Abstract B84: Determinants of colorectal cancer screening in three Asian communities.
Authors: Kim Karen , Vallina Helen , Chandrasekar Edwin 
Published: August 2014

Objectives: While cancer screening has been shown to be effective in detecting cancer at early stages and reducing mortality, Asian-Americans are the least likely racial/ethnic group to obtain cancer screening tests. The purpose of this study is to describe colorectal cancer screening (CRS) by sigmoidoscopy or a colonoscopy across three different Asian communities (Chinese, Cambodian and Vietnamese) in Chicago. Specially, we examined determinants, such as health insurance coverage, regular facility for health care, understanding health information given by health providers, years in the U.S. and age, on CRS behavior.

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. CACS consisted of face-to-face interviews. With a three-stage random sampling of the Chinese community and Respondent Driven Sampling (RDS) of the Cambodian and Vietnamese communities, 383 Chinese, 250 Vietnamese, and 150 Cambodian community members were interviewed using 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).

Results: A total of 783 participants completed the survey; 465 were aged 50 or older. The proportion of adults aged 50 or older who reported ever having a sigmoidoscopy or a colonoscopy was 27% Chinese, 36% Cambodian, and 31% Vietnamese. Overall, 83%, 91%, and 83% of Chinese, Cambodian, and Vietnamese, respectively, reported they had health insurance and nearly 86% were covered by either Medicare or Medicaid, or both. In addition, 89%, 84%% and 96% of Chinese, Cambodian and Vietnamese respectively, reported they had a regular health care facility. The majority of Chinese and Vietnamese, 84% and 87% respectively, reported they usually understood information given by their health providers. For Cambodian, only 44% reported they usually understood information given by their health providers and this subgroup was less likely to be screened before (p &lt; .004). Vietnamese who were older (p = .037) and Chinese who were in the U.S. longer (p &lt; .0005) were more likely to report having a sigmoidoscopy or a colonoscopy before.

Conclusion: Despite access to care (health insurance and regular facility for health care), CRS rates were extremely low among these Asian communities. For Cambodians, understanding information given by health providers was negatively associated with having a sigmoidoscopy or a colonoscopy before. Older Vietnamese were more likely to report having a sigmoidoscopy or a colonoscopy before, as were Chinese who were in the U.S. longer.

Citation Format: Karen Kim, Helen Vallina, Edwin Chandrasekar. Determinants of colorectal cancer screening in three Asian communities. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr B84.