S290 Is Fecal Immunochemical Test (FIT) the Answer to Increasing Colorectal Cancer Screening (CRC) Uptake in the Filipino Community? Results From a Conjoint Analysis Survey

Abstract

Introduction: Asian Americans are the fastest growing major racial/ethnic group in the US, with Filipinos comprising the 3rd largest group. While >80% of Filipinos are proficient in English, and have insurance rates, education levels, and incomes that exceed the general US population, they have lower CRC screening rates and worse CRC outcomes vs. non-Hispanic Whites. To begin to address this disparity, we used conjoint analysis to understand Filipinos’ preferences for the different CRC screening test options. Methods: To quantify Filipinos’ preferences for CRC screening tests, we conducted a choice-based conjoint analysis survey for individuals ≥40yo at average risk for CRC who had not undergone prior screening. From 4/29-11/7/21, we recruited Filipinos at an academic medical center and through a national survey research firm (Cint). Using the conjoint data, we performed simulations to determine each individual’s preferred screening test; for this analysis, we focused on the proportion of people who preferred annual FIT or colonoscopy every 10 years as both are tier 1 tests according to the US Multi-Society Task Force (MSTF) on CRC. We then performed logistic regression to explore whether demographics predicted decision making on FIT vs colonoscopy; variables with p< .20 from bivariate analyses were included as covariates in the regression model. Results: Overall, 105 participants completed the survey; most respondents were female (74.3%) and aged 40-49y (84.8%). Moreover, 64.8% of participants stated they planned to get screened for CRC and they reported high self-perceived benefits of CRC screening (median 4.4, IQR 3.8-4.8; 1-5 scale, higher=more beneficial). When performing simulations using the conjoint data for the US MSTF tier 1 tests, we found that 66.7% of respondents preferred an annual FIT while 33.3% preferred a colonoscopy every 10 years (Figure). In a regression analysis that accounted for sex, marital status, household income, employment status, and geographic region, no variables were significantly associated with individual's preference for FIT over colonoscopy (Table). Conclusion: We found that 2 in 3 Filipinos prefer annual FIT over colonoscopy for their CRC screening and that demographics poorly predict individual decision making. To improve CRC screening uptake in the Filipino community, our data suggest that community-based interventions should either focus primarily on FIT or employ a choice-based approach (ie, FIT or colonoscopy).Figure 1.: Data from simulations using conjoint analysis data assessing the proportion of respondents who would prefer each MSTF tier 1-recommended test (N=105) Table 1. - Regression analysis on preferring FIT every year over colonoscopy every 10 years for CRC screening; screening test preferences were determined through simulations from conjoint analysis-derived data (N=105) Variable Prefers FIT every year for CRC screening n (% of row) aOR [95% CI] Sex: Male 21 (77.8%) Reference Female 49 (62.8%) 0.61 (0.20, 1.86) Marital status: Married or living with a partner 53 (62.4%) Reference Not married 17 (85.0%) 2.65 (0.61, 11.44) Total household income: ≤$100,000 34 (79.1%) reference >$100,000 31 (62.0%) 0.72 (0.24, 2.20) Prefer not to say 5 (41.7%) 0.23 (0.05, 1.12) Employment status: Unemployed, on disability, on leave of absence from work, retired, or a homemaker 19 (82.6%) reference Employed or student 51 (62.2%) 0.36 (0.10, 1.31) US region: Northeast/South/ Midwest 15 (83.3%) reference West 55 (63.2%) 0.70 (0.15, 3.21) Has non-first degree relative or friend diagnosed with CRC 11 (44.0%) 0.42 (0.15, 1.16)