Department of Psychiatry, University of California San Francisco, San Francisco, California.
Asian American Research Center on Health, San Francisco, California.
Cancer. 2018 Apr 1;124 Suppl 7(Suppl 7):1560-1567. doi: 10.1002/cncr.31097.
Nonadherence to colorectal cancer (CRC) screening among Asian Americans is high but not well understood. This study examined correlates of screening intention among Filipino, Hmong, and Korean Americans who were nonadherent to CRC screening.
Using cross-sectional, preintervention survey data from 504 Asian Americans (115 Filipinos, 185 Hmong, and 204 Koreans) aged 50-75 years who were enrolled in a multisite cluster randomized controlled trial of lay health educator intervention, we analyzed correlates of self-reported CRC screening nonadherence, which was defined as not being up-to-date for fecal occult blood test, sigmoidoscopy, or colonoscopy.
Only 26.8% of participants indicated intention to obtain screening within 6 months (Hmong: 12.4%; Korean: 30.8%; and Filipino: 42.6%; P < .001). Only one third of participants had undergone a prior screening, and a majority did not know that screening is a method of CRC prevention method (61.3%) or had any knowledge of CRC screening guidelines (53.4%). Multivariable analyses revealed that patient-provider ethnicity concordance, provider's recommendation of screening, participants' prior CRC screening, perceived severity and susceptibility of CRC, and knowledge of guidelines were positively associated with screening intention. Specifically, knowing one or more screening guidelines doubled the odds of screening intention (adjusted odds ratio, 2.38; 95% confidence interval, 1.32-4.28). Hmong were less likely to have screening intention than Filipinos, which was unexplained by socio-demographics, health care factors, perceived needs for CRC screening, or knowledge of screening guidelines.
CRC screening intention among nonadherent Filipino, Hmong, and Korean Americans was low. Targeting knowledge of CRC screening guidelines may be effective strategies for increasing CRC screening intention among nonadherent Asian Americans. Cancer 2018;124:1560-7. © 2018 American Cancer Society.
亚洲裔美国人对结直肠癌（CRC）筛查的不依从率很高，但尚不清楚其原因。本研究旨在探讨不依从 CRC 筛查的菲律宾裔、苗族裔和韩国裔美国人的筛查意向相关因素。
利用来自参加多中心、分层随机对照试验的 504 名年龄在 50-75 岁之间的、不依从 CRC 筛查的亚裔美国人（115 名菲律宾裔、185 名苗族裔和 204 名韩国裔）的横断面、干预前调查数据，我们分析了自我报告的 CRC 筛查不依从的相关因素，其定义为粪便潜血试验、乙状结肠镜检查或结肠镜检查未按时进行。
只有 26.8%的参与者表示在 6 个月内有进行筛查的意向（苗族裔：12.4%；韩国裔：30.8%；菲律宾裔：42.6%；P < .001）。只有三分之一的参与者曾进行过筛查，且大多数人不知道筛查是 CRC 预防方法（61.3%）或对 CRC 筛查指南有任何了解（53.4%）。多变量分析显示，患者与医生的种族一致性、医生对筛查的推荐、参与者既往的 CRC 筛查、对 CRC 的严重程度和易感性的认知、以及对指南的了解与筛查意向呈正相关。具体而言，了解一个或多个筛查指南使筛查意向的可能性增加一倍（调整后的优势比，2.38；95%置信区间，1.32-4.28）。与菲律宾裔相比，苗族裔更不可能有筛查意向，其原因无法用社会人口统计学、医疗保健因素、对 CRC 筛查的需求认知或对筛查指南的了解来解释。
不依从 CRC 筛查的菲律宾裔、苗族裔和韩国裔美国人的 CRC 筛查意向较低。针对 CRC 筛查指南的知识可能是提高不依从的亚裔美国人 CRC 筛查意向的有效策略。癌症 2018；124:1560-7. © 2018 美国癌症协会。
