Division of Medical Oncology, British Columbia Cancer Agency, University of British Columbia, Vancouver, Canada.
Am J Clin Oncol. 2013 Apr;36(2):167-73. doi: 10.1097/COC.0b013e3182439068.
Although research shows that African Americans and Hispanics frequently receive less colorectal cancer screening (CRCS) than whites, few studies have focused on CRCS among Asians. The aims of this study were to compare CRCS between Asians and whites and to evaluate for clinical predictors of CRCS.
From the 2007 California Health Interview Survey, we identified all Asian and white respondents who were eligible for CRCS. Logistic regression was performed to evaluate for differences in CRCS. We used stratified and interaction analyses to examine whether associations between race and CRCS were modified by insurance status, birthplace, or language skills, while controlling for other confounders.
Baseline characteristics were similar between Asians and whites. Only 58% of Asians and 66% of whites reported undergoing up-to-date CRCS (P < 0.01). In multivariate analyses, visiting a physician more than 5 times produced the highest odds of being up-to-date with screening. When compared with whites, Asians had decreased odds of being up-to-date with screening. Stratified analyses showed that this disparity existed mainly in the insured, but not in the uninsured, and it was not modified by place of birth or English language proficiency.
Despite its ability to reduce mortality, CRCS is suboptimal in our US population-based cohort of Asians when compared with whites. A contributing factor to this problem for the Chinese and Koreans may be a lack of awareness regarding CRCS, whereas the source of the problem in the Vietnamese seems to be related to healthcare access.
尽管研究表明非裔美国人和西班牙裔人接受结直肠癌筛查（CRCS）的频率低于白人，但很少有研究关注亚洲人的 CRCS。本研究的目的是比较亚洲人与白人间的 CRCS，并评估 CRCS 的临床预测因素。
我们从 2007 年加利福尼亚健康访谈调查中确定了所有符合 CRCS 条件的亚裔和白人受访者。使用逻辑回归评估 CRCS 差异。我们使用分层和交互分析来检验种族与 CRCS 之间的关联是否因保险状况、出生地或语言技能而改变，同时控制其他混杂因素。
亚洲人和白人间的基线特征相似。只有 58%的亚洲人和 66%的白人报告接受了最新的 CRCS（P<0.01）。在多变量分析中，看医生超过 5 次的人接受筛查的几率最高。与白人相比，亚洲人接受筛查的几率较低。分层分析表明，这种差异主要存在于有保险的人群中，而不在没有保险的人群中，且不受出生地或英语熟练程度的影响。
尽管 CRCS 能够降低死亡率，但与白人相比，在我们基于人群的美国亚裔队列中，CRCS 的效果并不理想。造成这种情况的一个因素可能是中国人和韩国人对 CRCS 的认识不足，而越南人的问题似乎与医疗保健获取有关。
