Abstract
BACKGROUND: Nonadherence to colorectal cancer (CRC) screening among Asian Americans is high but not well understood. This study examined correlates of screening intention among Filipino, Hmong, and Korean Americans who were nonadherent to CRC screening. METHODS: Using cross-sectional, preintervention survey data from 504 Asian Americans (115 Filipinos, 185 Hmong, and 204 Koreans) aged 50-75 years who were enrolled in a multisite cluster randomized controlled trial of lay health educator intervention, we analyzed correlates of self-reported CRC screening nonadherence, which was defined as not being up-to-date for fecal occult blood test, sigmoidoscopy, or colonoscopy. RESULTS: Only 26.8% of participants indicated intention to obtain screening within 6 months (Hmong: 12.4%; Korean: 30.8%; and Filipino: 42.6%; P < .001). Only one third of participants had undergone a prior screening, and a majority did not know that screening is a method of CRC prevention method (61.3%) or had any knowledge of CRC screening guidelines (53.4%). Multivariable analyses revealed that patient-provider ethnicity concordance, provider's recommendation of screening, participants' prior CRC screening, perceived severity and susceptibility of CRC, and knowledge of guidelines were positively associated with screening intention. Specifically, knowing one or more screening guidelines doubled the odds of screening intention (adjusted odds ratio, 2.38; 95% confidence interval, 1.32-4.28). Hmong were less likely to have screening intention than Filipinos, which was unexplained by socio-demographics, health care factors, perceived needs for CRC screening, or knowledge of screening guidelines. CONCLUSION: CRC screening intention among nonadherent Filipino, Hmong, and Korean Americans was low. Targeting knowledge of CRC screening guidelines may be effective strategies for increasing CRC screening intention among nonadherent Asian Americans. Cancer 2018;124:1560-7. © 2018 American Cancer Society.