Understanding the Barriers and Facilitators to Colorectal Screening among South Asian Immigrants in NYC

Background: South Asian immigrants, comprised of Asian Indian, Bangladeshi and Pakistani subgroups, remain poorly understood and are one of the most understudied racial/ethnic minority groups in the US. Aggregated data can mask further significant differences as Asian Indians, Bangladeshis, and Pakistanis have reported colorectal cancer (CRC) screening rates ranging from as low as 25% to 41%. The goal of this one-year study is to understand the barriers and facilitators of CRC screening among South Asian immigrants in NYC using a mixed methods, community-engaged approach. Methods: Quantitative data from the NYC Community Health Survey, a large, city-wide cross-sectional dataset, from South Asian immigrants from India, Bangladesh and Pakistan were aggregated from 2009-2012 (n=175). Descriptive and regression analyses were conducted to explore barriers and facilitators to colonoscopy screening. Qualitative data from in-depth interviews with NYC South Asian immigrants (n=42) collected information on knowledge, attitudes, and behaviors related to CRC screening, and provided contextual information on quantitative findings. Results: Preliminary results suggest South Asian immigrants face a number of barriers to colonoscopy screening, including access to care factors such as health coverage type and having a regular PCP, sociodemographic factors such as years in country and language, and lifestyle factors. Qualitative results also suggest lack of knowledge is a significant barrier to screening. Both types of data reveal gender differences in colonoscopy screening behavior. Conclusion: A confluence of poor access to healthcare, language barriers, and cultural and social beliefs play a role in CRC screening disparities among South Asian immigrants.