Tongan perceptions of cancer

Background: There is little published information about cancer-related knowledge, attitudes, and preventive behaviors of Tongans in the United States. The purpose of this study was to evaluate answers to the following questions: What is cancer? What causes cancer? And what can you do to prevent cancer? Methods: We completed face-to-face, semi-structured interviews with 48 self-reported Tongans (16 men and 32 women) over the age of 18 years, selected through non-probability purposive sampling with help from Tongan community-based organizations. The questions regarded demographic characteristics, and cancer-related knowledge, attitudes and preventive behaviors. The research settings were San Mateo, California and Salt Lake City, Utah. We analyzed the data using qualitative content analysis of individual interviews to identify themes. Results: All but one of the 48 participants had migrated to the U.S. from Tonga. The average income was approximately $3100 per month and average household size was six. Fewer than half of participants had health insurance. The theme that cancer was equivalent to death was pervasive through all the responses. Weaknesses in the body and exposure to toxins in the environment were dominant themes in the causation of cancer. Leading a healthy life and prayer were among the preventive measures cited by the respondents. Conclusion: The association of cancer with death is a strong indication that cancer information is not reaching this community. Interventions must take this into account and include Tongan cancer survivors in order to enhance the effectiveness of early screening efforts.