Culture matters: Cultural views of cancer and colorectal cancer screening behavior among Asian Αmericans

Background: Although screening has been found to reduce colorectal cancer (CRC) mortality, Asian Americans continue to report low CRC screening. Few studies have examined the association of cultural views and CRC screening in this population.

Objective: To examine the association between Asian cultural views of cancer and receiving CRC screening within the past two years among Asian Americans.

Methods: A cross-sectional examination was conducted of 858 Chinese, Korean, and Vietnamese adults. Asian cultural views were measured using 16-items from a validated cultural views scale, and CRC screening was self-reported. Logistic regression was used to investigate the association between Asian cultural views and CRC screening adjusting for potential confounders.

Results: When cultural views were categorized into tertiles (Asian, Neutral, and Western), herb use and self-care were significantly associated with screening and showed a gradient effect. For example when examining herb use, those with more Asian cultural views had a 78% decreased odds of receiving CRC screening than those with more Western cultural views (OR:0.22; 95% CI:0.06-0.77), whereas those with Neutral cultural views had a 32% decreased odds than those with more Western cultural views (OR:0.68; 95% CI:0.47-0.99) after adjusting for age. As continuous variables, 10-point increases in herb use and self care scores were associated with a 12% (odds ratio [OR]:0.88; 95% confidence interval [95% CI]:0.82-0.97) and 7% (OR:0.93; 95% CI:0.87-1.00) decreased likelihood that an individual received screening, respectively.

Conclusions: Findings from this study suggest that future interventions addressing herb use and self-care can potentially increase CRC screening among Asian Americans.