Abstract A31: Understanding colorectal cancer screening behaviors among five Asian-American subgroups
Authors: Lam Helen , Quinn Michael , Chandraskar Edwin , Patel Reena , Kim Karen 
Published: October 2015

Objectives: Unlike other cancer screening tests, which rely on early detection, colorectal cancer screening (CRS) provides an opportunity for prevention since most colorectal cancer (CRC) begin as a benign polyp. However, over 20 million people age 50 to 75 in the U.S. have never undergone CRS. Furthermore, lower screening rates were observed among minority groups, especially immigrants with low English proficiency (LEP). Asian Americans are now the most rapidly growing minority and immigrant group in the U.S. The purpose of this study was to understand 5 different Asian subgroups' beliefs, attitudes, and perceived controls on CRS.

Methods: This study is part of a larger government funded study to create an infrastructure for sustainable research and dissemination of evidence-based medicine. The partnerships include five different Asian-American subgroups in the Chicago Metropolitan area: Cambodian, Chinese, Korean, Laotian and Vietnamese. The focus groups were facilitated by partner community-based organization staffs using participants' native language and observed by two research team members. A training course was provided prior to the focus group. The focus group discussions were recorded and later transcribed into English by the facilitator. The contents were then analyzed using the Theory of Planned Behavior (TPB) by five research team members until consensus arrived. Themes were identified under three major categories as described in the TPB: behavioral beliefs, normative beliefs and control beliefs.

Results: Six focus groups were conducted with a total of 56 participants from 5 different Asian-American subgroups. All participants were foreign-born and 66% were female. About one-third of the participants did not have any high school education. Only 64% of the participants had health insurance coverage and 59% had a regular place for health care. The average age was 55 years old and the average time in the U.S. was 21 years. About 71% of the participants have screened for cancer before. Although there were various beliefs and attitudes on cancer screening across the five subgroups, such as cancer can be contagious or proper diet can prevent cancer, they also shared some common beliefs and attitudes, such as early detection of cancer can save life. The common control beliefs across the five subgroups included, but not limited to, language barrier and unfamiliar with the U.S. healthcare systems

Conclusion: Cancer has been the leading cause of death among Asian Americans since 1980; the first and only racial/ethnic group to experience cancer as the leading cause of death. In addition, the US Asian population is very diverse and differs with respect to country of origin, culture and beliefs, time in the USA, primary language spoken and socioeconomic status. If we are to extend the reach and address cancer disparities in this population, innovative dissemination strategies based on the understanding of cultural differences and traditional health beliefs are the priority. The focus group findings provide the first glance on the differences and similarities in cancer screening beliefs and attitudes among five Asian subgroups.

Funding Source: AHRQ 1R24HS022063-01

Citation Format: Helen Lam, Michael Quinn, Edwin Chandraskar, Reena Patel, Karen Kim. Understanding colorectal cancer screening behaviors among five Asian-American subgroups. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A31.