Abstract A14: Colorectal cancer screening: Does racial/ethnic and language concordance matter?
Authors: Kim Karen , Chandraskar Edwin , Quinn Michael , Lam Helen 
Published: May 2015

Objectives: Asian-Americans are the only racial/ethnic population to experience cancer as the leading cause of death. Barriers to cancer screening among Asian-Americans have been widely studied; however, the importance of concordance that may link to health care disparities has yet to be studied in the Asian-American population. Racial/ethnic and language concordance is found to foster trust, communication and better patient-provider interaction, but whether it can also improve compliance of cancer screening guidelines remain unknown. The purpose of this study was to examine how physician racial/ethnic and language concordance may motivate colorectal cancer screening (CRS) using Fecal Occult Blood Test (FOBT) among Korean Americans.

Methods: This study used a prospective design with random sampling. Participants in this study were recruited through Korean community-based organizations. Presenters of the educational sessions were all male physicians and different in their race/ethnicity (Korean-American and White) and language capacity (Korean-speaking and English-speaking). Participants were randomly assigned to one of the three groups: the White physician, English speaking with an interpreter; Korean-American physician, English speaking with an interpreter, and Korean-American physician, Korean speaking. A culturally tailored presentation was given during the sessions. All three group educations were conducted concurrently in three separated rooms. Participants who agreed to participate in the study were asked to fill out a bilingual pre- and post-survey. Each participant was offered a no-cost FOBT kit at the end of the session, and had four weeks to mail back the FOBT kit. The two main independent variables were racial/ethnic and language concordances. Racial/ethnic concordance was determined by the presenter's race/ethnicity, while language concordance was determined by the use of an interpreter. The main dependent variable of interest was the return of FOBT kit.

Results: Following the recommendation guideline for CRS, only participants who were older than 49 years old were included in the final data analysis. A total of 115 participants completed the pre and post surveys, and 78 (68%) met the age criterion. Of the 78 participants, 69% were female, 48% completed high school education and all of them were foreign-born. Only 40% reported having a regular place for health care and 39% reported having a primary care physician (PCP). Participants who had a regular place for health care were more likely to have a PCP than participants who didn't, 83% and 11% respectively (p &lt; .0005). 63% of the participants returned their FOBT kit within 4 weeks. The Korean and Korean-speaking presenter groups had the highest return rate, 78%, compared to 63% for the Korean and English-speaking presenter groups and 52% for the White and English-speaking presenter groups. For race/ethnic concordance only, the return rate was 70% for Korean presenters and 52% for the White presenter; while for language concordance only, the return rate was 78% for Korean-speaking presenter and 52% for the English-speaking presenters.

Conclusion: This preliminary study provides important information on how race/ethnic and language concordance might influence CRS behaviors. Although some studies show that interpreter use can overcome language barriers, our study shows that screening behavior was reduced among the non-Korean presenter and non-Korean speaking cohort. Therefore, while reduction in language barriers using interpreter may improve patient-provider communication, further larger scale studies are warranted to explore concordance and cancer screenings among race/ethnic minority groups.

Citation Format: Karen Kim, Edwin Chandraskar, Michael Quinn, Helen Lam. Colorectal cancer screening: Does racial/ethnic and language concordance matter?. [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 A14. doi:10.1158/1538-7755.DISP13-A14