Agreement between birthplace and self-reported ethnicity in a population-based mammography service.

BACKGROUND: Ethnicity is associated with genetic, environmental, lifestyle and social constructs. Difficult to define using a single variable, but strongly predictive of health outcomes and useful for planning healthcare services, it is often lacking in administrative databases, necessitating the use of a surrogate measure. A potential surrogate for ethnicity is birthplace. Our aim was to measure the agreement between birthplace and ethnicity among six major ethic groups as recorded at the population-based mammography service for British Columbia, Canada (BC). METHODS: We used records from the most-recent visits of women attending the Screening Mammography Program of British Columbia to cross-tabulate women's birthplaces and self-reported ethnicities, and separately considered results for the time periods 1990-1999 and 2000-2006. In general, we combined countries according to the system adopted by the United Nations, and defined ethnic groups that correspond to the nation groups. The analysis considered birthplaces and corresponding ethnicities for South Asia, East/Southeast Asia, North Europe, South Europe, East Europe, West Europe and all other nations combined. We used the kappa statistic to measure the concordance between self-reported ethnicity and birthplace. RESULTS: Except for the 'Other' category, the most-common birthplace was East/Southeast Asia and the most-common ethnicity was East/Southeast Asian. The agreement between birthplace and self-reported ethnicity was poor overall, as evidenced by kappa scores of 0.22 in both 1990-1999 and 2000-2006. There was substantial agreement between ethnicity and birthplace for South Asians, excellent agreement for East/Southeast Asians, but poor agreement for Europeans. CONCLUSION: Birthplace can be used as a surrogate for ethnicity amongst people with South Asian and East/Southeast Asian ethnicity in BC.

Predisposing, reinforcing and enabling factors associated with hepatitis B testing in Chinese Canadians in British Columbia.

BACKGROUND: Liver cancer, a significant health problem in Chinese, can be controlled through HBV blood testing, vaccination, and community education about HBV. The PRECEDE framework has been very helpful in identifying factors associated with health practices. OBJECTIVES: The objective was to identify factors associated with HBV testing in Chinese Canadians, using the PRECEDE framework. METHODS: Five hundred and thirty-three randomly selected Chinese Canadian adults were interviewed about HBV blood testing practices. Factors were grouped as predisposing, reinforcing and enabling. RESULTS: Fifty-five percent had received HBV blood testing. Several predisposing factors, all reinforcing factors and one enabling factor were associated with HBV testing in bivariate analysis. A physician's recommendation for testing was the strongest factor associated with testing in multiple logistic regression analysis (OR=4.4, p<0.0001). INTERPRETATION: Many Chinese Canadian adults in Vancouver have not been tested for HBV. Continuing educational efforts are needed and the PRECEDE framework can inform the development of health education interventions.

Hepatitis B knowledge and practices among Chinese immigrants to the United States.

INTRODUCTION: Chinese immigrants to the United States experience high rates of liver cancer. Chronic carriage of hepatitis B virus (HBV) is the most common underlying cause of liver cancer among Chinese Americans. Our objective was to describe Chinese immigrants' hepatitis B knowledge, testing, and vaccination levels. METHODS: A community-based, in-person survey of Chinese men and women was conducted in Seattle during 2005. Our study sample included 395 individuals. RESULTS: Less than one-half (48%) of our study group indicated they had received a hepatitis B blood test, and about one-third (31%) indicated they had been vaccinated against hepatitis B. The proportions of respondents who knew HBV can be spread during childbirth, during sexual intercourse, and by sharing razors were 70%, 54%, and 55%, respectively. Less than one-quarter of the study group knew that HBV cannot be spread by eating food that was prepared by an infected person (23%) and by sharing eating utensils with an infected person (16%). DISCUSSION: Over 50% of our respondents did not recall being tested for HBV. Important knowledge deficits about routes of hepatitis B transmission were identified. Continued efforts should be made to develop and implement hepatitis B educational campaigns for Chinese immigrant communities.

Comparison of cancer incidence in Iran and Iranian immigrants to British Columbia, Canada.

Migrant studies provided strong evidence about the role of environment and life style in cancer risk. Iran has experienced many immigrants to other countries with different cultures and environment. This study compares cancer incidence rates in Iran, Iranian immigrants to British Columbia (BC), Canada, and the BC general population. Cancer incidence rates were computed from two population-based cancer registries in Iran and from the BC cancer registry. A listing of common Iranian surnames and given names was produced to identify Iranian immigrants within the BC cancer registry. Age-standardized rates (ASRs) were calculated using mid year census data. The overall cancer incidence rate for Iranian female immigrants was intermediate between rates for Iran and the BC general population, and the rate for Iranian male immigrants was lower as compared to the other population groups. For female Iranian immigrants, the incidence of breast cancer was increased four-fold, and for colorectal cancer two-fold, as compared to Iranian rates. A dramatic decrease was found in the incidence of both stomach and oesophageal cancers for Iranian immigrants of both sexes. For male Iranian immigrants, the incidence of prostate cancer was increased as compared to Iranian rates. Differences in incidence rates of specific cancers were observed between BC Iranian immigrants and Iran, with cancer patterns in Iranian immigrants being more similar to the BC general population. This warrants further investigation into differences in lifestyle and cancer detection.

Methodology to identify Iranian immigrants for epidemiological studies.

Determining ethnic differences in cancer patterns using administrative databases is often a methodological challenge for information on ethnicity or place of birth is commonly lacking. This paper describes the approach we used to identify Iranians residing in British Columbia (BC), Canada and who were registered within the BC Cancer Registry. A listing of common Iranian surnames and given names was generated from two sources: a residential telephone book (with a high density of Iranians) and a provincial breast cancer screening program (which allowed for the selection of women born in Iran). Surnames and given names were reviewed manually and the Iranian names were identified and coded as 'highly probable' and 'probable' Iranian. A name directory was then created and linked with the BC Cancer Registry to identify Iranian cancer cases. Using this method, 1729 surnames and 737 given names were selected from the telephone book, and 1881 surnames and 757 given names from the screening program. The majority of these names were coded as 'highly probable' Iranian (98% and 96% for surnames and given names, respectively). 12% of surnames and 10% of given names were common to both sources. A listing of the most common Iranian surnames and given names is provided. In conclusion, in the absence of other ethnicity data, surnames and given names can be very helpful to identify persons of specific ethnicities when these ethnic groups have distinctive names.