Asian Americans in California: A Pooled Analysis of Predictors for Breast, Cervical, and Colorectal Cancer Screening

Background: This study examines predictors of screening for breast, cervical, and colorectal cancers and factors underlying low screening rates among Asian Americans in California.

Methods: Five cycles of California Health Interview Survey (CHIS) were pooled (N= 23,196) to explore predictors of cancer screening among Asian Americans. CHIS is a random-digit-dial health survey conducted in multiple languages, including English, Cantonese, Mandarin, Korean, and Vietnamese. Logistic regressions were conducted to examine predictors of screening for breast (mammogram in past 2 years, women ages 40+), cervical (Pap test in past 3 years, women ages 18+), and colorectal cancers (FOBT and/or endoscopy in past 5 years, ages 50+, both genders). All models included socio-demographic, health care access, acculturation, survey year, and Asian nationality variables.

Results: Regression analyses indicated that Asians without insurance, no usual source of care, or no annual doctor visits were significantly less likely to report screening for all cancer types. Unlike Asian men, Asian women who lived in the U.S. for longer were more likely to report all screening types. Screening utilization for breast and colorectal cancers increased over time. Compared to Chinese adults, Koreans had significantly lower rates of breast and colorectal cancer screening and Filipino men had lower rates of colorectal cancer screening.

Conclusions: Although breast and colorectal cancer screening rates increased among Asian Americans between 2001 and 2009, disparities by nationality persisted. Policy and intervention efforts to increase screening should target Asians without health care access, more recent immigrants, and specific nationalities to reduce disparities in this population.