Provider knowledge and practice regarding hepatitis B screening in Chinese-speaking patients

  • Cindy J. Lai
  • Tung T. Nguyen
  • Jimmy Hwang
  • Susan L. Stewart
  • Anson Kwan
  • Stephen J. McPhee


Background. The extent to which academic general medicine providers screen Chinese-speaking patients for hepatitis B virus (HBV) is not known.Methods. Retrospective cohort study of Chinese-speaking patients’ HBV screening status and survey of providers’ HBV knowledge/screening.Results. Most patients (65%) received HBV screening. Being screened was independently associated with marital status and years in the clinic. Providers with Asian language abilities and greater knowledge of HBV risk factors/guidelines were more likely to screen.Conclusions. Chinese-speaking patients in this setting were underscreened for HBV. Providers underestimated the risks associated with Chinese ethnicity. Education is needed to improve risk assessment and guideline awareness.


Chinese Immigrant Asian Language Chinese Ethnicity General Medicine Practice Fecal Occult Blood Test Card 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Tong MJ, Sun SC, Schaeffer BT, Chang NK, Lo KJ, Peters RL. Hepatitis-associated antigen and hepatocellular carcinoma in Taiwan. Ann Intern Med. 1971;75:687–691.PubMedGoogle Scholar
  2. 2.
    Tong MJ, Hwang SJ. Hepatitis B virus infection in Asian Americans. Gastroenterol Clin North Am. 1994;23:523–536.PubMedGoogle Scholar
  3. 3.
    Merican I, Guan R, Amarapuka D, et al. Chronic hepatitis B virus infection in Asian countries. J Gastroenterol Hepatol. 2000;15:1356–1361.CrossRefPubMedGoogle Scholar
  4. 4.
    Tong MJ, Yu M, Co R, Eastin B. Hepatitis B virus markers in the foreign-born Chinese population of Los Angeles, California. J Infect Dis. 1984;149:475.PubMedGoogle Scholar
  5. 5.
    Hann HW. Hepatocellular carcinoma in Asian Americans. Cancer Causes and Control. 1998;83:1723–1729.Google Scholar
  6. 6.
    London WT. Prevention of hepatitis B virus and hepatocellular carcinoma in Asian residents in the United States. Asian Clin Sci Monogr: Hepatitis B Infect. 1990;11:49–57.Google Scholar
  7. 7.
    Chao S, Prapong W, So SK. Incidence and Characterization of Hepatitis B Infection in Chinese-Americans in the San Francisco Bay Area [abstract]. Philadelphia; American Public Health Association; 2002.Google Scholar
  8. 8.
    Parkin DM, Whelan SL, Raymond L, Young J (eds). Cancer Incidence in Five Continents, Volume 7. Lyon, France: IARC Scientific Publications; 1997.Google Scholar
  9. 9.
    Ries LAG, Eisner MP, Kosary CL, et al., (eds). SEER Cancer Statistics Review, 1975–2002. Bethesda, MD: National Cancer Institute; 2005.Google Scholar
  10. 10.
    Thompson MJ, Taylor VM, Jackson JC, et al. Hepatitis B knowledge and practices among Chinese American women in Seattle, Washington. J Cancer Educ. 2002;17:222–226.PubMedGoogle Scholar
  11. 11.
    Hiatt RA, Pasick RJ, Perez-Stable EJ, et al. Pathways to early cancer detection in the multiethnic population of the San Francisco Bay Area. Health Educ Quar. 1996;23S(S10–27).Google Scholar
  12. 12.
    Wismer BA, Moskowitz JM, Chen AM, et al. Rates and independent correlates of pap smear testing among Korean-American women. Am J Public Health. 1998;88:656–660.CrossRefPubMedGoogle Scholar
  13. 13.
    Thompson MJ, Taylor VM, Yasui Y, et al. Hepatitis B knowledge and practices among Chinese Canadian women in Vancouver, British Columbia. Can J Public Health. 2003;94:281–286.PubMedGoogle Scholar
  14. 14.
    Tu SP, Yasui Y, Kuniyuki AA, et al. Mammography screening among Chinese-American women. Cancer. 2003;97:1293–1302.CrossRefPubMedGoogle Scholar
  15. 15.
    NICOS. San Francisco Chinese Community Health Agenda Project/Chinese Community Health Report; 2004.Google Scholar
  16. 16.
    Asian, Inc. Table 1: Population of San Francisco, 1980 to 2000, by Race and Ethnicity. Vol. 2005.; Last accessed: April 26, 2007.Google Scholar
  17. 17.
    Jackson SL, Hislop TG, Teh C, et al. Screening mammography among Chinese Canadian women. Can J Public Health. 2003;94:275–280.PubMedGoogle Scholar
  18. 18.
    Lee MM, Lee F, Stewart S, McPhee S. Cancer screening practices among primary care physicians serving Chinese Americans in San Francisco. West J Med. 1999;170:148–155.PubMedGoogle Scholar
  19. 19.
    U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and Improving Health and Objectives for Improving Health, Vol. 2005. Washington, DC: U.S. Government Printing Office; 2000.Google Scholar
  20. 20.
    Taylor VM, Jackson JC, Tu SP, et al. Cervical cancer screening among Chinese Americans. Cancer Detect Prev. 2002;26:139–145.CrossRefPubMedGoogle Scholar
  21. 21.
    Tu SP, Jackson SL, Yasui Y, Deschamps M, Hislop TG, Taylor VM. Cancer preventive screening: a cross-border comparison of United States and Canadian Chinese women. Prev Med. 2005;41:36–46.CrossRefPubMedGoogle Scholar
  22. 22.
    McPhee SJ, Detmer WM. Office-based interventions to improve delivery of cancer prevention services by primary care physicians. Cancer. 1993;73(suppl):1100–1112.CrossRefGoogle Scholar
  23. 23.
    Shea S, DuMouchel W, Bahamonde L. A meta-analysis of 16 randomized controlled trials to evaluate computer-based clinical reminder systems for preventive care in the ambulatory setting. J Am Med Inform Assoc. 1996;3:399–409.PubMedGoogle Scholar
  24. 24.
    Goldberg D, Schiff GD, McNutt R, Furumoto-Dawson A, Hammerman M, Hoffman A. Mailings timed to patients’ appointments: a controlled trial of fecal occult blood test cards. Am J Prev Med. 2004;26:431–435.CrossRefPubMedGoogle Scholar
  25. 25.
    Toth-Pal E, Nilsson GH, Furhoff AK. Clinical effect of computer generated physician reminders in health screening in primary health care-a controlled clinical trial of preventive services among the elderly. Int J Med Inform. 2004;73:695–703.CrossRefPubMedGoogle Scholar
  26. 26.
    Szilagyi PG, Bordley C, Vann JC, et al. Effect of patient reminder/recall interventions on immunization rates: A review. Jama. 2000;284:1820–1827.CrossRefPubMedGoogle Scholar

Copyright information

© American Association for Cancer Education 2007

Authors and Affiliations

  • Cindy J. Lai
    • 1
  • Tung T. Nguyen
    • 1
  • Jimmy Hwang
    • 1
  • Susan L. Stewart
    • 1
  • Anson Kwan
    • 1
  • Stephen J. McPhee
    • 1
  1. 1.Division of General Internal Medicine, Department of MedicineUniversity o of California, San FranciscoSan Francisco

Personalised recommendations