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Colorectal Cancer Screening Compliance among Asian and Pacific Islander Americans

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Abstract

Colorectal cancer (CRC) screening prevalence remains low among Asians and Pacific Islanders. This study examined disparities and predictors of CRC screening compliance in adults age 50–75 years in Asians and Pacific Islanders in Hawai‘i. Hawai‘i Behavioral Risk Factor Surveillance System (BRFSS) data for 2011–2014 were analyzed. CRC screening status was dichotomized. Logistic regression was used to examine ethnic differences in and predictors of CRC screening status. Filipinos (OR 0.56), Chinese (OR 0.70), and Hawaiians (OR 0.75) were significantly less likely than whites to be CRC compliant. Higher education and income, employment, regular health provider, and routine checkups were important predictors of CRC compliance. Findings confirm lower CRC screening compliance in three of the four largest Asian and Pacific Islander groups in Hawai‘i and that CRC screening compliance is influenced by several factors. Culturally tailored education and navigation services may be effective in reducing these disparities.

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References

  1. Torre LA, Goding Sauer AM, Chen MS, Kagawa-Singer M, Jemal A, Siegel RL. Cancer statistics for Asian Americans, Native Hawaiians, and Pacific Islanders, 2016: converging incidence in males and females. CA Cancer J Clin. 2016;66(3):182–202. doi:10.3322/caac.21335. Epub 2016 Jan 14.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Asian American Center for Advancing Justice. A community of contrasts Asian Americans in the United States: 2011. http://www.advancingjustice-aajc.org/sites/aajc/files/Community_of_Contrast.pdf (2015). Accessed 30 September 2015.

  3. American Cancer Society Cancer Facts & Figs. http://www.cancer.org/acs/groups/content/@research/documents/document/acspc-047079.pdf (2016). Accessed 20 February 2016.

  4. US Preventive Services Task Force, Colorectal cancer: screening. http://www.uspreventiveservicestaskforce.org/Page/Topic/recommendation-summary/colorectal-cancer-screening (2008). Accessed October 2008.

  5. Zlot AI, Silvey K, Newell N, Coates RJ, Leman R. Family history of colorectal cancer: clinicians’ preventive recommendations and patient behavior. Prev Chronic Dis. 2012;9:100254. doi:10.5888/pcd9.100254.

    Google Scholar 

  6. Doubeni CA. The impact of colorectal cancer screening in the United States population: is it time to celebrate? Cancer 2014;120(18):2810–2813. doi:10.1002/cncr.28789.

    Article  PubMed  PubMed Central  Google Scholar 

  7. American Cancer Society. Colorectal Cancer Facts & Figs. 2014–2016. http://www.cancer.org/acs/groups/content/documents/document/acspc-042280.pdf (2015). Accessed 28 September 2015.

  8. Liss DT, Baker DW. Understanding current racial/ethnic disparities in colorectal cancer screening in the United States: the contribution of socioeconomic status and access to care. Am J Prev Med. 2014;46(3):228–36.

    Article  PubMed  Google Scholar 

  9. Lee HY, Lundquist M, Ju E, Luo X, Townsend A. Colorectal cancer screening disparities in Asian Americans and Pacific Islanders: which groups are most vulnerable? Ethn Health. 2011;16(6):501–18. doi:10.1080/13557858.2011.575219.

    Article  PubMed  Google Scholar 

  10. Yi M, Xu J, Chang GJ, Du XL, Song Y, He J, Ren Y, Wei Y, Yang J, Hunt KK, Li X. Comparative analysis of lifestyle factors, screening test use, and clinicopathologic features in association with survival among Asian Americans with colorectal cancer. Br J Cancer. 2013;108(7):1508–1514. doi:10.1038/bjc.2013.97.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Kandula NR, Wen M, Jacobs EA, Lauderdale DS. Low rates of colorectal, cervical, and breast cancer screening in Asian Americans compared with non-Hispanic whites: cultural influences or access to care? Cancer. 2006;107(1):184–192. doi:10.1002/cncr.21968.

