Abstract PO-089: Racial/ethnic disparities in oral cancer screening between low-income Asian Americans aged 18-50 and their White counterparts
Authors: Lu Wenyue , Zhu Lin , Wang Bohui , Zhu Di , Yeh Ming-chin , Ma Grace X. 
Published: January 2022

Background. Asian Americans (AAs) aged 18-50 have higher incidence and mortality rates of oral cancer. However, scant attention has been focusing on oral cancer disparities among this population. Although oral cancer screening is not recommended for asymptomatic adults, it's effective in oral cancer early detection among high-risk populations. The study aimed at assessing the racial/ethnic disparities in oral cancer screening experienced by Asian Americans aged 18-50 living federal poverty level, comparing with their White counterparts. Method. The sample consists of 1540 low-income adults (478 AAs and 1062 Whites) aged 18-50 from the 2011-2018 National Health and Nutrition Examination Survey (NHANES) combined datasets. Weighting was applied since NHANES oversampled Asian Americans. We conducted bivariate analysis such as t-test and chi-square test to examine the association between demographic and behavioral factors =and oral cancer screening among high-risk populations. Multiple logistic regressions were used to identify the risk factors of oral cancer screening disparities. All data analyses were conducted in Stata 16. A p value smaller than 0.05 was considered statistically significant, while a p value between 0.05-0.1 was taken as marginally significant criteria. Results. AAs are predominately foreign-born (79.13%), about half of them only spoke their native languages at home (47.69%), and 27.31% of them did not have health insurance. Overall, AAs had significantly lower oral cancer screening rate than Whites (7.33% vs. 16.69%, p=0.006). Specifically, within those who were not covered with health insurance, AAs were less likely to receive oral cancer screening than Whites (3.5% vs.13.73%, p=0.060); among those who did not receive any HPV vaccine shots, Asians had lower oral cancer screening rate than Whites (7.64% vs.14.72%, p=0.058); among those who were not self-motivated to visit their dentists, Asians reported extremely low oral cancer screening rate (2.24%), which was significantly (p=0.016) lower than that of Whites (10.27%). Although Asians had higher self-motivation to do dental visit than Whites (62.96% vs. 52.72%, p=0.009), among self-motivated patients, AAs were less likely to be told the importance of checking for oral cancer by their dentists (12.94% vs. 23.54%, p=0.063), compared with Whites. Logistic regressions also showed that the negative impacts of less-frequent dental visits on oral cancer screening was stronger among AAs (OR=0.45, p=0.042) than in Whites (OR=0.75, p=0.005), controlling for other variables. Conclusion. AAs experience oral cancer screening disparities among multiple high-risk/vulnerable populations. There is an urgent need of educational intervention to promote oral cancer screening for AAs, especially among high-risk subpopulations, and to improve dentists' awareness of AAs' oral cancer screening needs.

Citation Format: Wenyue Lu, Lin Zhu, Bohui Wang, Di Zhu, Ming-chin Yeh, Grace X. Ma. Racial/ethnic disparities in oral cancer screening between low-income Asian Americans aged 18-50 and their White counterparts [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-089.