Colorectal Cancer Screening among Underserved Korean Americans in Los Angeles County
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Use of colorectal cancer screening is extremely low among Korean Americans. The objective of this study was to gather information on predictors, facilitators, barriers, and intervention preferences with respect to colorectal cancer screening that may inform the development of future interventions for underserved Korean Americans.
We developed a questionnaire guided by the Health Behavior Framework and administered it to a convenience sample of 151 Korean Americans aged 40–70 recruited through a community based organization in Los Angeles.
In our sample in which 60% of the subjects did not have health insurance, only 17% reported having received a stool blood test within the past year or sigmoidoscopy or colonoscopy within the past 5 years. Having received a physician recommendation was significantly associated and having symptoms of the disease was marginally associated with the outcome variable. Although 64% of respondents reported having a primary care physician, only 29% received a screening recommendation from a physician. Barriers to colorectal cancer screening were lack of health insurance and inability to afford testing, not knowing where to go for testing, language barrier, and fear of being a burden to the family. Intervention preferences included educational seminars, media campaigns, and print materials.
Our findings point to the need for a multi-faceted approach that includes educational seminars at community venues, a media campaign, and physician education to increase colorectal cancer screening in this underinsured Korean American population.
- US Department of Commerce Bureau of Commerce. Statistical Brief: United States, November 2000.
- Maxwell, AE, Song, H (2003) Cancer screening of Korean Americans in Los Angeles County: adding pieces to the puzzle. Korean Korean Am Stud Bull 13: pp. 59-70
- Koh, HK, Koh, HC (1993) Health issues in Korean Americans. Asian Am Pac Isl J Health 1: pp. 176-93
- Chen, MS (1993) A 1993 status report on the health status of Asian Pacific Islander Americans: comparisons with healthy people 2000 objectives. Asian Am Pac Isl J Health 1: pp. 37-55
- Chen, MS, Hawks, BL (1995) A debunking of the myth of healthy Asian Americans and Pacific Islanders. Am J Health Promot 9: pp. 261-8
- Lin-Fu, JS (1993) Asian and Pacific Islander Americans: an overview of demographic characteristics and health care issues. Asian Am Pac Isl J Health 1: pp. 20-36
- California cancer facts & figures: American Cancer Society; 2002.
- California cancer facts and figures: American Cancer Society; 2005.
- California cancer facts & figures: American Cancer Society; 2006.
- Colorectal cancer test use among persons aged > or = 50 years–United States, 2001. MMWR Morb Mortal Wkly Rep 2003;52(10):193–6.
- From the Centers for Disease Control and Prevention. Trends in screening for colorectal cancer–United States, 1997 and 1999. JAMA 2001;285(12):1570–1.
- Etzioni, DA, Ponce, NA, Babey, SH, Spencer, BA, Brown, ER, Ko, CY (2004) A population-based study of colorectal cancer test use: results from the 2001 California Health Interview Survey. Cancer 101: pp. 2523-32 CrossRef
- Juon, HS, Han, W, Shin, H, Kim, KB, Kim, MT (2003) Predictors of older Korean Americans’ participation in colorectal cancer screening. J Cancer Educ 18: pp. 37-42 CrossRef
- Kim, K, Yu, ES, Chen, EH, Kim, J, Brintnall, RA (1998) Colorectal cancer screening knowledge and practices among Korean Americans. Cancer Pract 6: pp. 167-75 CrossRef
- Maxwell, AE, Bastani, R, Warda, US (2000) Demographic predictors of cancer screening among Filipino and Korean immigrants in the United States. Am J Prev Med 18: pp. 62-8 CrossRef
- Sarna, L, Tae, YS, Kim, YH, Brecht, ML, Maxwell, AE (2001) Cancer screening among Korean Americans. Cancer Pract 9: pp. 134-40 CrossRef
- Bastani, R, Marcus, AC, Maxwell, AE, Das, IP, Yan, KX (1994) Evaluation of an intervention to increase mammography screening in Los Angeles. Prev Med 23: pp. 83-90 CrossRef
- Bastani, R, Maxwell, AE, Bradford, C, Das, IP, Yan, KX (1999) Tailored risk notification for women with a family history of breast cancer. Prev Med 29: pp. 355-64 CrossRef
- Becker, M, Maiman, L (1974) The health belief model: origins and correlates in psychological theory. Health Educ Monogr 2: pp. 336-53
- Ajzen, I, Madden, T (1986) Prediction of goal-directed behaviour: attitudes, intentions ad perceived behavioral control. J Exp Soc Psychol 22: pp. 453-74 CrossRef
- Fishbein, M, Ajzen, I. (1975) Belief, attitude, intention and behavior: An introduction to theory and research. Addison-Wesley, Reading, MA
- Green, L, Kreuter, M, Deeds, S, Partridge, K. (1980) Health education planning: a diagnostic approach. Mayfield Publishing Co, Palo Alto, CA
- Bandura, A (1977) Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 84: pp. 191-215 CrossRef
- Rosenstock, IM, Strecher, VJ, Becker, MH (1988) Social learning theory and the Health Belief Model. Health Educ Q 15: pp. 175-83
- Maxwell, AE, Bastani, R, Warda, US (1998) Mammography utilization and related attitudes among Korean-American women. Women Health 27: pp. 89-107 CrossRef
- Maxwell, AE, Bastani, R, Warda, US (1998) Misconceptions and mammography use among Filipino-and Korean-American women. Ethn Dis 8: pp. 377-84
- Choi, S (2003) Korean translation of the AANCART questionnaire. Korean Korean Am Stud Bull 13: pp. 98-117
- Ponce, NA, Lavarreda, SA, Yen, W, Brown, ER, DiSogra, C, Satter, DE (2004) The California health interview survey 2001: translation of a major survey for California’s multiethnic population. Public Health Rep 119: pp. 388-95 CrossRef
- Wong, ST, Gildengoren, G, Nguyen, T, Mock, J (2005) Disparities in colorectal cancer screening rates among Asian Americans and non-Latino whites. Cancer. 104: pp. 2940-7 CrossRef
- AskCHIS. Available: http://www.chis.ucla.edu/main/. Accessed November 2006.
