Cancer-screening program reaches out to Pacific Islander women
Pacific Islander women have the highest rate of newly diagnosed late-stage cancer in Washington state and one of the worst five-year survival rates, according to a recent Susan G. Komen study. The challenge now is to persuade them to get regular mammograms and Pap smears.
Seattle Times staff reporter
Wearing a black T-shirt that reads, "I am on the clock: end breast cancer by Jan. 1, 2020," Fa'amaile Frost spends Monday afternoons at the Filipino Community Center in Seattle urging women to schedule regular mammograms and Pap smears.
Frost, who works with International Community Health Services (ICHS), reaches out to Pacific Islander women — often skeptical or unaware of the importance of these tests — at her physical-activity and diabetes-awareness classes, and in churches and community centers.
If they agree, she refers them to free or low-cost providers. Frost is Samoan, and in sharing a similar cultural thread, she's able to gain the women's trust.
"That is usually a challenge," Frost said. "Some are afraid because they're undocumented. Some are afraid because they don't have insurance. Some are not interested to have others look at their breasts."
Pacific Islander women have the highest rate of newly diagnosed late-stage cancer in Washington state and one of the worst five-year survival rates, according to the most recent community profile by Susan G. Komen For the Cure Puget Sound.
They have a lower incidence of breast cancer than other groups. But of the Pacific Islander women diagnosed here with breast cancer, 45 percent find out at an advanced stage.
A variety of factors keep many immigrants from early screening. Lack of insurance, transportation and trouble with English fluency are common. Also, for some, this type of preventive care was not widely available in their home countries.
According to the Komen report, many African-Americans, Native Americans and Alaska Natives are wary of services such as mammograms because of a history of unethical health studies involving racial minorities.
Worried about immigration status, many Hispanic women steer away from services, the report said. In the Asian/Pacific Islander group, Chinese, Japanese, Korean and Vietnamese women have higher five-year survival rates compared with Asian Indian and Pacific Islander women. At 76 percent, Pacific Islander women have one of the worst survival rates among all ethnic groups.
Last year, Komen Puget Sound listed Pacific Islander women as critical to reach and gave ICHS and Franciscan Health System in Pierce County more than $225,000 to boost screenings for all minority women.
To fully cover the cost for underinsured and uninsured women ages 40 to 64, advocates connect clients to the state's Washington Breast, Cervical and Colon Health program.
With the state program and services available at places like ICHS and Swedish Medical Center, Siniva Driggers, a retired nurse, has helped 30 women in the past year and a half get screened.
"Most of them didn't have insurance, didn't have resources," said Driggers, director of Samoan Nurses Organization of Washington (SNOW), a group of 13 nurses who educate the community on public-health issues. "One of the main barriers is they can't pay for it."
She adds some women may not meet income qualifications for Medicaid or age requirements for Medicare, so many lack insurance.
"Most of them never had mammograms before, and they don't understand what they're for ... they just don't know," she said. "It's mainly education for them."
In Tacoma, Driggers drives women to their appointments. In Seattle, ICHS, with help from Komen, provides bus passes.
According to ICHS advocate Sefie Cabiao, "church is the best place to find people." But at church, the Pacific Islander cultures split into various languages. Cabiao is fluent in two Filipino languages, Tagalog and Ilocano, while Frost is fluent in Samoan and can speak basic Tongan.
A few years ago, Tupou Tuinukuafe, of Tukwila, spoke to Frost and got a mammogram. "I thought maybe I was OK, but I still got checked," she said.
A member of the First Tongan United Methodist Church in Seattle, Tuinukuafe, now 68, helps Frost translate the information to the congregation in her native Tongan.
"I explained to my people to come over and take these tests," she said.
Some Pacific nations like the Marshall Islands endured nuclear testing during and after World War II, leading to higher cancer rates.
"I know they're higher in those situations, but it's kind of hard to reach them when I don't have a person who knows their culture and knows the language," Driggers said. Fluent in Samoan, she's looking for Marshallese translators to help.
The Swedish mammography van visits the ICHS Holly Park Clinic and attends Pacific Islander community events throughout the year.
"We're starting to see repeaters coming back on a yearly basis," said Darlene Fanus, van supervisor.
Kibkabe Araya: 206-464-2266 or firstname.lastname@example.org.