Colorectal cancer screening behaviors among Korean Americans

Background Colorectal cancer is the third most common cancer and is the second leading cause of cancer deaths in the United States. Although the incidence of colorectal cancer has been decreasing with colorectal cancer screenings, disparities of colorectal cancer and screening prevalence exist for racial and ethnic groups. The colorectal cancer is the most commonly diagnosed cancer of Korean American men and the second most common cancer of Korean American women. The incidence of colorectal cancer has dramatically increased in Korean Americans, however, there is little known about their colorectal cancer screening behaviors and the factors that may predict screening behaviors have not been fully investigated. Purposes The purposes of this study were to: 1) describe colorectal cancer screening behaviors of Korean Americans, 2) identify predictors and barriers influencing colorectal cancer screening behaviors, 3) identify the differences in colorectal cancer screening behaviors between men and women, and 4) identify the differences in colorectal cancer screening behaviors between new immigrants who have lived in the United States less than 10 years and those who have lived in the United States more than 10 years. Methods The Health Belief Model was a theoretical framework and a cross-sectional descriptive design was used with a survey. A sample of 254 Korean Americans participated in this study. Correlation, Chi-square, and Multiple logistic regression were used to analyze data. Results In this study, Korean American had lower rates of colorectal cancer screenings compared to the United States general population. Only 20% of the sample had ever had a fecal occult blood test, 49% had ever had a colonoscopy, and 19% had ever had a sigmoidoscopy in their lifetime. Korean Americans had low rates of annual physical exam and periodic cancer screening, moderate colorectal cancer knowledge, low cancer fatalism, limited colorectal cancer literacy, lack of health care access, and a low rate of receiving the physician’s recommendation of colorectal cancer screenings. The greatest predictors influencing colorectal cancer screening were annual physical exam and periodic cancer screening for a fecal occult blood test, and the physician’s recommendation for a colonoscopy and a sigmoidoscopy. There were no significant differences by gender in colorectal cancer screening behaviors. However, significant differences were found between the two groups divided by length of United States residence. Although there were no significant differences in awareness, knowledge, and literacy of colorectal cancer and screening, and perceived benefits of screening, new immigrants had lower rates of all three colorectal cancer screenings, lower annual physical exam and periodic cancer screening, higher uninsured, less receiving physician’s recommendation, and higher perceived barriers to colorectal cancer screening than those who have lived in the United States >10 years. Implications The findings of this study suggest that improved efforts are needed to increase colorectal cancer screenings among Korean Americans. Further research is needed to increase a physician’s recommendation for colorectal cancer screenings and awareness for the importance of annual checkups and periodic cancer screening among Korean Americans.