Abstract
Improving rates of colorectal cancer (CRC) screening can reduce CRC-related mortality, which is estimated to cause about 50,630 deaths in the U.S. by the end of 2018. There is a noted increasing prevalence of CRC among Korean Americans. Although CRC screening has been widely implemented, Korean Americans over the age of 50 have the lowest rates of proper CRC screening, compared to those of other Asian ethnicities. Barriers, such as language and culture, may be making participation in screening procedures difficult for those with immigrant backgrounds. Thus, this study aimed to determine whether proper CRC education can enhance awareness, knowledge, and behavior in screening among Korean Americans living in the Los Angeles Koreatown area. This study was conducted among 100 self-identified Korean Americans between the ages of 45-75, who voluntarily participated in this study through local community outreach from January to June 2018. Educational brochures were provided for those in the control group, while those in the intervention group attended an additional short educational seminar. All participants were asked to complete a questionnaire after, and data were collected on site. We found that intervention had a significant effect on awareness regarding colorectal polyps (OR (odds ratio): 22.47; 95% CI: 6.42-78.62; p-value <0.001) and fecal occult blood tests (FOBTs)/stool blood test (OR, 245.37; 95% CI: 34.55-1742.75; p-value <0.001). Willingness for CRC screening in following 6 months significantly increased (OR: 87.17; 95% CI: 19.01-399.63; p-value <0.001). Knowledge on options for CRC screening (OR: 126.63; 95% CI: 23.61-679.07; p-value <0.001) and stool blood tests (OR: 157.17; 95% CI: 18.02-1370.41; p-value <0.001) were significantly enhanced. In additional univariate analysis, we found that Korean Americans with higher level of education, birthplace in US or better general health showed better CRC awareness or knowledge. There is a significant gap in our knowledge and understanding of the contributing factors that may be leading to low CRC screening rates in Korean Americans. This study suggests that well-tailored educational seminars can overcome certain barriers to screening and improve CRC knowledge and awareness, which is critical to achieving greater screening compliance. Our findings provide important references for designing effective strategies to increasing CRC screening rates among Korean Americans.
Highlights
Colorectal cancer (CRC) is the third most common cancer and third leading cause of cancer-related deaths in both men and women in the United States (US) [1]
We found that intervention had a significant effect on awareness regarding colorectal polyps (OR: 22.47; 95% CI: 6.42-78.62; p-value
We found that Korean Americans with higher level of education, birthplace in US or better general health showed better colorectal cancer (CRC) awareness or knowledge
Summary
Colorectal cancer (CRC) is the third most common cancer and third leading cause of cancer-related deaths in both men and women in the United States (US) [1]. According to statistics provided by the American Cancer Society (ACS), treatment options for CRC have greatly improved recently, resulting in more than 1 million CRC survivors in the US alone. Along with this development, early diagnosis through regular and timely screening can decrease CRC risk; there are certain populations that have shown a steady rise in CRC incidence. CRC screening has been widely implemented, Korean Americans over the age of 50 have the lowest rates of proper CRC screening, compared to those of other Asian ethnicities. This study aimed to determine whether proper CRC education can enhance awareness, knowledge, and behavior in screening among Korean Americans living in the Los Angeles Koreatown area
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