Colorectal Cancer Screening Compliance among Asian and Pacific Islander Americans

Abstract

Colorectal cancer (CRC) screening prevalence remains low among Asians and Pacific Islanders. This study examined disparities and predictors of CRC screening compliance in adults age 50-75 years in Asians and Pacific Islanders in Hawai'i. Hawai'i Behavioral Risk Factor Surveillance System (BRFSS) data for 2011-2014 were analyzed. CRC screening status was dichotomized. Logistic regression was used to examine ethnic differences in and predictors of CRC screening status. Filipinos (OR 0.56), Chinese (OR 0.70), and Hawaiians (OR 0.75) were significantly less likely than whites to be CRC compliant. Higher education and income, employment, regular health provider, and routine checkups were important predictors of CRC compliance. Findings confirm lower CRC screening compliance in three of the four largest Asian and Pacific Islander groups in Hawai'i and that CRC screening compliance is influenced by several factors. Culturally tailored education and navigation services may be effective in reducing these disparities.

Colorectal cancer screening prevalence and predictors among Asian American subgroups using Medical Expenditure Panel Survey National Data

“…The CHIS and the Hawaii BRFSS show that CRCS prevalence nonetheless varied considerably between AA groups depending on the year of study. [10][11][12][13][14][15] Similarly, local studies (northern California health care organizations, Chicago Asian Community Survey, Asian American Liver Cancer Program) found different screening prevalence between AA subgroups, and this prevalence was lower than that reported in the epidemiological datasets (Table 1). 2,16,17 Varying CRCS prevalence among subgroups highlight factors that influence CRCS (eg, access to health care and/or a physician, immigration and acculturation patterns, knowledge and attitudinal barriers, educational and income levels).…”

“…19 For Chinese and Filipinos, health care access factors associated with CRCS were having health insurance, a regular provider, and being able to afford a doctor. 10,11,14 Demographic factors associated with CRCS were income and years in the United States for Chinese, Filipinos, and South Asians; English use for Filipinos and South Asians; and education level of Chinese and Filipinos. 2,[19][20][21][22][23][24] For Filipinos and South Asians, knowledge and attitude factors have been found to be associated with CRCS (eg, CRCS benefits, perceived CRCS barriers).…”

The Role of Physician Recommendation in Colorectal Cancer Screening Receipt Among Immigrant Chinese Americans

“…Inadequate access to health care, patient-physician communication barriers, limited health literacy, culturally-based beliefs, and language barriers are known factors limiting CRC screening among Chinese Americans [9][10][11][12]. The combination of low health literacy and limited English proficiency has been negatively associated with being up-to-date for CRC screening in Chinese Americans [11].…”

Associations with the Receipt of Colon Cancer Screening Among a Diverse Sample of Arab Americans in NYC

“…Higher level of education was significantly associated with higher rates of getting a recommendation to have CRC screening by the primary care physician but not significantly associated with completing screening for CRC. Previous studies have shown the effect of lower education on increasing the risk of non-participation in CRC screening [31,32]. According to a systematic review of socioeconomic factors and doctor-patient communication, more educated patients tend to communicate more actively with their physicians than patients with a lower education level, eliciting more information [33].…”