Online Program

323852
Intention to Obtain Colorectal Cancer Screening among Filipino, Hmong and Korean Older Americans


Wednesday, November 4, 2015

Janice Y. Tsoh, PhD, Department of Psychiatry, University of California, San Francisco, San Francisco, CA
Elisa Tong, MD, Division of General Internal Medicine, Department of Medicine, University of California, Davis, Sacramento, CA
Angela Jo, M.D., Asian American Network for Cancer Awareness, Research, and Training (AANCART), Los Angeles, CA
Angela Sy, DrPH, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
Penny Lo, Community Based Organization, Hmong Women's Heritage Association, Sacramento, CA
May Chee Lo, 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
Ginny Gildengorin, PhD, Department of Medicine, University of California, San Francisco, San Francisco, CA
Hy Lam, B.S., Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA
Ching Wong, BS, Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
Susan Stewart, PhD, Division of Biostatistics, University of California-Davis, Davis, 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
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
Background: Non-adherence to colorectal cancer (CRC) screening among Asian Americans is high but not well understood.

Objective: This study aimed to describe screening intention and its correlates among Filipino, Hmong and Korean Americans who were non-adherent to CRC screening.

Methods: We analyzed cross-sectional survey data from 363 Asian Americans (65 Filipinos, 168 Hmong, and 130 Koreans), aged 50 to 75, who were non-adherent, defined as never screened or not up-to-date (fecal occult blood test [FOBT] >1 year ago, sigmoidoscopy >5 years ago, or colonoscopy >10 years ago). Screening intention was defined as planning to get screening within 6 months. Knowledge of screening guidelines was measured by the number of correct responses to: age to begin CRC screening, and the recommended intervals for FOBT, sigmoidoscopy and colonoscopy. Multivariable logistic regression was conducted to identify factors associated with CRC screening intention.

Results: Respondents’ mean age was 60.6 years, with 21% males, 83% limited English proficient, 78% insured, and 40% ever-screened.  Two-thirds did not think that CRC screening could prevent cancer while 56% knew none of the CRC screening guidelines. Only 26% had CRC screening intention (Hmong 13%, Korean 34%, Filipino 43%, p=0.001), and 29% of those ever-screened intended to get screening again. In multivariable analyses, guideline knowledge (OR=1.6, 95% CI: 1.2-2.2) and prior screening (OR=1.9; 95% CI: 1.1-3.2) were positively associated with screening intention. The ethnic difference in CRC screening intention remained after adjusting for knowledge, healthcare access and other factors, with Hmong less likely to intend to get CRC screening than Filipinos (OR=0.3, 95% CI: 0.1-0.8).

Conclusion: Intention to get CRC screening among Filipino, Hmong, and Korean Americans who were non-adherent was low, even among those who had prior screening. Increasing knowledge of CRC screening guidelines is important to increase screening intention and adherence to CRC screening among Asian Americans.

Learning Areas:

Diversity and culture
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related education
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe intention of obtaining colorectal cancer screening among Filipino, Hmong and Korean older Americans. Identify correlates related to intention to obtain colorectal cancer screening among the Asian older American sample studied. Describe opportunities to increase intention to obtain colorectal cancer screening among Filipino, Hmong and Korean older Americans.

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

Presenting author's disclosure statement:

Not Answered