Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans.

Routinely recommended screening for breast, cervical, and colorectal cancers can significantly reduce mortality from these types of cancer, yet screening is underutilized among Asians. Surveys rely on self-report and often are underpowered for analysis by Asian ethnicities. Electronic health records (EHR) include validated (as opposed to recall-based) rates of cancer screening. In this article, we seek to better understand cancer screening patterns in a population of insured Asian Americans. We calculated rates of compliance with cervical, breast, and colorectal cancer screening among Asians from an EHR population and compared them with non-Hispanic whites. We performed multivariable modeling to evaluate potential predictors (at the provider- and patient-level) of screening completion among Asian patients. Aggregation of Asian subgroups masked heterogeneity in screening rates. Asian Indians and native Hawaiians and Pacific Islanders had the lowest rates of screening in our sample, well below that of non-Hispanic whites. In multivariable analyses, screening completion was negatively associated with patient-physician language discordance for mammography [OR, 0.81; 95% confidence interval (CI), 0.71-0.92] and colorectal cancer screening (OR, 0.79; CI, 0.72-0.87) and positively associated with patient-provider gender concordance for mammography (OR, 1.16; CI, 1.00-1.34) and cervical cancer screening (OR, 1.66; CI, 1.51-1.82). In addition, patient enrollment in online health services increased mammography (OR, 1.32; CI, 1.20-1.46) and cervical cancer screening (OR, 1.31; CI, 1.24-1.37). Language- and gender-concordant primary care providers and culturally tailored online health resources may help improve preventive cancer screening in Asian patient populations. This study demonstrates how the use of EHR data can inform investigations of primary prevention practices within the healthcare delivery setting.

Thompson CA ，Gomez SL ，Chan A ，Chan JK ，McClellan SR ，Chung S ，Olson C ，Nimbal V ，Palaniappan LP ... -  《-》

Perceived discrimination is associated with reduced breast and cervical cancer screening: the Study of Women's Health Across the Nation (SWAN).

Jacobs EA ，Rathouz PJ ，Karavolos K ，Everson-Rose SA ，Janssen I ，Kravitz HM ，Lewis TT ，Powell LH ... -  《-》

Breast and cervical cancer screening among Asian subgroups in the USA: estimates from the National Health Interview Survey, 2008, 2010, and 2013.

Shoemaker ML ，White MC 《-》

Low health literacy and cancer screening among Chinese Americans in California: a cross-sectional analysis.

Cancer is the leading cause of death among Asian Americans. Chinese Americans comprise the largest Asian American ethnic group. Low health literacy (LHL) is associated with lower cancer screening rates, but this association has not been studied in Chinese Americans. We examined the relationship between LHL and meeting US Preventive Service Task Force (USPSTF) guidelines for cervical, colorectal and breast cancer screening among Chinese Americans. Observational study of Chinese respondents in the 2007 California Health Interview Survey, a population-based survey. Interview languages included English, Cantonese and Mandarin. California, USA PARTICIPANTS: Chinese respondents in age/gender groupings appropriate for USPSTF cancer screening guidelines (cervical: women ages 21-65, n=632; colorectal: men or women ages 50-75, n=488; and breast: women ages 50-74, n=326). Relationships were tested using multivariable logistic regression models controlling for healthcare access and demographic factors, including limited English proficiency (LEP). The combined effects of having both LHL and LEP were specifically examined. LHL was measured by 2-items on perceived ease-of-use of written medical materials. All study variables were self-reported. Cancer screening percentages among Chinese Americans were 77.8% for cervical, 50.9% for colorectal (47.9% for women and 54.2% for men), and 85.5% for breast. LHL was associated with lower odds of meeting breast cancer screening guidelines (OR 0.41; 95% CI 0.20 to 0.82). Respondents with both LHL and LEP were significantly less likely to have up-to-date colorectal (OR 0.49; 95% CI 0.25 to 0.97) and breast cancer screening (OR 0.21; 95% CI 0.08 to 0.54) than those with neither health communication barrier. In all multivariable models, having seen a physician in the past year was a significant predictor of an up-to-date screening. In Chinese Americans, LHL and LEP were negatively associated with up-to-date breast and colorectal cancer screening, independent of a recent physician visit. Efforts to promote cancer screening among Chinese Americans should consider and address LHL, LEP and physician access barriers.

Sentell TL ，Tsoh JY ，Davis T ，Davis J ，Braun KL ... -  《BMJ Open》

Patient-physician language concordance and use of preventive care services among limited English proficient Latinos and Asians.

Jih J ，Vittinghoff E ，Fernandez A 《-》