Tailored breast care for recent South Asian immigrants

Dr. Ophira Ginsburg is establishing an innovative yet sustainable system in Bangladesh that uses affordable mobile phone technology to improve breast cancer screening, treatment adherence and survival rates. And, in Toronto’s South Asian community, she is uncovering how cultural attitudes discourage these women from seeking breast care in their new country.

More than 15 trips to low-income countries have taught Dr. Ophira Ginsburg of Women’s College Research Institute a few things about cultural attitudes toward breast cancer, and how they impact immigrants to Canada.

“The vast majority of cancer deaths occur in low- and middle-income countries, and about a third of these deaths could be prevented,” Ginsburg explains. “It’s easy to assume it’s as simple as a resource issue, but particularly for women, it goes far beyond that.”

Ginsburg explains that many cultures view breast cancer as a curse and a death sentence, and for women – who have low social status in many low-income countries – seeking expensive and inconvenient treatments places them at risk of divorce or abandonment. The result is that many of these women die without even seeking care.

“These attitudes and behaviours can follow immigrants when they arrive in Canada, making this population particularly vulnerable to undiagnosed breast disease,” says Ginsburg, who is also an assistant professor at the University of Toronto’s department of medicine and Dalla Lana School of Public Health.

Along with Dr. Farah Ahmad of York University, Dr. Ginsburg is doing research to understand how Bangladeshi women who come to Toronto are influenced by their own – and their families’ – assumptions about breast cancer. This work links the expertise of their collaborators in Dhaka, Bangladesh with the community workers at the Thorncliffe Neighbourhood Office, Crescent Town – an agency that serves new, primarily Bangladeshi immigrants.

“We’re examining factors that may influence how women in Bangladesh seek health care for a breast problem, and comparing our findings to factors that influence Bangladeshi immigrant women in Canada,” says Ginsburg.
And it’s a good thing, because preliminary results indicate that these two populations aren’t as similar as might be assumed.

“We expected to find that Bangladeshi women in Toronto would be motivated by the same pressures as women in Bangladesh,” says Ginsburg. “We expected that patriarchy would be a major contributor to women’s decision to seek breast care.”

But early results indicate that it’s a different sort of family pressure that prevents Bangladeshi women in Toronto from pursuing breast care. Many of these women are concerned about becoming a burden by asking a family member to accompany them for their health-care visits. Ginsburg feels the insights gained when the study concludes will inform best practices in both countries, both for breast cancer care and for a wide array of other health conditions.

“This is likely a barrier that impacts health care for many diseases, not just breast cancer,” says Ginsburg. “We need to understand how women are making decisions to seek care, so that we can create targeted interventions that help them maintain their health.”

Dr. Ophira Ginsburg is also the medical director of cancer prevention and screening at Lakeridge Health’s  R.S. McLaughlin Durham Regional Cancer Centre in Oshawa.