Low screening rates among Filipinos despite high health insurance coverege

Background: Racial/ethnic health disparities are exacerbated by inequities in access to health care. However elevated prevalence of diabetes, breast and prostrate cancer has been observed in Filipino-Americans despite higher education, health insurance and English proficiency levels.

Objective: To characterize screening patterns and determinants of screening adherence..

Methods: Surveys to evaluate health access and behaviors were administered to 328 Filipinos in a Northern California city.

Results: Over half (59%) were college graduates, 81% had health insurance, 97% were US citizens or permanent residents and 95% reported English proficiency. Among 184 women, 61% reported having a Pap test in the previous 3 years; 59% > 40 years had a mammogram in the previous year, while 44% >60 years never had a bone density scan. Among men >50 years, 38% had a PSA (prostate) test in the previous year while 52% did not. Among adults > 50 years, 30% had colorectal cancer screening in the previous year, and 30% of those > 45 years never had a glucose test. Multivariable analysis adjusting for age, education, health insurance, years in the US, body mass index (BMI), and reported health status showed no association with adherence to timely screening for bone density, Pap, mammogram, prostate, or colorectal cancer screening. Older age, overweight, and having insurance were independently associated with glucose screening in the previous year.

Conclusion: Despite high health insurance and education, Filipino-Americans had low screening adherence. Promoting prevention screening is urgently needed because of their elevated prevalence of selected cancers and type 2 diabetes.