Background
Methods
Outcome variable
Statistical analysis
Reasons for not receiving CRC screening
Doctor recommendation
Results
Asian American Group | |||||
---|---|---|---|---|---|
Japanese (N = 619) | Chinese (N = 1,432) | Filipino (N = 753) | Korean (N = 675) | Vietnamese (N = 709) | |
Year | |||||
2001 | .74 (.66, .81) | .59 (.54, .65) | .56 (.48, .63) | .49 (.42, .57) | .51 (.45, .57) |
2003 | .74 (.66, .82) | .63 (.57, .69) | .54 (.45, .63) | .40 (.31, .50) | .58 (.49, .67) |
2005 | .81 (.76, .86) | .64 (.58, .69) | .65 (.57, .72) | .34 (.56, .42) | .60 (.52, .68) |
Age | |||||
50-64 yr | .64 (.57, .71) | .54 (.49, .58) | .54 (.48, .59) | .38 (.31, .44) | .52 (.46, .58) |
≥ 65 yr | .84 (.79, .89) | .74 (.70, .78) | .65 (.57, .72) | .47 (.39, .54) | .70 (.63, .76) |
Gender | |||||
Male | .74 (.68, .81) | .61 (.56, .66) | .61 (.53, .68) | .37 (.31, .44) | .53 (.46, .60) |
Female | .77 (.72, .83) | .63 (.59, .68) | .57 (.51, .62) | .43 (.37, .49) | .61 (.53, .68) |
Education | |||||
≤ 12 yrs | .79 (.72, .87) | .59 (.54, .64) | .58 (.49, .67) | .38 (.30, .45) | .60 (.55, .66) |
>12 yrs | .75 (.69, .80) | .65 (.61, .70) | .58 (.53, .64) | .44 (.37, .50) | .48 (.39, .57) |
Marital status | |||||
Not married | .69 (.60, .77) | .66 (.60, .72) | .55 (.46, .63) | .40 (.31, .48) | .60 (.51, .69) |
Married | .81 (.76, .86) | .61 (.58, .65) | .60 (.54, .65) | .41 (.35, .47) | .56 (.50, .62) |
Employment status | |||||
Not employed | .84 (.80, .88) | .69 (.65, .73) | .60 (.53, .68) | .47 (.41, .53) | .67 (.61, .72) |
Employed | .62 (.54, .70) | .54 (.48, .59) | .57 (.50, .63) | .34 (.28, .41) | .41 (.33, .49) |
Federal poverty level | |||||
0-99% FPL | .75 (.49, 1.00) | .59 (.52, .66) | .46 (.30, .63) | .42 (.32, .52) | .58 (.51, .65) |
100-199% FPL | .73 (.60, .86) | .64 (.57, .70) | .55 (.45, .65) | .39 (.30, .49) | .61 (.51, .70) |
200-299% FPL | .80 (.71, .89) | .54 (.45, .64) | .58 (.46, .69) | .38 (.26, .51) | .51 (.36, .67) |
≥ 300% FPL | .77 (.71, .82) | .66 (.60, .71) | .62 (.56, .68) | .42 (.33, .51) | .54 (.42, .65) |
English proficiency | |||||
NA*/very well | .80 (.76, .85) | .71 (.64, .77) | .62 (.56, .68) | .54 (.34, .74) | .56 (.31, .81) |
Well/not well/not at all well | .62 (.52, .73) | .60 (.57, .64) | .54 (.47, .60) | .40 (.35, .45) | .57 (.52, .62) |
Health insurance | |||||
No | .32 (.00, .69) | .27 (.18, .35) | .26 (.12, .40) | .27 (.18, .36) | .58 (.46, .69) |
Yes | .77 (.73, .81) | .67 (.63, .70) | .60 (.56, .65) | .46 (.41, .52) | .57 (.52, .62) |
Usual source of care | |||||
No | .31 (.14, .49) | .26 (.18, .35) | .30 (.12, .47) | .27 (.18, .37) | .23 (.05, .41) |
Yes | .78 (.74, .82) | .66 (.62, .69) | .59 (.55, .64) | .44 (.38, .49) | .59 (.54, .64) |
Most recent doctor's visit | |||||
>1 yr ago | .41 (.24, .58) | .23 (.16, .31) | .45 (.26, .64) | .24 (.14, .34) | .30 (.16, .45) |
Past yr | .80 (.76, .84) | .68 (.65, .72) | .59 (.54, .64) | .45 (.34, .50) | .60 (.55, .65) |