- Juon, HS, Kim, M, Shankar, S, Han, W (2004) Predictors of adherence to screening mammography among Korean American women. Prev Med 39: pp. 474-81 CrossRef
- Hay, JL, Ford, JS, Klein, D, Primavera, LH, Buckley, TR, Stein, TR (2003) Adherence to colorectal cancer screening in mammography-adherent older women. J Behav Med 26: pp. 553-76 CrossRef
- Honda, K (2004) Factors associated with colorectal cancer screening among the US urban Japanese population. Am J Public Health 94: pp. 815-22 CrossRef
- Klabunde, CN, Vernon, SW, Nadel, MR, Breen, N, Seeff, LC, Brown, ML (2005) Barriers to colorectal cancer screening: a comparison of reports from primary care physicians and average-risk adults. Med Care 43: pp. 939-44 CrossRef
- Seeff, LC, Nadel, MR, Klabunde, CN, Thompson, T, Shapiro, JA, Vernon, SW (2004) Patterns and predictors of colorectal cancer test use in the adult U.S. population. Cancer 100: pp. 2093-103 CrossRef
- Tang, TS, Solomon, LJ, McCracken, LM (2001) Barriers to fecal occult blood testing and sigmoidoscopy among older Chinese-American women. Cancer Pract 9: pp. 277-82 CrossRef
- Coughlin, SS, Thompson, T (2005) Physician recommendation for colorectal cancer screening by race, ethnicity, and health insurance status among men and women in the United States, 2000. Health Promot Pract 6: pp. 369-78 CrossRef
- Jang, Y, Kim, G, Chiriboga, DA (2005) Health, healthcare utilization, and satisfaction with service: barriers and facilitators for older Korean Americans. J Am Geriatr Soc 53: pp. 1613-7 CrossRef
- Shin, H, Song, H, Kim, J, Probst, JC (2005) Insurance, acculturation, and health service utilization among Korean-Americans. J Immigr Health 7: pp. 65-74 CrossRef
- Sohn, L, Harada, ND (2005) Knowledge and use of preventive health practices among Korean women in Los Angeles county. Prev Med 41: pp. 167-78 CrossRef
- Juon, HS, Choi, Y, Kim, MT (2000) Cancer screening behaviors among Korean-American women. Cancer Detect Prev 24: pp. 589-601
- Min, PG (1998) Korean immigrants in Los Angeles. ISSR working papers in the Social Sciences 5: pp. 1-17
- Juon, HS, Seo, YJ, Kim, MT (2002) Breast and cervical cancer screening among Korean American elderly women. Eur J Oncol Nurs 6: pp. 228-35 CrossRef
- Adams, EK, Thorpe, KE, Becker, ER, Joski, PJ, Flome, J (2004) Colorectal cancer screening, 1997–1999: role of income, insurance and policy. Prev Med 38: pp. 551-7 CrossRef
- Jacobs, EA, Karavolos, K, Rathouz, PJ, Ferris, TG, Powell, LH (2005) Limited English proficiency and breast and cervical cancer screening in a multiethnic population. Am J Public Health 95: pp. 1410-6 CrossRef
- Yu MY, Wu TY. Factors influencing mammography screening of Chinese American women. J Obstet Gynecol Neonatal Nurs 2005;34(3):386–94.
- Colorectal Cancer Screening among Underserved Korean Americans in Los Angeles County
Journal of Immigrant and Minority Health
Volume 10, Issue 2 , pp 119-126
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Colorectal cancer
- Cancer screening
- Korean Americans
- Medically underinsured
- Medically indigent
- Industry Sectors
- Author Affiliations
- 1. Department of Family Medicine, David Geffen School of Medicine at UCLA, 650 Charles Young Drive, South A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
- 2. Division of Cancer Prevention and Control Research, UCLA School of Public Health, Los Angeles, CA, USA
- 3. Department of Biostatics, UCLA School of Public Health, Los Angeles, CA, USA