Abstract
PurposeThe purpose of the study was to pilot test the English and Urdu version of the Colon Cancer Screening Behaviours Survey among South Asians in Canada. The first objective was to evaluate feasibility of administration, data collection using computer assisted personal interviewing software on a tablet, and response burden. The second objective was to examine the prevalence of colorectal cancer screening among South Asians and evaluate the psychometric properties of sub-scales in the survey.MethodsPurposive, network and snowball sampling were used to recruit participants for this cross-sectional study. Interviewer-led administration of the Colon Cancer Screening Behaviours Survey was conducted across two cities in Ontario, Canada. Qualitative data analysis assessed feasibility; and sub-scales were evaluated through principal component analysis, item-scale correlations, and construct validity using multiple linear and logistic regression.ResultsA total of 328 South Asians participated, 47% Urdu speaking, and 53% English speaking. There was a 23% refusal rate to participate. Feasibility identified: (1) successful recruitment despite reasons for refusal; (2) problematic items and response categories; and (3) computer/tablet limitations. Principal component analysis identified 14 components that explained 68.7% of total variance; 34 items were retained after factor analysis. Internal consistency of 4 scales ranged from 0.79–0.91. There were significant differences in perceived barriers scale scores (− 12.21; 95% CI, − 17.13 to - 7.28; p < 0.0001) between those who participated and those who did not participate in screening. No association was found with years of residence and uptake of screening after adjustment (OR 0.91 (0.46–1.79), p = 0.783).ConclusionsRecruitment and data collection methods are feasible among South Asians if functionality of the tablet selected is improved. The Colon Cancer Screening Behaviours Survey was finalized and retained items in sub-scales demonstrated good psychometric properties to assess behaviours for colon cancer screening among South Asians in Canada. The interviewer-led survey may be used by public health, cancer care or other health practitioners to describe or predict colorectal cancer screening behaviours among South Asians in similar settings or adapted and tested in other contexts.
Highlights
Worldwide, colorectal cancer (CRC) is one of the top three cancers diagnosed among men and women [1]
Increasing CRC trends in South Asian countries may influence the risk of CRC among South Asians (SAs) who settle in other countries including those in the west, especially when evidence shows that the “healthy immigrant effect” tends to diminish with long term residence [4]
Hislop et al [5] report increased rates of CRC among SAs in Canada compared to their counterparts from India, rates remained lower than native-born Canadians
Summary
Colorectal cancer (CRC) is one of the top three cancers diagnosed among men and women [1]. In Sri Lanka, CRC is the fourth most common cancer diagnosed in men [2, 3]. Hislop et al [5] report increased rates of CRC among SAs in Canada compared to their counterparts from India, rates remained lower than native-born Canadians. It is estimated that the risk for CRC increases by 5–7% every 5 years with time of settlement [6]. This gradual increased risk resembles the current patterns of incidence in the general population given that CRC among SAs in Canada accounted for one of the top three cancers diagnosed [5]. Comparable trends of CRC incidence are noted among SAs in the United States (US) and the United Kingdom (UK) [7,8,9,10]
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