    Article  PubMed  Google Scholar 

  12. Nguyen D, Salvail FR. The Behavioral Risk Factor Surveillance System: 2013 results. 2014, http://health.hawaii.gov/brfss/files/2015/04/HBRFSS_2013results_OCT06_Apr15.pdf (2015). Accessed 30 September 2015.

  13. Starr RR, Taflinger FV, Teel CM. Insights in public health: public health perspectives on colorectal cancer screening. Hawai‘i. J Med Public Health. 2014;73(3):223–7.

    Google Scholar 

  14. Pagano I, Morita SY, Dhakal S, Hundahl SA, Maskarinec G. Time dependent ethnic convergence in colorectal cancer survival in Hawai‘i. BMC Cancer. 2003 Feb;25(3):1–5.

    Google Scholar 

  15. Jones RM, Devers KJ, Kuzel AJ, Woolf SH. Patient-reported barriers to colorectal cancer screening: a mixed-methods analysis. Am J Prev Med. 2010;38(5):508–16. doi:10.1016/j.amepre.2010.01.021.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Braun KL, Fong M, Kaanoi M, Kamaka ML, Gotay CC. Testing a culturally appropriate, theory-based intervention to improve colorectal cancer screening among Native Hawaiians. Prev Med. 2005;40(6):619–27. doi:10.1016/j.ypmed.2004.09.005.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Sentell TL, Braun KL, Davis J, Davis T. Colorectal cancer screening: low health literacy and limited English proficiency among Asians and Whites in California. J Health Commun. 2013; 18(Suppl 1):242–255. doi:10.1080/10810730.2013.825669.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Holden DJ, Jonas DE, Porterfield DS, Reuland D, Harris R. Systematic review: enhancing the use and quality of colorectal cancer screening, Ann Intern Med. 2010;152(10): 688–676. doi:10.7326/003-4819-152-10-201005180-00239.

    Article  Google Scholar 

  19. Ferrer RR, Ramirez M, Beckman LJ, Danao LL, Ashing-Giwa KT. The impact of cultural characteristics on colorectal cancer screening adherence among Filipinos in the United States: a pilot study. Psychooncology. 2011;20(8):862–70. doi:10.1002/pon.1793.

    Article  PubMed  Google Scholar 

  20. Maxwell AE, Bastani R, Crespi CM, Danao LL, Cayetano RT. Behavioral mediators of colorectal cancer screening in a randomized controlled intervention trial. Prev Med. 2011 52(2):167–73. doi:10.1016/j.ypmed.2010.11.007.

    Article  PubMed  Google Scholar 

  21. Centers for Disease Control [CDC]. The BRFSS data usage guide. http://www.cdc.gov/brfss/data_documentation/pdf/userguidejune2013.pdf (2013). Accessed 31 July 2015.

  22. Nguyen D, Salvail FR. The Behavioral Risk Factor Surveillance System: 2011 results. 2012, http://health.hawaii.gov/brfss/files/2014/03/HBRFSS_2011results.pdf (2015). Accessed 30 September 2015.

  23. Nguyen D, Salvail FR. The Behavioral Risk Factor Surveillance System: 2012 results. 2013, http://health.hawaii.gov/brfss/files/2015/09/BRFSS_2012_tina15_results_S.pdf (2015). Accessed 30 September 2015.

  24. Nguyen D, Salvail FR. The Behavioral Risk Factor Surveillance System: 2014 results. http://health.hawaii.gov/brfss/files/2015/08/HBRFSS_2014_results.pdf (2015). Accessed 30 September 2015.

  25. SPSS Inc. SPSS for windows, version 23.0. Chicago:SPSS Inc;2015.

    Google Scholar 

  26. Department of Business, Economic Development & Tourism [DBEDT]. Hawai‘i ranking and comparisons. http://dbedt.hawaii.gov/economic/ranks (2016). Accessed 20 February 2016.

