Advertisement

Journal of General Internal Medicine

, Volume 19, Issue 2, pp 156–166 | Cite as

Barriers to colorectal cancer screening in Latino and Vietnamese Americans

Compared with non-Latino white Americans
  • Judith M. E. Walsh
  • Celia P. Kaplan
  • Bang Nguyen
  • Ginny Gildengorin
  • Stephen J. McPhee
  • Eliseo J. Pérez-Stable
Original Articles

Abstract

OBJECTIVE: To identify current colorectal cancer (CRC) screening practices and barriers to screening in the Latino, Vietnamese, and non-Latino white populations.

METHODS: We conducted a telephone survey of Latino, non-Latino white, and Vietnamese individuals living in San Jose, California. We asked about demographics, CRC screening practices, intentions to be screened, and barriers and facilitators to screening.

RESULTS: Seven hundred and seventy-five individuals (40% white, 29.2% Latino, and 30.8% Vietnamese) completed the survey (Response Rate 50%). Overall, 23% of respondents reported receipt of fecal occult blood test (FOBT) in the past year, 28% reported sigmoidoscopy (SIG) in the past 5 years, and 27% reported colonoscopy (COL) in the past 10 years. Screening rates were generally lower in Latinos and Vietnamese. Vietnamese were less likely than whites to have had SIG in the past 5 years (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.09 to 0.72), but ethnicity was not an independent predictor of FOBT or COL. Only 22% of Vietnamese would find endoscopic tests uncomfortable compared with 79% of whites (P<.05). While 21% of Latinos would find performing an FOBT embarrassing, only 8% of whites and 3% of Vietnamese felt this way (P<.05). Vietnamese were more likely than whites to plan to have SIG in the next 5 years (OR, 2.24; 95% CI, 1.15 to 4.38), but ethnicity was not associated with planning to have FOBT or COL.

CONCLUSIONS: Rates of CRC screening are lower in ethnic minority populations than in whites. Differences in attitudes and perceived barriers suggest that culturally tailored interventions to increase CRC screening will be useful in these populations

