The influence of culture and cancer worry on colon cancer screening among older Chinese-American women

Abstract

Objectives: This study investigated the hypothesis that adherence to colon cancer screening guidelines among Chinese women was associated with Eastern cultural views and anxiety about developing colon cancer.

Design: Cross-sectional data from a community-based longitudinal study were used to examine the hypothesis of this study. Measures of sociodemographics, medical access factors, cultural views of health care, cancer worry, and practices of colon cancer screening were administered by a computer assisted telephone interview.

Participants: Four hundred and thirty-three Chinese-American women from Metropolitan Washington, DC age 50 years and older and without a history of colon cancer completed the telephone interview.

Main outcome measure: Adherence to utilization of either fecal occult blood test (FOBT) within a year, sigmoidoscopy within five years, or colonoscopy within 10 years was used to define two outcome categories: current screeners and noncurrent screeners.

Results: Controlling for covariates, this study found that: 1) women with more Eastern cultural views were less likely to be current screeners; 2) women who thought about the chance of getting colon cancer had approximately three-fold greater odds of being current screeners than women who never thought about colon cancer; and 3) women receiving physician recommendation for colon cancer screening had more than three-fold increased odds of being current screeners than those who had not received a recommendation.

Conclusions: In addition to the lack of physician recommendation, older Chinese women face cultural and psychological barriers to obtaining timely colon cancer screening. These barriers may be reduced through culturally sensitive intervention studies.