  27. Homayoon B, Shahidi NC, Cheung WY. Impact of Asian ethnicity on colorectal cancer screening: a population-based analysis. Am J Clin Oncol. 2013;36:167–73. doi:10.1097/COC.0b013e3182439068.

    Article  PubMed  Google Scholar 

  28. Sentell TL, Tsoh JY, Davis T, Davis J, Braun KL. Low health literacy and cancer screening among Chinese Americans in California: a cross-sectional analysis. BMJ Open. 2015;5(1):e006104. doi:10.1136/bmjopen-2014-006104.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Francisco D, Rankin L, Kim SC. Adherence to colorectal cancer and polyps screening recommendations among Filipino-Americans. Gastroenterol Nurs. 2014;37(6), 384–390. doi:10.1097/SGA.0000000000000071.

    Article  PubMed  Google Scholar 

  30. Maxwell AE, Bastani R, Danao LL, Antonio C, Garcia GM, Crespi CM. Results of a community-based randomized trial to increase colorectal cancer screening among Filipino Americans. Am J Public Health. 2010;100(11):2228–34. doi:10.2105/AJPH.2009.176230.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Maxwell AE, Danao LL, Cayetano RT, Crespi CM, Bastani R. Adoption of an evidence-based colorectal cancer screening promotion program by community organizations serving Filipino Americans. BMC Public Health. 2014;14:246. doi:10.1186/1471-2458-14-246.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Wu T, Kao JY, Hsieh H, Tang Y, Chen J, Lee J, Oakley D. Effective colorectal cancer education for Asian Americans: a Michigan program. J Cancer Educ. 2010;25(2):146–52. doi:10.1007/s13187-009-0009-x.

    Article  PubMed  Google Scholar 

  33. Freeman HP. Patient navigation: a community centered approach to reducing cancer mortality. J Cancer Educ. 2006;21(1 Suppl):S11–14.

    Article  PubMed  Google Scholar 

  34. Braun KL, Thomas ML, Domingo JB, Allison AL, Ponce A, Kamakana HP, Brazzel SS, Aluli NE, Tsark JU. Reducing cancer screening disparities in Medicare beneficiaries through cancer patient navigation. J Am Geriatr Soc. 2015;63(2):365–70. doi:10.1111/jgs.13192.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Centers for Disease Control [CDC]. 2014 summary data quality report. http://www.cdc.gov/brfss/annual_data/2014/pdf/2014_dqr.pdf (2015). Accessed 5 November 2015.

  36. Naylor K, Ward J, Polite BN. Interventions to improve care related to colorectal cancer among racial and ethnic minorities: a systematic review. J Gen Intern Med. 2012;27(8):1033–46. doi:10.1007/s11606-012-2044-2.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number U54CA153459 and partially supported by National Institute of Health Grants, U54MD007584 and P20GM103466. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors also would like to acknowledge Florentina Salvail of the Hawai‘i State Department of Health for her valuable guidance in analysis of Hawai‘i’s BRFSS dataset.

Funding

This study was funded by the National Cancer Institute of the National Institutes of Health under Award Number U54CA153459 and partially supported by National Institute of Health grants, U54MD007584 and P20GM103466.

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Correspondence to Jermy-Leigh B. Domingo.

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Jermy-Leigh B. Domingo declares that she has no conflict of interest. John J. Chen declares that he has no conflict of interest. Kathryn L. Braun declares that she has no conflict of interest.

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This article does not contain any studies with human participants performed by any of the authors.

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Domingo, JL.B., Chen, J.J. & Braun, K.L. Colorectal Cancer Screening Compliance among Asian and Pacific Islander Americans. J Immigrant Minority Health 20, 584–593 (2018). https://doi.org/10.1007/s10903-017-0576-6

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