ASPO Abstracts
Colorectal cancer screening among foreign-born older adults living in the US: Gender and Racial differences
Category: Cancer Health Disparities, Early Detection & Risk Prediction
Conference Year: 2018
Abstract Body:
Background Previous research has explored disparities in colorectal cancer screening (CRCS) between foreign- and US-born individuals, but national level studies on CRC behaviors among foreign-born individuals are limited. We examined gender and racial/ethnic differences in CRCS among foreign-born older adults in the US, and additional factors impacting their screening behaviors including acculturation. Methods Data were from the 2013 and 2015 National Health Interview Survey data on older adult women (N=2253) and men (n=1752) aged 50 to 75 years. Up-to-date CRCS was defined as a fecal occult blood (FOBT) test within 1 year, a sigmoidoscopy (SIG) within 5 years, or a colonoscopy (COL) within 10 years. We used multivariable logistic regression analysis to determine whether gender and race/ethnicity were associated with CRCS after controlling for sociodemographic, health access, and acculturation related factors. Analyses were stratified by gender to evaluate associations of interactions between gender and race/ethnicity, as well as gender and US citizenship with CRCS. All data were weighted to account for complex sampling methods. Results Of the 4005 foreign-born participants, 49.83% had up-to-date CRCS. Difference in CRCS between women (51.40%) and men (47.90%) was marginally significant, P ‰¤ 0.06. However, there was a significant difference in CRCS among Whites (58.078%), Hispanics (43.03%), Blacks (54.06%), and Asians (50.39%), P < 0.01. Overall, Asians were significantly less likely to report CRCS compared with Whites (AOR: 0.74, CI: 0.59- 0.93). US citizenship (AOR: 1.35, 95% CI: 1.11-1.65), was associated with increased screening among women. Additional factors associated with increased CRCS included: increased age (65 years), higher income and education, having health insurance and having a usual source of healthcare. In analyses stratified by gender, race/ethnicity was associated with CRCS among women, but not men. Asian women were less likely to report CRCS (AOR: 0.69, CI: 0.50-0.96) than white women. Conclusion Prevalence of CRCS is low among racial/ethnic minority immigrants, particularly Hispanics, in the US. Screening disparities experienced by these immigrants may be addressed by improving healthcare access, especially for noncit
Keywords: Colorectal cancer screening foreign-born individuals older adults race/ ethnicity