Effect of provider status on preventive screening among Korean-American women in Alameda County, California

Background Previous research suggests that having a doctor of the same ethnicity may be associated with lower rates of breast and cervical cancer screening in some Asian-American women. This study analyzes the effect of having a Korean, non-Korean, or no regular doctor upon several measures of screening among Korean-American women. Methods A random sample of 339 Korean-American women in Alameda County, California, were surveyed by telephone. Contingency tables and multivariable logistic regression were used to evaluate the association between provider status and six measures of recent screening, controlling for insurance and demographics. Results Having a non-Korean doctor was associated with an increased likelihood of having a Pap smear (odds RATIO = 2.19, 95% confidence INTERVAL = 1.00, 4.80), mammogram (odds RATIO = 7.63, 95% confidence INTERVAL = 2.35, 24.84), and clinical breast examination (odds RATIO = 3.76, 95% confidence INTERVAL = 1.54, 9.20) in the past 2 years, compared to having a Korean doctor. This relationship is less apparent for nonfemale specific screening tests like cholesterol exams and routine checkups. Conclusions Women who have a Korean doctor have less than optimal rates of breast and cervical cancer screening compared to women who have a non-Korean doctor. Having a Korean doctor may indicate less access to preventive health services, and programs to increase screening should target both Korean physicians and their female patients.