263626 Impact of physician recommendation on colorectal cancer screening in Chinese American immigrants

Sunday, October 28, 2012

Gem M. Le, PhD, MHS , Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA
Elaine Chow, BS , NICOS Chinese Health Coalition, San Francisco
Janice Y. Tsoh, PhD , Department of Psychiatry, UCSF, San Francisco, CA
Ginny Gildengorin, PhD , Department of Medicine, University of California, San Francisco, San Francisco, CA
Susan Stewart, PhD , Division of Biostatistics, University of California-Davis, Davis, CA
Adam Burke, PhD, MPH, LAc , Health Education/Holistic Health Studies, San Francisco State University, San Francisco, CA
Jun Wang, PhD , Health Education, San Francisco State university, San Francisco, CA
Ching Wong, BS , Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
Kent Woo, MSW , NICOS Chinese Health Coalition, San Francisco, CA
Stephen J. McPhee, MD , Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
Tung T. Nguyen, MD , Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
Background: Colorectal cancer (CRC) screening rates are low among Chinese Americans, the largest Asian ethnic group in the United States. Although physician recommendation for CRC screening is known to be associated with increased screening rates in the general population, little is known about its impact in Chinese American immigrants.

Methods: We analyzed baseline data from 319 Chinese Americans aged 50-75 enrolled in an ongoing trial to promote CRC screening. Participants reported on receipt of fecal occult blood testing (FOBT) and endoscopy (sigmoidoscopy or colonoscopy).

Results: Among participants, 22% were male, 95% were limited English proficient, and 11% were uninsured. Only 62.1% reported ever receiving a FOBT, while 37.3% received an endoscopy. Only 52.0% reported receiving a physician recommendation for FOBT and 28.8%, for endoscopy. In multivariate analyses, age >60 was associated with FOBT receipt (OR=2.1, 95% CI: 1.1-4.3), while >10 years in the U.S. was associated with endoscopy receipt (OR=2.5, 95% CI: 1.3-4.6). All other sociodemographic factors, health insurance, having a regular place of health care or a primary care doctor had no significant impact on receipt of either test. Physician recommendation, however, was strongly associated with receipt of FOBT (OR=16.8, 95% CI: 8.7-32.1) and endoscopy (OR=8.4, 95% CI: 3.9-18.2).

Conclusions: Chinese Americans reported low rates of physician recommendations for CRC screening, yet physician recommendation was a very strong influence on their receipt of screening. Interventions to increase physician recommendation of CRC screening are essential to reduce CRC morbidity and mortality among Chinese American immigrants.

Learning Areas:
Diversity and culture
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related research

Learning Objectives:
Learning Objectives: 1. Describe factors associated with CRC screening among Chinese American immigrants. 2. Recognize the impact of physician recommendation on CRC screening among Chinese American immigrants

Keywords: Cancer Screening, Asian Americans

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a research associate on various epidemiologic and public health intervention studies focused on understanding and addressing racial/ethnic disparities in cancer control and prevention.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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