Colorectal cancer screening prevalence and predictors among Asian American subgroups using Medical Expenditure Panel Survey National Data

Angela U. Sy, Eunjung Lim, Lana Sue Ka’opua, Merle Kataoka-Yahiro, Yumiko Kinoshita, Susan L Stewart

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Asian American (AA) ethnic subgroups are diverse in socio-economic status, years in the United States, English proficiency, and cultures with different health seeking behaviors and health care access. Fifty-two percent of AAs age ≥50 years had colorectal cancer screening (CRCS) in 2013, compared with 61% of non-Hispanic whites. We hypothesized that CRCS prevalence among AA ethnicities is heterogeneous and that the reasons related to CRCS among AA subgroups are associated with demographic characteristics, acculturation, health care access, and health attitudes. METHODS: Medical Expenditure Panel Survey data for 2009-2014 compared CRCS status among whites (n = 28,834), Asian Indians (n = 466), Chinese (n = 652), and Filipinos (n = 788). Multivariate logistic regression examined ethnic differences and correlates of CRCS accounting for complex sampling design. RESULTS: Whites had the highest prevalence of screening (62.3%), followed by Filipinos (55.0%), Chinese (50.9%), and Asian Indians (48.6%). Older age, having health insurance, and having a usual care provider predicted CRCS across all ethnicities. Different demographic, health care access, and health attitude predictors within each ethnic group were related to CRCS. CONCLUSION: This study contributes to the literature on influences of differential CRCS prevalence among AA subgroups. CRCS promotion should be tailored according to attitudes and structural barriers affecting screening behavior of specific ethnic subgroups to truly serve the health needs of the diverse AA population. Cancer 2018;124:1543-51.

Original languageEnglish (US)
Pages (from-to)1543-1551
Number of pages9
JournalCancer
Volume124
DOIs
StatePublished - Apr 1 2018

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Asian Americans
Health Expenditures
Early Detection of Cancer
Colorectal Neoplasms
Attitude to Health
Patient Acceptance of Health Care
Demography
Delivery of Health Care
Surveys and Questionnaires
Acculturation
Health
Health Insurance
Ethnic Groups
Logistic Models
Economics

Keywords

  • Asian Americans
  • Asian Indians
  • Chinese
  • colorectal cancer screening
  • Filipino

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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Colorectal cancer screening prevalence and predictors among Asian American subgroups using Medical Expenditure Panel Survey National Data. / Sy, Angela U.; Lim, Eunjung; Ka’opua, Lana Sue; Kataoka-Yahiro, Merle; Kinoshita, Yumiko; Stewart, Susan L.

In: Cancer, Vol. 124, 01.04.2018, p. 1543-1551.

Research output: Contribution to journalArticle

Sy, Angela U. ; Lim, Eunjung ; Ka’opua, Lana Sue ; Kataoka-Yahiro, Merle ; Kinoshita, Yumiko ; Stewart, Susan L. / Colorectal cancer screening prevalence and predictors among Asian American subgroups using Medical Expenditure Panel Survey National Data. In: Cancer. 2018 ; Vol. 124. pp. 1543-1551.
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abstract = "BACKGROUND: Asian American (AA) ethnic subgroups are diverse in socio-economic status, years in the United States, English proficiency, and cultures with different health seeking behaviors and health care access. Fifty-two percent of AAs age ≥50 years had colorectal cancer screening (CRCS) in 2013, compared with 61{\%} of non-Hispanic whites. We hypothesized that CRCS prevalence among AA ethnicities is heterogeneous and that the reasons related to CRCS among AA subgroups are associated with demographic characteristics, acculturation, health care access, and health attitudes. METHODS: Medical Expenditure Panel Survey data for 2009-2014 compared CRCS status among whites (n = 28,834), Asian Indians (n = 466), Chinese (n = 652), and Filipinos (n = 788). Multivariate logistic regression examined ethnic differences and correlates of CRCS accounting for complex sampling design. RESULTS: Whites had the highest prevalence of screening (62.3{\%}), followed by Filipinos (55.0{\%}), Chinese (50.9{\%}), and Asian Indians (48.6{\%}). Older age, having health insurance, and having a usual care provider predicted CRCS across all ethnicities. Different demographic, health care access, and health attitude predictors within each ethnic group were related to CRCS. CONCLUSION: This study contributes to the literature on influences of differential CRCS prevalence among AA subgroups. CRCS promotion should be tailored according to attitudes and structural barriers affecting screening behavior of specific ethnic subgroups to truly serve the health needs of the diverse AA population. Cancer 2018;124:1543-51.",
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AB - BACKGROUND: Asian American (AA) ethnic subgroups are diverse in socio-economic status, years in the United States, English proficiency, and cultures with different health seeking behaviors and health care access. Fifty-two percent of AAs age ≥50 years had colorectal cancer screening (CRCS) in 2013, compared with 61% of non-Hispanic whites. We hypothesized that CRCS prevalence among AA ethnicities is heterogeneous and that the reasons related to CRCS among AA subgroups are associated with demographic characteristics, acculturation, health care access, and health attitudes. METHODS: Medical Expenditure Panel Survey data for 2009-2014 compared CRCS status among whites (n = 28,834), Asian Indians (n = 466), Chinese (n = 652), and Filipinos (n = 788). Multivariate logistic regression examined ethnic differences and correlates of CRCS accounting for complex sampling design. RESULTS: Whites had the highest prevalence of screening (62.3%), followed by Filipinos (55.0%), Chinese (50.9%), and Asian Indians (48.6%). Older age, having health insurance, and having a usual care provider predicted CRCS across all ethnicities. Different demographic, health care access, and health attitude predictors within each ethnic group were related to CRCS. CONCLUSION: This study contributes to the literature on influences of differential CRCS prevalence among AA subgroups. CRCS promotion should be tailored according to attitudes and structural barriers affecting screening behavior of specific ethnic subgroups to truly serve the health needs of the diverse AA population. Cancer 2018;124:1543-51.

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