Mukherjea Arnab, Shariff-Marco Salma, Yang Juan, Tseng Winston, Palaniappan Latha, Li Jun, Ivey Susan L, Somsouk Ma, Gomez Scarlett Lin
Department of Public Health, California State University, East Bay, Hayward, CA.
Health Research for Action, School of Public Health, University of California, Berkeley, CA.
J Asian Health. 2022 Apr;10(e202202):1-12.
Colorectal cancer screening rates among South Asian Americans are among the lowest of US population groups. Few population-based studies have examined determinants of screening in this population. The purpose of this study was to identify factors associated with colorectal cancer screening among South Asian Americans.
Data from the 2001-2009 California Health Interview Survey and multivariable logistic regression were used to examine determinants of being non-adherent with colorectal cancer screening recommendations. Independent variables include sociodemographic and healthcare access measures.
Overall, 49% of 459 South Asian Americans were non-adherent to screening recommendations. Characteristics associated with non-adherence were the absence of flu shot, absence of doctor visits, sole use of non-English language at home and ≤40% life spent in the United States. In the multivariable model, screening non-adherence was associated with ≤40% life in the United States (odds ratio [95% confidence interval] 3.0 [1.4-6.5]), use of non-English at home (2.8 [1.0-7.8]) and no flu shot (2.5 [1.3-4.8]). Obese (BMI > 27.5 kg/m2) versus normal-weight patients were less likely to be non-adherent (0.4 [0.2-0.9]).
Length of time in the United States and language spoken at home rather than English proficiency were associated with non-adherence to colorectal cancer screening, reflecting the importance of acculturation and retention of cultural values. Health conditions and behaviors reflecting more proactive healthcare utilization may reinforce the importance of provider recommendations and perceived efficacy of health prevention. Qualitative research would inform cultural tailoring necessary to improve colorectal cancer screening rates among the rapidly growing South Asian American population.
南亚裔美国人的结直肠癌筛查率在美国所有人群组中处于最低水平。很少有基于人群的研究调查该人群筛查的决定因素。本研究的目的是确定与南亚裔美国人结直肠癌筛查相关的因素。
使用2001 - 2009年加利福尼亚健康访谈调查的数据和多变量逻辑回归来检查未遵循结直肠癌筛查建议的决定因素。自变量包括社会人口统计学和医疗保健可及性指标。
总体而言，459名南亚裔美国人中有49%未遵循筛查建议。与未遵循相关的特征包括未接种流感疫苗、未看医生、在家只说非英语以及在美国生活时间≤40%。在多变量模型中，筛查不依从与在美国生活时间≤40%（比值比[95%置信区间]3.0[1.4 - 6.5]）、在家使用非英语（2.8[1.0 - 7.8]）和未接种流感疫苗（2.5[1.3 - 4.8]）有关。肥胖（体重指数>27.5 kg/m²）与正常体重的患者相比，不依从的可能性较小（0.4[0.2 - 0.9]）。
在美国的居住时间和在家说的语言而非英语熟练程度与结直肠癌筛查不依从有关，这反映了文化适应和文化价值观保留的重要性。反映更积极利用医疗保健的健康状况和行为可能会强化医疗服务提供者建议的重要性以及对健康预防效果的认知。定性研究将为改善快速增长的南亚裔美国人群体的结直肠癌筛查率所需的文化定制提供信息。
