Okitondo Christian, Kawaya-Tshola Khezia, Okitondo Herve
Department of Epidemiology & Biostatistics at University of Georgia, United States.
St. George's University School of Medicine, Grenada.
J Cancer Policy. 2025 Mar;43:100516. doi: 10.1016/j.jcpo.2024.100516. Epub 2024 Nov 17.
Colorectal cancer screening rates are lower among immigrants compared to U.S.-born individuals. This study examined the association between time spent in the U.S. and CRC screening adherence in a diverse sample of immigrants, while considering the role of sociodemographic factors.
Data from the 2010, 2013, 2015, and 2018 NHIS were analyzed. The sample included 6298 immigrants aged 50-75. Multivariable logistic regression was used to assess the association between time in the U.S. (<15 years vs. ≥15 years) and CRC screening adherence, adjusting for sociodemographic factors.
Overall, 47.6 % of immigrants adhered to CRC screening guidelines. Immigrants residing in the U.S. for 15 years or more had significantly higher odds of screening adherence (AOR = 1.63; 95 % CI, 1.29-2.05) compared to those with less than 15 years of residence in the U.S. This association varied by race/ethnicity, with the greatest impact seen among Asian immigrants. Socioeconomic factors, particularly education and having a usual source of care, were also significantly associated with screening adherence.
Time in the U.S. is a significant predictor of CRC screening adherence among immigrants, with those residing 15 years or more showing higher adherence across racial and ethnic groups. Socioeconomic factors, including education, income, health insurance, and having a usual place of care, are strongly associated with screening adherence across all immigrant groups. These findings underscore the need for tailored interventions to enhance screening rates, particularly among recent immigrants and those with limited socioeconomic resources.
与在美国出生的人相比，移民中的结直肠癌筛查率较低。本研究在一个多样化的移民样本中，考察了在美国居住的时间与结直肠癌筛查依从性之间的关联，同时考虑了社会人口学因素的作用。
分析了2010年、2013年、2015年和2018年美国国家健康访谈调查（NHIS）的数据。样本包括6298名年龄在50 - 75岁的移民。采用多变量逻辑回归来评估在美国居住的时间（<15年与≥15年）与结直肠癌筛查依从性之间的关联，并对社会人口学因素进行调整。
总体而言，47.6%的移民遵守结直肠癌筛查指南。与在美国居住时间少于15年的移民相比，在美国居住15年或更长时间的移民进行筛查的依从性显著更高（调整后的比值比[AOR]=1.63；95%置信区间[CI]，1.29 - 2.05）。这种关联因种族/民族而异，在亚洲移民中影响最大。社会经济因素，特别是教育程度和有常规的医疗服务来源，也与筛查依从性显著相关。
在美国居住的时间是移民中结直肠癌筛查依从性的一个重要预测因素，居住15年或更长时间的移民在所有种族和民族群体中表现出更高的依从性。社会经济因素，包括教育、收入、医疗保险和有常规的就医地点，与所有移民群体的筛查依从性密切相关。这些发现强调了需要采取针对性的干预措施来提高筛查率，特别是在新移民和社会经济资源有限的人群中。
