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    Jesse N. Nodora, DrPH, is Assistant Professor in the Department of Family Medicine and Public Health and Moores UC San Diego Cancer Center. His research focus is in informed decision-making, patient-provider communication, health literacy, and systems interventions among poor and underserved populations.

    Renee Cooper, MPH, performed the data analysis for this manuscript as a part of her Master's thesis requirement. Her interests are in health disparities, health care access, and immigrant Hispanic populations in the United States.

    Gregory A. Talavera, MD, MPH, is Professor at San Diego State University's Graduate School of Public Health. His research projects explore the culture-specific beliefs that serve as barriers to chronic disease prevention and control.

    Linda Gallo, PhD, is Professor in the Department of Psychology at San Diego State University. Her research focuses on psychosocial and behavioral processes in chronic disease risks and outcomes and on socioeconomic status and ethnicity-related health inequities.

    María Mercedes Meza Montenegro, PhD, is Professor in Biotechnology Department at the Instituto Tecnológico de Sonora. Her research interests are in understanding environmental and genetics factors which are responsible of the health adverse effects, specially cancer through the determination of novel biomarkers.

    Ian Komenaka, MD, is a surgical oncologist and medical director of the Breast Center at Maricopa Integrated Health Center. His research interests are in patient-provider communication and health literacy and health outcomes in low-income populations.

    Loki Natarajan, PhD, is Professor in the Department of Family Medicine and Public Health at UC San Diego. She is a biostatistician with interests in various areas of methodological research.

    Luis Enrique Gutiérrez Millán, PhD, is Professor in Molecular Biology at the University of Sonora. His research interests are in conducting investigation on molecular biology of cancer.

    Adrian Daneri-Navarro, PhD, is Professor in the Department of Physiology at the University of Guadalajara. His research interests are in identification of prognostic and predictive factors for breast cancer.

    Melissa Bondy, PhD, is Professor at Baylor College of Medicine. As a genetic and molecular epidemiology, her research targets the development of innovative ways to assess the roles of heredity and genetic susceptibility.

    Abenaa Brewster, MD, is an Associate Professor in the Department of Clinical Cancer Prevention at MD Anderson Cancer Center. She is a breast medical oncologist with research expertise in molecular epidemiology.

    Patricia Thompson, PhD, is Professor in the Department of Pathology at Stony Brook University. Her research has focused on the evolution of molecular and cellular changes that occur during the development of breast and other cancers.

    María Elena Martinez, PhD, is Professor in Family Medicine and Public Health at UC San Diego and Leader of the Reducing Cancer Disparities Program at Moores Cancer Center. Her research interests are understanding cancer disparities throughout the cancer continuum particularly in Hispanic populations.

    Funding statement: This work was supported by NIH/NCI (UO1CA153086, CA023074-2953, CA116199-02S1); Cancer Center Support Grant (P30CA023074); the Avon Foundation; the Susan G. Komen for the Cure® (KG090934); and the ACS Mentored Research Scholar grant MRSG-11-102-01-CPPB-ACS/MRSG. The authors have no conflicts to disclose.

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