Correlates of colorectal cancer screening among South Asian immigrants in the United States

Cancer Nurs. Jan-Feb 2014;37(1):E19-27. doi: 10.1097/NCC.0b013e31828db95e.


Background: South Asians are a rapidly increasing population in the United States. Little is known about influences on their cancer screening behaviors, an important prerequisite to designing culturally appropriate education.

Objective: The purpose of this study was to evaluate rates and correlates of colorectal cancer (CRC) screening, knowledge, and beliefs among South Asians.

Methods: A subsample of those 50 years or older (n = 275) was drawn from the South Asian Health Descriptor Study, an assessment of multiple health indicators conducted in Chicago, Illinois.

Results: Indians represented 87% of the sample; 2.2% of participants believed that they were at risk for CRC; 8% reported a past stool blood test (SBT); and 13.6% had had a sigmoidoscopy or colonoscopy. Language acculturation (adjusted odds ratio [AOR], 1.93; confidence interval [CI], 1.1-3.5) and medical mistrust (AOR, 0.243; CI, 0.091-0.650) were significantly related to SBT completion. Language acculturation (AOR, 3.30; CI, 1.8-5.5), income (AOR, 2.70; CI, 1.0-7.1), living in the United States for more than 5 years (AOR, 8.6; CI, 1.9-14.5), perception of CRC risk (AOR, 8.9; CI, 1.1-17.7), and past SBT (AOR, 5.0; CI, 1.8-14.0) were significantly related to endoscopic cancer screening.

Conclusions: Facilitators and barriers to different CRC tests vary. Education to increase CRC screening may need to be targeted to culture and specific barriers to each screening test rather than generic messages for all screening tests.

Implications for practice: Because barriers to CRC screening may differ among people based on the specific screening test being recommended. Primary care practitioners should recognize this fact and identify different barriers to enhance adherence to screening recommendations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asian Americans* / statistics & numerical data
  • Colonoscopy / nursing*
  • Colorectal Neoplasms / diagnosis
  • Colorectal Neoplasms / ethnology
  • Colorectal Neoplasms / nursing*
  • Culture
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Illinois / epidemiology
  • Male
  • Mass Screening* / methods
  • Middle Aged
  • Occult Blood*
  • Patient Compliance* / statistics & numerical data
  • Psychometrics
  • Reproducibility of Results
  • Sigmoidoscopy / nursing
  • United States / epidemiology