Model 1 | Model 2 | Model 3 | Model 4 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
OR | 95% CI | p | OR | 95% CI | p | OR | 95% CI | p | OR | 95% CI | p | |
Ethnicity | ||||||||||||
Japanese (ref) | ||||||||||||
Chinese | 0.62 | (0.39, 1.00) |
.049
| 0.73 | (0.46, 1.17) | .188 | 0.96 | (0.59, 1.56) | .862 | 1.03 | (0.62, 1.70) | .921 |
Filipino | 0.53 | (0.31, 0.91) |
.022
| 0.60 | (0.35, 1.02) | .060 | 0.67 | (0.39, 1.17) | .159 | 0.61 | (0.35, 1.06) | .082 |
Korean | 0.41 | (0.24, 0.71) |
.001
| 0.49 | (0.29, 0.83) |
.008
| 0.67 | (0.38, 1.17) | .159 | 0.83 | (0.45, 1.54) | .559 |
Vietnamese | 0.46 | (0.28, 0.77) |
.003
| 0.67 | (0.40, 1.14) | .138 | 0.90 | (0.51, 1.56) | .702 | 0.80 | (0.46, 1.41) | .442 |
Year | ||||||||||||
2001 (ref) | ||||||||||||
2003 | 1.05 | (0.58, 1.92) | .867 | 1.01 | (0.56, 1.82) | .974 | 1.02 | (0.57, 1.82) | .958 | 0.98 | (0.55, 1.76) | .948 |
2005 | 1.59 | (0.91, 2.79) | .102 | 1.61 | (0.94, 2.78) | .085 | 1.64 | (0.94, 2.86) | .082 | 1.74 | (1.00, 3.05) | .052 |
Ethnicity × Year | ||||||||||||
Japanese × 2003 (ref) | ||||||||||||
Japanese × 2005 (ref) | ||||||||||||
Chinese × 2003 | 1.12 | (0.57, 2.18) | .749 | 1.19 | (0.61, 2.30) | .615 | 1.18 | (0.60, 2.28) | .633 | 1.11 | (0.57, 2.17) | .759 |
Chinese × 2005 | 0.75 | (0.40, 1.44) | .391 | 0.75 | (0.40, 1.42) | .383 | 0.74 | (0.39, 1.41) | .356 | 0.65 | (0.33, 1.26) | .202 |
Filipino × 2003 | 0.89 | (0.39, 2.01) | .775 | 0.85 | (0.37, 1.93) | .694 | 0.83 | (0.36, 1.89) | .649 | 0.85 | (0.37, 1.94) | .700 |
Filipino × 2005 | 0.91 | (0.45, 1.84) | .789 | 0.88 | (0.44, 1.79) | .727 | 0.88 | (0.43, 1.82) | .734 | 0.85 | (0.41, 1.78) | .669 |
Korean × 2003 | 0.64 | (0.30, 1.39) | .259 | 0.69 | (0.32, 1.48) | .339 | 0.68 | (0.31, 1.46) | .319 | 0.64 | (0.28, 1.46) | .289 |
Korean × 2005 | 0.33 | (0.15, 0.69) | .004
| 0.32 | (0.15, 0.67) |
.003
| 0.32 | (0.15, 0.68) |
.003
| 0.26 | (0.12, 0.58) |
.001
|
Vietnamese × 2003 | 1.29 | (0.61, 2.76) | .502 | 1.33 | (0.63, 2.80) | .458 | 1.33 | (0.63, 2.81) | .450 | 1.42 | (0.66, 3.05) | .372 |
Vietnamese × 2005 | 0.96 | (0.48, 1.93) | .906 | 0.86 | (0.43, 1.72) | .677 | 0.87 | (0.43, 1.76) | .708 | 0.83 | (0.41, 1.69) | .605 |
Age | 1.05 | (1.03, 1.06) |
<.001
| 1.05 | (1.03, 1.06) |
<.001
| 1.05 | (1.03, 1.06) |
<.001
| 1.04 | (1.02, 1.05) |
<.001
|
Age × age | .998 | (.997, .999) |
.001
| .998 | (.998, .999) |
.003
| .998 | (.997, .999) |
.002
| .998 | (.998, .999) |
.001
|
Gender | ||||||||||||
Male (ref) | ||||||||||||
Female | 1.06 | (0.90, 1.25) | .501 | 1.13 | (0.94, 1.37) | .187 | 1.12 | (0.93, 1.35) | .239 | 1.05 | (0.86, 1.27) | .637 |
Education | ||||||||||||
≤ 12 years (ref) | ||||||||||||
> 12 years | 1.12 | (0.90, 1.39) | .308 | 1.06 | (0.85, 1.32) | .593 | 1.04 | (0.83, 1.30) | .721 | |||
Marital status | ||||||||||||
Not married (ref) | ||||||||||||
Married | 1.29 | (1.04, 1.58) |
