Disparities in Breast Cancer Screening, Diagnosis, and Outcomes Among Vietnamese American Women: A Systematic Review

Breast cancer remains a leading cause of cancer-related mortality among women globally. Vietnamese women experience unique challenges, including sociocultural, linguistic, and systemic barriers, contributing to disparities in screening utilization, late-stage diagnoses, and treatment outcomes. Despite advances in early detection and care, inequities persist. A systematic review was conducted following PRISMA guidelines, with the protocol registered on PROSPERO. PubMed, Embase, and Scopus were searched for original studies published from 2000 to 2024 examining breast cancer screening, outcomes, molecular/genetic features, and disparities in Vietnamese populations. Narrative synthesis was employed due to heterogeneity in study metrics and methodologies. Forty-one studies encompassing 39,324 Vietnamese participants (mean age 48.15 ± 7.48 years) were included. Social networks and acculturation positively influenced screening uptake, while systemic barriers such as language, cultural stigma, and lack of insurance deterred participation. Across included studies, mammography screening rates among Vietnamese women ranged widely from 26% to 83%, consistently lower than the U.S. national average of 81%, and lower than rates reported in many Asian American subgroups. Late-stage diagnoses were prevalent, occurring in 32.9% of Vietnamese women, with foreign-born Vietnamese women exhibiting higher mortality than U.S.-born counterparts. Molecular studies revealed distinct tumor subtypes, including higher HER2-positive and triple-negative breast cancer rates. Interventions, including culturally tailored education and patient navigator programs, demonstrated success in addressing screening and care disparities. Vietnamese women face significant breast cancer disparities driven by sociocultural, systemic, and biological factors. Effective solutions require integrating culturally tailored solutions to promote equitable outcomes and reduce disparities in breast cancer care.