Aim. This paper reports a study exploring how traditional Chinese life philosophy, including fatalism, influences understanding of the concepts of health and illness, and the impact of these concepts on cancer screening behaviour.
Background. The language of risk is central to contemporary Western understanding of health and illness. Women aged over 50 years are considered at risk of developing breast cancer and are highly recommended to undergo regular mammographic screening. However, screening rates among Chinese women are consistently lower than for most other groups.
Methods. In-depth interviews, in Cantonese, were conducted with a convenience sample of 20 Chinese-Australian women, and the data analysed thematically, using case summaries, coding and matrix tables. The data were collected in 2001.
Findings. The findings revealed that when dealing with cancer prevention, Chinese-Australian women are heavily influenced by cultural traditions related to the lifecycle and disease prevention. Informants believed that contracting disease, including cancer, is inevitable and that there is no way to prevent it. Fatalism appears to be a significant barrier to their participation in cancer screening services.
Conclusion. Our findings suggest that the effects of breast cancer screening and other health promotion programmes, which are general and do not take account of cultural variations may be compromised when it comes to cultural minorities. In the case of older Chinese-Australian women, breast cancer screening promotion programmes may overcome acceptance of fatalistic philosophy if they emphasize increased risk following immigration.