Cancer Care

Data from the SEER (Surveillance Epidemiology and End Results) Registry of the National Cancer Institute reported that the top three cancers in Koreans in Los Angeles to be stomach, lung and liver. Stomach cancer is the leading cancer in Korea. Factors such as diet consisting of salted, fermented foods, smoking and H. pylori infection are thought to be contributing factors. As compared to the white population Koreans were found to have a five times greater prevalence of stomach cancer. (Koh, 1997)

One study reported that in California, about 36% of Korean men are current smokers, which is the highest prevalence among all Asian American groups examined in the study. (McCracken et.al. 2007). Lung cancer death rates are highest in Korea Americans in the same study. In a report from the US department of health and human services reporting on the health status of Asian Americans in the US from 1992-1994, reported that higher percentages of adults of Korean descent (22.5%) were current smokers. (Kuo 1997).

Liver cancer incidence and mortality rates of Koreans in California are the highest of all Asian American groups in females and second highest in males. (McCracken et.al. 2007). This is thought to be the result of the high prevalence of Hepatitis B infection in the Korean population. In addition it is reported that Koreans in California have the highest proportion who report alcohol consumption, 71.1% in men and 43.4% in women when compared to the other Asian groups. Another study of Korean American men revealed the prevalence of liver cancer to be eight times greater that the white population (Koh HK, et. al., 1993).

It is important to be aware of the differences in incidence and prevalence of cancer in the different Asian groups. This enables clinicians to be aware of conditions that may be more common in certain populations thus providing tools to better care for the patient and their ethnic population. Those taking care of ethnic populations in addition to frequency of certain cancer s should be aware of low prevalence of cancer screening. In one study of Asians in California, Koreans had the lowest prevalence of most screening tools such as endoscopy, fecal occult blood test, pap smears and mammograms. (McCracken 2007). The statistics of older Koreans in Los Angeles and preventive health measures are alarming. About one-half of the sample, 45% of the older Korean women had never had a mammogram and of those who had a mammogram only 24% had had one in the last year

Decision-Making and Disclosure

Attitudes regarding disclosure and consent are often conflicted in the Korean population. Some believe that voicing thoughts about death and illness will precipitate death and illness. Often Koreans believe that if the ill family member is told that they are ill or have a terminal diagnosis that they will lose the will to live or become depressed. Koreans often believe that only the family, and not the patient, should be told about a terminal diagnosis. In this family-centered model it is the sole responsibility of the family to hear bad news about the patient’s diagnosis and prognosis and to make the difficult decisions regarding goals of care. This approach toward decision making is used to protect the patient from bad news. Koreans are less likely to favor telling the truth about diagnosis and prognosis and are less likely to choose the patient as primary decision maker.   Several prior studies regarding informing patients regarding the diagnosis of cancer with different ethnic groups have yielded similar results. (Eleazer, GP et.al., 1996).   However this is often a source of conflict between the family and with the healthcare professionals who believe that the patient should be informed about the medical conditions.   In these cases asking the patient what they would like to know about their condition would be important for disclosure and decision making.