A Korean-American Blueprint for Early Detection

Casey Kwon beat breast cancer, but she almost didn't get a chance to fight.

Six years ago, the 40-year-old mother was busy with three young children, and a mammogram wasn't a priority. Then she found a lump in her breast. Over the next 18 months, she endured two surgeries, chemotherapy and radiation treatments.

In 2002, Kwon chose to share her story with the Korean-American Cancer Project, an initiative overseen by Bloomberg School researcher Hee-Soon Juon, PhD '92, MS. At that time, Juon, an associate professor in Health, Behavior and Society, was developing culturally appropriate education materials and intervention programs for breast and cervical cancer. Her goal: to educate Korean-born women about the importance of early detection and cancer screening procedures like mammograms and pap smears. Breast cancer is the most commonly diagnosed cancer among Korean-American women in the U.S., yet this group has one of the lowest mammogram screening rates of all ethnic groups in the country.

Kwon's recollections about her own experiences with breast cancer served as the blueprint for an information booklet published as part of Juon's pilot study.

"I never thought that I could have cancer, and most of my friends that I talk to, they never expect to have cancer," says Kwon, now 46. "It was always somebody else's story, but never me—that's one thing I wanted to point out."

Kwon's participation in the Korean-American Cancer Project centered on the development of a storyline for an attractive magazine-style, 12-page booklet, or "photonovel," in Korean. It uses photographs and cartoon dialogue "bubbles" to tell the story of Yoojin, a Korean woman who discovers a lump in her breast in the shower. Soon after, Yoojin bumps into her old friend, Hyosun, at the grocery store. She tells Yoojin about being diagnosed with breast cancer two years ago and her successful treatment. At Hyosun's urging, Yoojin has a mammogram. The story ends differently than Casey Kwon's—with a negative mammogram.

"A lot of the conversations in the photonovel are how I felt and my fears," says Kwon.

As part of Juon's study on the effectiveness of a culturally integrated cancer intervention, she put together a breast cancer education program, including the booklet and a Korean-dubbed videotape on breast self-examination. The materials were used in small group presentations to 105 Korean-American women, recruited mainly from churches.

Six months after the education program, Juon found that the women in the intervention group were nearly three times more likely to report intentions to have a mammogram.

The results highlight the importance of language and culture in developing successful public health interventions for immigrant populations. According to the study, effective strategies to increase breast cancer awareness among Korean women include distributing Korean language breast cancer education materials at doctors' offices and grocery stores, as well as bringing mobile mammogram clinics to Korean churches, which typically serve as social networking hubs for Korean immigrant communities.

"A lot of Koreans think that having cancer is pretty close to death," says Kwon. "Early detection is not a cure, but it really could save a lot of trouble."