Association between acculturation and cancer screening practices among Asian Indians residing in Houston, Texas

Background: Asian Indians represent one of the fastest growing immigrant groups in the United States; a population that grew from less than 0.5% in 1960 to almost 5% in 2011. Cancer is one of the leading cause of death among this population. Non-adherence to screening recommendations remains a concern as cancer is often detected at a later stage.

Purpose: To examine the association between acculturation and cancer screening among Asian Indians living in the Greater Houston area.

Methods: Data from the South Asian Health Needs Assessment (SAHNA) project was analyzed.  Participants included 1525 self-identified Asian Indians, 18 years or older, living in the Greater Houston area.  To measure acculturation, responses from 10 questions on language and food preferences, country of birth for self and parents, years in US, and age at arrival in US were used to create an acculturation scale.   A composite score (range 10-33) from all items was categorized into tertiles (low, medium and high) for acculturation.

Results: 1138 participants answered the questions used to create the acculturation scale.  Significant associations were found between greater acculturation and likelihood of ever having a mammogram (p=.006), clinical breast examination (p =.02) or Pap test (p=.003) among females and for having prostate cancer screening (PSA, DRE or both) (p<.001) among males. Acculturation was not associated with colorectal cancer screening.

Conclusion: Asian Indians with higher levels of acculturation were more likely to have had breast and cervical cancer screening (females) and prostate cancer screening (males), therefore outreach should be targeted towards the less acculturated.