Online Program

321382
Social Demographic and Healthcare Factors Associated with Colorectal Cancer Screening Among Filipino, Hmong, and Korean Americans


Tuesday, November 3, 2015

Tung T. Nguyen, MD, Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, and Asian American Research Center on Health (ARCH), San Francisco, CA
Janice 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
Elisa Tong, MD, Division of General Internal Medicine, Department of Medicine, University of California, Davis, Sacramento, CA
Angela Sy, DrPH, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
Angela Jo, M.D., Asian American Network for Cancer Awareness, Research, and Training (AANCART), Los Angeles, CA
Penny Lo, Community Based Organization, Hmong Women's Heritage Association, Sacramento, CA
MJ Sung, UCLA, Los Angeles, CA
Charlene Cuaresma, MPH, Student Equity, Excellence, and Diversity, University of Hawaii at Manoa, Honolulu, HI
May Lo, Hmong Women's Heritage Association, Sacramento, CA
Marjorie Kagawa-Singer, PhD, RN, MN, Department of Community Health Sciences, UCLA School of Public Health and Asian American Studies Center, Los Angeles, CA
Background: Colorectal cancer (CRC) screening is effective, but screening remains sub-optimal among Asian Americans

Objective/Purpose: Evaluate the factors associated with CRC screening among Filipinos (Honolulu, HI), Hmong (Sacramento, CA), and Koreans (Los Angeles, CA) aged 50-75.

Methods: We conducted a baseline survey of participants enrolled in a health education study. The sample was recruited by lay health workers, each of whom aimed to find 15 participants, about half of whom never had CRC screening. CRC screening ever was defined by any self-reported receipt of fecal occult blood test (FOBT), sigmoidoscopy, or colonoscopy; up-to-date was defined as FOBT within 1 year, sigmoidoscopy within 5 years, or colonoscopy within 10 years.

Results: Among 166 Filipinos, 293 Hmong, and 233 Koreans, the average age was 61.3 years,with 78.3% women, 64.7% married, 50% < high school education, 42.9% with income <$20,000/year, and 99.0% foreign-born. Most had health insurance (85.1%), a primary care physician (85.4%, with 53.5% reporting an Asian PCP), and a physician visit within 12 months (82.5%). In multivariable models, factors associated with CRC screening ever were being Korean (OR 0.45, CI 0.22, 0.91 compared to Hmong), having >2 chronic health conditions (OR 1.69, CI 1.13, 2.50), having health insurance (OR 2.71, CI 1.68, 4.36), and having a PCP (OR 2.05, CI 1.08, 3.89 for Asian PCP; OR 2.69, CI 1.37, 5.29 for non-Asian PCP). Income (OR 1.68, CI 1.11, 2.55 for $20,000/year or more vs. <$20,000/year), having health insurance (OR 2.63, CI 1.43, 4.81), having seen a physician within 12 months (OR 2.49, CI 1.41, 4.42), and having a PCP (OR 2.43, CI 1.27, 4.68 for non-Asian PCP compared with no PCP) were associated with being up-to-date.

Conclusions: Increasing health insurance coverage and access to primary care are needed to increase CRC screening among Filipino, Hmong, and Korean Americans.

Learning Areas:

Assessment of individual and community needs for health education
Diversity and culture
Implementation of health education strategies, interventions and programs

Learning Objectives:
List factors associated with colorectal cancer screening receipt among Filipino, Hmong, and Korean Americans age 50-75.

Keyword(s): Asian Americans, Cancer Prevention and Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator of multiple federally funded grants addressing cancer screening among Asian Americans.
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.