.018
| 1.28 | (1.04, 1.58) |
.019
| 1.25 | (1.00, 1.56) |
.046
| |||
Employment status | ||||||||||||
Not employed (ref) | ||||||||||||
Employed | 0.67 | (0.53, 0.84) |
.001
| 0.66 | (0.53, 0.83) |
.001
| 0.66 | (0.52, 0.83) |
<.001
| |||
Federal poverty level | ||||||||||||
0-99% (ref) | ||||||||||||
100-199% | 1.30 | (0.98, 1.72) | .074 | 1.29 | (0.97, 1.72) | .076 | 1.29 | (0.96, 1.72) | .089 | |||
200-299% | 1.42 | (1.00, 2.03) | .051 | 1.36 | (0.96, 1.94) | .087 | 1.32 | (0.92, 1.89) | .129 | |||
≥ 300% | 2.12 | (1.53, 2.94) |
<.001
| 1.89 | (1.37, 2.60) |
<.001
| 1.67 | (1.20, 2.33) |
.003
| |||
English Proficiency | ||||||||||||
Well/not/not at all well (ref) | ||||||||||||
NA/very well | 1.65 | (1.28, 2.11) |
<.001
| 1.59 | (1.22, 2.06) |
.001
| ||||||
Health insurance | ||||||||||||
No (ref) | ||||||||||||
Yes | 1.48 | (1.09, 2.00) |
.011
| |||||||||
Usual source of care | ||||||||||||
No (ref) | ||||||||||||
Yes | 2.15 | (1.49, 3.10) |
<.001
| |||||||||
Most recent doctor's visit | ||||||||||||
> 1 year (ref) | ||||||||||||
≤ 1 year | 2.92 | (2.11, 4.05) |
<.001
| |||||||||
P-value, joint significance of added covariates (adjusted Wald test) |
<.001
|
<.001
|
<.001
|
Japanese | Chinese | Filipino | Korean | Vietnamese | Total | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
n | % | n | % | n | % | n | % | n | % | n | % | |
Reasons for not receiving endoscopy
| ||||||||||||
Unaware of test | 61 | 51% | 150 | 53% | 110 | 53% | 81 | 46% | 101 | 47% | 503 | 50% |
Have no health problems | 23 | 19% | 60 | 21% | 45 | 22% | 65 | (+)37% | 84 | (+)39% | 277 | 28% |
Fear of pain/embarrassed | 11 | 9% | 25 | 9% | 15 | 9% | 6 | 3% | 5 | 2% | 62 | 6% |
Other | 24 | 20% | 46 | 16% | 39 | 16% | 23 | 13% | 24 | 11% | 156 | 16% |
Total | 119 | 100% | 281 | 100% | 209 | 100% | 175 | 100% | 214 | 100% | 998 | 100% |
χ2(12) = 46.6, P < .001 | ||||||||||||
Reasons for not receiving FOBT
| ||||||||||||
Unaware of test | 113 | 68% | 213 | 65% | 147 | 64% | 132 | 59% | 126 | (-)49% | 731 | 61% |
Have no health problems | 14 | (-)8% | 74 | 22% | 48 | 21% | 71 | 32% | 95 | (+)37% | 302 | 25% |
Other | 38 | (+)23% | 43 | 13% | 36 | 16% | 20 | 9% | 37 | 14% | 174 | 14% |
Total | 165 | 100% | 330 | 100% | 231 | 100% | 223 | 100% | 258 | 100% | 1207 | 100% |
χ2(8) = 61.7, P < .001 |
2001
|
2005
|
Change, 2001 to 2005
| ||||||
---|---|---|---|---|---|---|---|---|
Proportion | n | Comparisons with p < .05 | Proportion | n | Comparisons with p < .05 | Proportion | p, difference, 2001 to 2005 | |
Japanese
| 0.31 | 19/62 | 0.33 | 27/83 | J/K (p < .001) | 0.02 | 0.809 | |
Chinese
| 0.22 | 30/138 | 0.26 | 67/255 | F/C (p=.021) | 0.04 | 0.32 | |
Filipino
| 0.23 | 25/111 | J/V (p=.032) | 0.39 | 44/114 | C/K (p < .001) | 0.16 | 0.009 |
Korean
| 0.18 | 21/120 | 0.11 | 20/180 | F/K (p < .001) | -0.07 | 0.115 | |
Vietnamese
| 0.16 | 23/141 | 0.22 | 26/118 | F/V (p=.006) | 0.06 | 0.242 |