Colorectal cancer screening disparities in Asian Americans and Pacific Islanders: which groups are most vulnerable?
Colorectal cancer screening disparities in Asian Americans and Pacific Islanders: which groups are most vulnerable?
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DOI：
10.1080/13557858.2011.575219
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发表时间：
2011-01-01
影响因子：
3.1
通讯作者：
Townsend, Aloen
中科院分区：
文献类型：
--
作者：
Lee, Hee Yun;Lundquist, Melissa;Townsend, Aloen
背景资料。结直肠癌(CRC)是亚裔美国人和太平洋岛民(AAPIs)死亡的一个重要原因，但研究一直报告AAPIs的CRC筛查率低于非拉丁裔白人和非裔美国人。此外，现有研究倾向于在报告结直肠癌筛查时将AAPI合并为一个组，掩盖了AAPI组之间存在的癌症筛查中不成比例的负担。这项研究考察了聚集和分类的AAPI群体与非拉丁裔白人在CRC筛查率方面的差异，以确定在获得CRC筛查方面最脆弱的AAPI亚群。这项研究使用了2001年、2003年和2005年加州健康访谈调查(CHIS)的合并数据，特别是来自七个AAPI群体(中国、日本、韩国、菲律宾、南亚、越南和太平洋岛民)和非拉丁裔白人的50岁及以上成年人(n=52,491)的数据。利用Andersen的卫生服务利用行为模型来筛选结直肠癌筛查中种族/民族差异的潜在混杂因素。当AAPI群体被视为一个集合时，他们的CRC筛查率(46.8%)低于非拉丁裔白人(57.7%)。当对AAPI组进行分类时，注意到进一步的差异：韩国人(32.7%)的结直肠癌筛查率最低，而日本人(59.8%)最高。当潜在的诱因、诱因和需求混杂因素的影响被调整后，韩国人、菲律宾人和南亚人接受结直肠癌筛查的可能性比非拉丁裔白人低。AAPI亚组之间的比较进一步显示，菲律宾人、韩国人、太平洋岛民和南亚人接受结直肠癌筛查的可能性低于中国人、日本人和越南人。这些结果强调了确定AAPI分类亚组之间结直肠癌筛查行为差异的重要性，以帮助卫生专业人员和政策制定者优先考虑哪些AAPI亚组在促进结直肠癌筛查方面需要最紧迫的干预措施。
Background. Colorectal cancer (CRC) is a significant cause of mortality among Asian Americans and Pacific Islanders (AAPIs), yet studies have consistently reported lower CRC screening rates among AAPIs than among non-Latino Whites and African Americans. Moreover, existing research tends to aggregate AAPIs as one group when reporting CRC screening, masking the disproportionate burden in cancer screening that exists across AAPI groups.Methods. This study examines differences in CRC screening rates in both aggregated and disaggregated AAPI groups as compared with non-Latino Whites in order to identify the most vulnerable AAPI subgroups in terms of obtaining CRC screening. This study utilizes merged data from the 2001, 2003, and 2005 California Health Interview Survey (CHIS), specifically the data pertaining to adults aged 50 and older (n = 52,491) from seven AAPI groups (Chinese, Japanese, Korean, Filipino, South Asian, Vietnamese, and Pacific Islander) and non-Latino Whites. Andersen's Behavioral Model of Health Services Use was utilized to select potential confounders to racial/ethnic differences in CRC screening.Results. When AAPI groups were considered as an aggregate, their CRC screening rate (46.8%) was lower than that of non-Latino Whites (57.7%). When AAPI groups were disaggregated, further disparity was noted: Koreans (32.7%) showed the lowest CRC screening rate, whereas Japanese (59.8%) had the highest. When the influence of potential predisposing, enabling, and need confounders was adjusted, Koreans, Filipinos, and South Asians were found to have a lower likelihood than non-Latino Whites to undergo CRC screening. Comparisons among AAPI subgroups further revealed that Filipinos, Koreans, Pacific Islanders, and South Asians were less likely than Chinese, Japanese, and Vietnamese to receive CRC screening.Conclusion. These results highlight the importance of identifying differences in CRC screening behavior among disaggregated AAPI subgroups in order to help health professionals and policy-makers prioritize which AAPI subgroups need the most urgent interventions in terms of CRC screening promotion.