Abstract
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.
Highlights
Data from the California Health Interview Survey (CHIS) indicate that levels and temporal trends in colorectal cancer (CRC) screening prevalence vary among Asian American groups; the reasons for these differences have not been fully investigated
Using California Health Interview Survey (CHIS) data, we recently reported the prevalence of CRC screening in 2001, 2003 and 2005 in California among whites, blacks, Latinos, Asians and the population overall, and among five Asian American groups with adequate sample sizes for analysis, Chinese, Filipino, Japanese, Korean and Vietnamese Americans [5]
Since Asian Americans make up 12.5% of the population in California, which is a much larger proportion than the national average of 4.5%, and since CHIS oversampled several Asian American groups, this data set is well suited to examining disparities in CRC screening among Asian American ethnic groups
Summary
Data from the California Health Interview Survey (CHIS) indicate that levels and temporal trends in colorectal cancer (CRC) screening prevalence vary among Asian American groups; the reasons for these differences have not been fully investigated. Few reports on the burden of CRC disaggregate Asian American populations: California Cancer Registry data indicate that the incidence of CRC is higher in Japanese American males and females than in Non-Hispanic whites and other racial/ ethnic groups and Japanese American males have a significantly higher CRC mortality [2]. Using data from the Surveillance, Epidemiology, and End Results program, Lin and colleagues demonstrated that Filipino American males are significantly less likely than other racial/ethnic groups to be diagnosed at an early stage. Their 5 year survival rate is significantly lower than those of other racial/ethnic groups. Chinese American females have poorer 5-year survival after CRC than
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