Key words

colorectal cancer screening prevention 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Kronborg O, Fenger C, Olsen J, Jorgensen OD, Sondergaard O. Randomized study of screening for colorectal cancer with fecal-occult-blood test. Lancet. 1996;348:1467–71.PubMedCrossRefGoogle Scholar
  2. 2.
    Hardcastle JD, Chamberlain JO, Robinson MH, et al. Randomised controlled trial of faecal-occult-blood screening for colorectal cancer. Lancet. 1996;348:1472–7.PubMedCrossRefGoogle Scholar
  3. 3.
    Mandel JS, Bond JH, Church TR, et al. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med. 1993;328:1365–71.PubMedCrossRefGoogle Scholar
  4. 4.
    Coffield AB, Maciosek MV, McGinnis JM, et al. Priorities among recommended clinical preventive services. Am J Prev Med. 2001;21:1–9.PubMedCrossRefGoogle Scholar
  5. 5.
    United States Preventive Services Task Force. Clinical guidelines. screening for colorectal cancer: recommendation and rationale. Ann Intern Med. 2002;137:129–31.Google Scholar
  6. 6.
    Rex DK, Johnson DA, Lieberman DA, Burt RW, Sonnenberg A. Colorectal cancer prevention 2,000: screening recommendations of the American College of Gastroenterology. Am J Gastroenterol. 2000;95:868–77.PubMedGoogle Scholar
  7. 7.
    Winawer SJ, Fletcher RH, Miller L, et al. Colorectal cancer screening: clinical guidelines and rationale. Gastroenterology. 1997;112:594–642.PubMedCrossRefGoogle Scholar
  8. 8.
    Colorectal cancer test use among persons aged ≥ 50 years—United States 2001. Morb Mortal Wkly Rep. 2003;52:193–6.Google Scholar
  9. 9.
    Perez-Stable EJ, Otero-Sabogal R, Sabogal F, McPhee SJ, Hiatt RA. Self-reported use of cancer screening tests among latinos and anglos in a prepaid health plan. Arch Intern Med. 1994;154:1073–81.PubMedCrossRefGoogle Scholar
  10. 10.
    Perez-Stable EJ, Sabogal F, Otero-Sabogal R. Use of cancer screening tests in the San Francisco Bay Area. comparison of Latinos and Anglos. J Natl. Cancer Inst. Monographs. 1995;18:147–53.PubMedGoogle Scholar
  11. 11.
    Harlan LC, Bernstein AB, Kessler LG. Cervical cancer screening, who is not screened and why? Am J Public Health. 1991;81:885–90.PubMedCrossRefGoogle Scholar
  12. 12.
    United States Government. United States Government Census Data 2000. Washington, DC: US Government Printing Office; 2000.Google Scholar
  13. 13.
    Bouvier LF, Agresta AJ. The future Asian population of the United States. In: Carino BV, ed. Pacific Bridges: The New Immigration from Asia and the Pacific Islands. Staten Island, NY: Center for Migration Studies; 1987;285–301.Google Scholar
  14. 14.
    Screening for colorectal cancer—United States 1997. Morb Mort Wkly Report. 1999;48:116–21.Google Scholar
  15. 15.
    Centers for Disease Control. Behavioral risk factor survey of Vietnamese—California, 1991. Morb Mort Wkly Report. 1992;41:69–72.Google Scholar
  16. 16.
    McPhee SJ, Jenkins CNH, Hung S, Nguyen KP, Ha NT, Fordham DC. Behaviorial risk factor survey of Vietnamese in California—1991. Morb Mort Wkly Report. 1992;41:69–72.Google Scholar
  17. 17.
    McPhee S, Bird J, Jenkins C, Ha N, Le B. Pathways to early cancer detection for Vietnamese: Suc Khoe La Vang! (Health is Gold!). Health Educ Q. 1996;23(suppl):60–75.Google Scholar
  18. 18.
    McPhee S, Bird J, Davis T, Ha N, Jenkins C, Le B. Barriers to breast and cervical cancer screening among Vietnamese-American women. Am J Prev Med. 1997;13:205–13.PubMedGoogle Scholar
  19. 19.
    McPhee SJ, Steward S, Brock KC, Bird JA, Jenkins CNH, Pham GQ. Factors associated with breast and cervical cancer screening practices among Vietnamese-American women. Cancer Detect. Prev. 1997;21:510–21.PubMedGoogle Scholar
  20. 20.
    Pasick RJ, D’Onofrio CN, Otero-Sabogal R. Similarities and differences across cultures: questions to inform a third generation for health promotion research. Health Educ Q. 1996;23(suppl):s142-s161.Google Scholar
  21. 21.
    Little R, Rubin D. Statistical Analysis with Missing Data. New York, NY: John Wiley and Sons; 1987.Google Scholar
  22. 22.
    Schafer J. Analysis of Incomplete Multivariate Data. London, UK: Chapman & Hall; 1997.Google Scholar
  23. 23.
    Allison P. Missing Data. Thousand Oaks, Calif: Sage University Papers Series on Quantitative Applications in the Social Sciences, 07-136; 2001.Google Scholar
  24. 24.
    Marin G, Sabogal F. Development of a short acculturation scale for Hispanics. Hispanic J Behav Sci. 1987;9:183–205.CrossRefGoogle Scholar
  25. 25.
    Seeff LD, Shapiro JA, Nadel MR, et al. Are we doing enough to screen for colorectal cancer: findings from the 1999 behavioral risk factor surveillance system. J Fam Pract. 2002;51:761–6.PubMedGoogle Scholar
  26. 26.
    Jenkins CNH, McPhee SJ, Bird JA, Bonilla NTH. Cancer risks and prevention practices among Vietnamese refugees. West J Med. 1990;153:34–9.PubMedGoogle Scholar
  27. 27.
    Suarez L, Goldman D, Weiss N. Validity of Pap smear and mammogram self-reports in a low-income Hispanic population. Am J Prev Med. 1995;11:94–8.PubMedGoogle Scholar
  28. 28.
    McPhee SJ, Nguyen TT, Shema SJ, et al. Validation of recall of breast and cervical cancer screening by women in ethnically diverse population. Prev Med. 2002;35:463–73.PubMedCrossRefGoogle Scholar
  29. 29.
    Nguyen TT, McPhee SJ, Nguyen T, et al. Predictors of cervical pap smear screening recognition, intention, and receipt among Vietnamese-American women. Am J Prev Med. 2002;23:207–214.PubMedCrossRefGoogle Scholar
  30. 30.
    Jenkins CNH, McPhee SJ, Bird JA, et al. Effect of a media-led education campaign on breast and cervical cancer screening among Vietnamese-American women. Prev Med. 1999;28:395–406.PubMedCrossRefGoogle Scholar
  31. 31.
    Lantz PM, Dupuis L, Reding DEA. Peer discussions of cancer among Hispanic migrant farm workers. Public Health Report. 1994;109:512–20.Google Scholar
  32. 32.
    Keefe S. Acculturation and the extended family among urban Mexican-Americans. In: Padilla AM, ed. Acculturation Theory Models and Some New Findings. Boulder, Colo: Westview Press; 1980.Google Scholar
  33. 33.
    Sabogal F, Marin G, Otero-Sabogal R, Marin BV, Perez-Stable E. Hispanic families and acculturation: what changes and what doesn’t? Hispanic J Behav Sci. 1987;9:397–412.CrossRefGoogle Scholar
  34. 34.
    Sandoval MC, De la Roza MC. A cultural perspective for serving the Hispanic client. In: Lefley HP, Pedersen PBEZ, eds. Cross Cultural Training for Mental Health Professionals. Springfield, Ill: Charles C Thomas; 1986;151–81.Google Scholar
  35. 35.
    Perez-Stable E, Otero-Sabogal R, Hiatt R, McPhee S. Misconceptions about cancer among Latinos and Anglos. JAMA 1992;268:3219–23.PubMedCrossRefGoogle Scholar
  36. 36.
    Carpenter V, Colwell B. Cancer knowledge, self-efficacy, and cancer screening behaviors among Mexican-American women. J Cancer Educ. 1995;10:217–22.PubMedGoogle Scholar
  37. 37.
    Hiatt RA, Perez-Stable EJQP Jr, Sabogal F. Otero-Sabogal R, McPhee SJ. Agreement between self-reported early cancer detection practices and medical audits in Hispanic compared with non-Hispanic white health plan members in Northern California. Prev Med. 1995;24:278–85.PubMedCrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2004

Authors and Affiliations

  • Judith M. E. Walsh
    • 1
    • 2
    • 3
  • Celia P. Kaplan
    • 1
    • 2
  • Bang Nguyen
    • 4
  • Ginny Gildengorin
    • 1
    • 2
    • 3
  • Stephen J. McPhee
    • 1
  • Eliseo J. Pérez-Stable
    • 1
    • 2
    • 3
  1. 1.the Division of General Internal Medicine, Department of MedicineUniversity of CaliforniaSan Francisco
  2. 2.Medical Effectiveness Research Center for Diverse PopulationsSan Francisco
  3. 3.Center for Aging in Diverse CommunitiesSan Francisco
  4. 4.Northern California Cancer CenterUnion City

Personalised recommendations