Abstract B73: Cervical cancer screening among Asian immigrants in Chicago
Authors: Chandraskar Edwin , Lam Helen , Kim Karen 
Published: May 2015

Objectives: The challenge to elimination racial/ethnic cancer disparities will remain at the forefront as the population of the U.S. continues to grow increasingly diverse. More important, not only will the population of the U.S. be increasing diversely, but the diversity will be substantially composed of recent immigrants and new generations. The 2010 American Community Survey shows 13.9 million individuals arrived at the U.S. between 2000 and 2010. The interaction between immigration and cancer disparities is complex; however, progress in this area is an important component to eliminate racial/ethnic cancer disparities. The purposes of this study were to 1) explore cervical cancer screening among Asian immigrants; and 2) examine how socio-economic characteristics may impact screening behaviors.

Methods: This was a cross-sectional study using data collected from the Chicago Asian Community Survey (CACS). Participants were recruited from three Asian communities, Chinese, Cambodian and Vietnamese, using a three-stage random sampling of the Chinese community and Respondent Driven Sampling (RDS) of the Cambodian and Vietnamese communities. The CACS consisted of face-to-face interviews and was conducted following cultural and language-specific survey guidelines. The survey questionnaire was developed from several validated national health surveys, including the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS), National Health and Nutrition Examination Survey (NHANES), and the National Health Interview Survey (NHIS). Female participants were asked whether they have ever had cervical cancer screening before and when they were last screened.

Results: A total of 783 participants completed the survey, and 433 met the gender and foreign-born criteria. Nearly 79% of these women had health insurance, and 86% reported having a regular place for health care. About 31% had high school or above education, but only 13% reported speaking well English. Half of these women were married, and 60% lived in a household with family annual income less than $20,000. Sixty percent (n = 260) reported having cervical cancer screening in the past and 44% (n = 190) were screened within the last two years. Socio-economic characteristics (health insurance coverage, a regular place for health care, English proficiency, education level, marital status, family income, employment status, age and years in the U.S.) together accounted for 10% to 14% of the variance for being screened before. Having health insurance coverage (OR = 3.84, 95% CI 1.87-7.85) and being married (OR= 2.07, 95% CI 1.24-3.41) had significant impacts on being screened before. Older women were less likely to report having screened before (OR= .97, 95%CI 0.95-0.99). Socio-economic characteristics also accounted for 19% to 26% of the variance for being screened within two years. Participants who had a regular place for health care were 5.4 times likely to have screened within 2 years (95% CI 1.83-15.93) than those who didn't. Older women and women in the U.S. longer were less likely to have screened within two years (OR = .95, 95% CI .92-.98 and OR = .96, 95% CI .92 - .97 respectively).

Conclusion: For Asian immigrants, access to care (having insurance coverage and having a regular place for health care) has a significant impact on being screened in the past and being up-to-date. Older women, who might be sexually inactive, were less likely being screened before and being up-to-date. Although women who were in the U.S. longer were less likely to have up-to-date screening, the degree of acculturation likely has a stronger influence than the duration in the U.S.

Citation Format: Edwin Chandraskar, Helen Lam, Karen Kim. Cervical cancer screening among Asian immigrants in Chicago. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B73. doi:10.1158/1538-7755.DISP13-B73