Determinants of colorectal cancer screening among South Asian Americans

Authors

  • Arnab Mukherjea California State University, East Bay
  • Salma Shariff-Marco University of California, San Francisco
  • Juan Yang University of California, San Francisco
  • Winston Tseng University of California, Berkeley
  • Latha Palaniappan Stanford University
  • Jun Li Centers for Disease Prevention and Control
  • Susan L. Ivey Health Research for Action; School of Public Health; University of California, Berkeley
  • Ma Somsouk University of California, San Francisco
  • Scarlett Lin Gomez University of California, San Francisco

Keywords:

colorectal cancer screening, South Asian, Asian Indian, immigration, acculturation

Abstract

Background: Colorectal cancer screening rates among South Asian Americans are among the lowest of U.S. 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.

Methods: 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.

Results: Overall, 49% of 459 South Asians were non-adherent to screening recommendations. Characteristics associated with non-adherence were absence of flu shot, absence of doctor visits, sole use of non-English language at home, and <40% life spent in US. In the multivariable model, screening non-adherence was associated with <40% life in US (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)).

Conclusions: Length of time in the US 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.

Author Biographies

Arnab Mukherjea, California State University, East Bay

Chair & Associate Professor
Department of Public Health

Salma Shariff-Marco, University of California, San Francisco

Associate Professor
Department of Epidemiology & Biostatistics

Member
Cancer Control Program
Helen Diller Family Comprehensive Cancer Center

Juan Yang, University of California, San Francisco

Research Associate
Department of Epidemiology & Biostatistics

Winston Tseng, University of California, Berkeley

Research Scientist
Associate Director of Research
Health Research for Action
School of Public Health

Latha Palaniappan, Stanford University

Professor
Scientific Director of Precision Genomics and Pharmacogenomics in Primary Care
School of Medicine

Jun Li, Centers for Disease Prevention and Control

Senior Epidemiologist
Division of Cancer Prevention & Control
National Center for Chronic Disease Prevention & Health Promotion

Susan L. Ivey, Health Research for Action; School of Public Health; University of California, Berkeley

Professor
Director of Research
Health Research for Action
School of Public Health

Ma Somsouk, University of California, San Francisco

Professor
Division of Gastroenterology
Department of Medicine

Scarlett Lin Gomez, University of California, San Francisco

Professor
Department of Epidemiology & Biostatistics

Co-Leader
Cancer Control Program
Helen Diller Family Comprehensive Cancer Center

Published

2022-04-16

How to Cite

Mukherjea, A., Shariff-Marco, S., Yang, J., Tseng, W., Palaniappan, L., Li, J., Ivey, S. L., Somsouk, M., & Gomez, S. L. (2022). Determinants of colorectal cancer screening among South Asian Americans. Journal of Asian Health, 1(2). Retrieved from https://journalofasianhealth.org/index.php/jasianh/article/view/9