Exploring Gender and Ethnic Variances in Colorectal Cancer Screening Practices Among Japanese, Filipino, and Chinese Americans in Hawaii

Exploring Gender and Ethnic Variances in Colorectal Cancer Screening Practices among Japanese, Filipino, and Chinese Americans in Hawaiʽi.

Abstract

Background/Purpose

Colorectal cancer (CRC) is unique from other types of cancer in that it is the only type of cancer screening where both genders are recommended to adhere to screening practices, receive the same options in screening modalities, and face similar risks. However, the examination of gender in CRC among the disaggregated Asian American (AA) population is under-researched and the exploration of how gender influences the underuse of screenings is warranted. Maintaining regular colorectal cancer screening practice (CCSP) is crucial for prevention and early detection and AA continue to experience high mortality rates due to CRC compared to other race/ethnic groups. This study disaggregates the AA population and examines CCSP among the three largest AA sub-groups in Hawaiʽi: Japanese, Filipino, and Chinese. Exploring the gender and ethnic variances in CCSP may shed light on their respective CCSP and unique characteristics.

Methods

The 2012 Behavioral Risk Factor Surveillance Survey (BRFSS) in Hawai’i was used for this study. Sample sizes included: Whites, n = 1659, Japanese, n = 761; Filipino, n = 335; Chinese, n = 193. CCSP was determined by 1) ever had blood stool test (BST) using home kit and 2) ever had sigmoidoscopy/colonoscopy (SC). We used chi-square analyses and simple bivariate and multiple logistic regression analyses to examine the association between CCSP, gender, ethnicity, and other sociodemographic and healthcare variables.

Results

Bivariate analyses indicated significant gender differences for BST among the total sample and Japanese, but not for SC. Overall, women are more likely to ever had a BST compared to men (χ² = 4.950, p <.05). More specifically, Japanese women are more likely to ever had a BST compared to Japanese men (χ² = 4.556, p <.05). Multivariate analyses indicated that men are less likely to have had a BST than women (odds ratio [OR] = .815, p < .01). Simple logistic regression analyses indicated ethnic variances. Filipinos are less likely to have had a BST and SC (OR = .590, p <.001; OR = .484, p <.001, respectively) and Japanese are more likely to have had SC (OR = 1.372, p <.01) when compared to Whites. Multivariate logistic regressions indicated that age significantly increased likelihood for BST; and single, HS graduate or less, and not having healthcare significantly decreased the likelihood for BST. Age and unemployment significantly increased likelihood for SC; and single, HS graduate or less, and not having healthcare significantly decreased likelihood for SC.

Conclusions and Implications

Unique ethnic variance in CCSP related with different sociodemographic and healthcare variables were revealed. Gender differences in CCSP among Japanese when conducting bivariate analyses were found, however, no gender variance was found when taking other covariates into account. Tailored approaches to reduce colorectal cancer screening disparities among AA are needed that may promote screening uptake.