The research confirms earlier findings that show a similar delay in breast cancer detection among other immigrant groups. "It is likely a combination of language, culture, and access to medical care" that causes this delay, says Emily White, PhD, a co-author of the study. Lead author Ashley N. Hedeen, MD, MPH, was out of the country and unavailable for comment.

Hedeen and White found that Hispanic women in general had a higher percentage of tumors larger than 1 centimeter (77.7%) at first diagnosis compared to non-Hispanic whites (70.3%) and a higher percentage of tumors larger than 2 centimeters at first diagnosis (45.9% versus 33%). Among Hispanics, those born in Latin America had a higher percentage of larger tumors than Hispanic women born in the U.S. The study points out that earlier detection would lead to better treatment options and could increase survival for these women.

Earlier research involving Asian women found similar results. "I would advocate screening as the most important intervention, rather than early recognition of symptoms," says White

And another study done in Northern California found a delay in breast cancer detection among Hispanic and Vietnamese immigrants and African-Americans, says Eve Nagler, MPH, CHES, Director for special populations in the cancer control department at the American Cancer Society (ACS).

"It’s more about acculturation than ethnicity," Nagler says. In other words, ethnicity is not as much a factor in delayed detection as the level to which the individual has assimilated to the culture of the U.S., she says.

Health care providers, educators, and volunteers who want to reach these groups need to consider the country of origin, Nagler says. The women bring that perspective with them. If screening is not a common practice where they come from, they are not likely to seek it in the U.S., she says.

Also, immigrants are concerned with many basic needs, such as housing, learning a new language and culture, schooling for their children, and immediate health concerns. "Early detection is the least of their concerns," Nagler says.

That is why it is important for the ACS and other health advocates to reach out to these women, she says. Nagler offers the example of a successful program started in the Chinese community of Flushing, N.Y., by a Chinese-American breast cancer survivor who approached the ACS with the idea. Because of the program, the message to get breast cancer screening is carried by the community’s Chinese-language radio stations and newspapers and is spread by word of mouth. "Now, there’s more early detection," Nagler says. "There’s a waiting list to get mammograms."

While there will be differences between ethnic groups – even within the broad categories of Asian and Hispanic – some of the same principles can be applied to how best to reach out to immigrant communities and other groups, Nagler says.

"Whether it’s newly arrived Bosnians or rural African-Americans who have been in Greenwood, Mississippi, for hundreds of years, until they know us and trust us, they’re not going to believe us," Nagler says. "We need to reach them. We cannot wait for them to call us or log onto our Web site."

The ACS estimates 192,200 women of all races will be diagnosed with breast cancer in the U.S. this year, and 40,200 women are expected to die of the disease. For more information on ACS guidelines about breast cancer screening, click here.