Explaining disparities in colorectal cancer screening among five Asian ethnic groups: A population-based study in California

BMC Cancer

Research Article

Cynthia M Antonio¹  Annette E Maxwell¹  Peiyun Lu¹  Catherine M Crespi² 

[1] Division of Cancer Prevention & Control Research, School of Public Health/Jonsson Comprehensive Cancer Center, University of California, Los Angeles, USA;Division of Cancer Prevention & Control Research, School of Public Health/Jonsson Comprehensive Cancer Center, University of California, Los Angeles, USA;Department of Biostatistics, School of Public Health, University of California, Los Angeles, USA;

关键词: English Proficiency;    California Health Interview Survey;    Screening Prevalence;    Asian Subgroup;    Asian Ethnic Group;   

DOI  :  10.1186/1471-2407-10-214

 received in 2009-07-17, accepted in 2010-05-19,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundData from the California Health Interview Survey (CHIS) indicate that levels and temporal trends in colorectal cancer (CRC) screening prevalence vary among Asian American groups; however, the reasons for these differences have not been fully investigated.MethodsUsing CHIS 2001, 2003 and 2005 data, we conducted hierarchical regression analyses progressively controlling for demographic characteristics, English proficiency and access to care in an attempt to identify factors explaining differences in screening prevalence and trends among Chinese, Filipino, Vietnamese, Korean and Japanese Americans (N = 4,188).ResultsAfter controlling for differences in gender and age, all Asian subgroups had significantly lower odds of having ever received screening in 2001 than the reference group of Japanese Americans. In addition, Korean Americans were the only subgroup that had a statistically significant decline in screening prevalence from 2001 to 2005 compared to the trend among Japanese Americans. After controlling for differences in education, marital status, employment status and federal poverty level, Korean Americans were the only group that had significantly lower screening prevalence than Japanese Americans in 2001, and their trend to 2005 remained significantly depressed. After controlling for differences in English proficiency and access to care, screening prevalences in 2001 were no longer significantly different among the Asian subgroups, but the trend among Korean Americans from 2001 to 2005 remained significantly depressed. Korean and Vietnamese Americans were less likely than other groups to report a recent doctor recommendation for screening and more likely to cite a lack of health problems as a reason for not obtaining screening.ConclusionsDifferences in CRC screening trends among Asian ethnic groups are not entirely explained by differences in demographic characteristics, English proficiency and access to care. A better understanding of mutable factors such as rates of doctor recommendation and health beliefs will be crucial for designing culturally appropriate interventions to promote CRC screening.

【 授权许可】

CC BY   
© Maxwell et al; licensee BioMed Central Ltd. 2010