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Correlates of Colorectal Cancer Screening Among South Asian Immigrants in the United States

Menon, Usha PhD, RN, FAAN; Szalacha, Laura EdD; Prabhughate, Abhijit PhD; Kue, Jennifer PhD

doi: 10.1097/NCC.0b013e31828db95e
Articles: Online Only

Background: South Asians are a rapidly increasing population in the United States. Little is known about influences on their cancer screening behaviors, an important prerequisite to designing culturally appropriate education.

Objective: The purpose of this study was to evaluate rates and correlates of colorectal cancer (CRC) screening, knowledge, and beliefs among South Asians.

Methods: A subsample of those 50 years or older (n = 275) was drawn from the South Asian Health Descriptor Study, an assessment of multiple health indicators conducted in Chicago, Illinois.

Results: Indians represented 87% of the sample; 2.2% of participants believed that they were at risk for CRC; 8% reported a past stool blood test (SBT); and 13.6% had had a sigmoidoscopy or colonoscopy. Language acculturation (adjusted odds ratio [AOR], 1.93; confidence interval [CI], 1.1–3.5) and medical mistrust (AOR, 0.243; CI, 0.091–0.650) were significantly related to SBT completion. Language acculturation (AOR, 3.30; CI, 1.8–5.5), income (AOR, 2.70; CI, 1.0–7.1), living in the United States for more than 5 years (AOR, 8.6; CI, 1.9–14.5), perception of CRC risk (AOR, 8.9; CI, 1.1–17.7), and past SBT (AOR, 5.0; CI, 1.8–14.0) were significantly related to endoscopic cancer screening.

Conclusions: Facilitators and barriers to different CRC tests vary. Education to increase CRC screening may need to be targeted to culture and specific barriers to each screening test rather than generic messages for all screening tests.

Implications for Practice: Because barriers to CRC screening may differ among people based on the specific screening test being recommended. Primary care practitioners should recognize this fact and identify different barriers to enhance adherence to screening recommendations.

Author Affiliations: College of Nursing, The Ohio State University, Columbus (Drs Menon, Szalacha, and Kue); Plan India, New Delhi, India (Dr Prabhughate).

This study was supported in part by funds from the Department of Bio-behavioral Health Science, College of Nursing, University of Illinois at Chicago.

The authors have no conflicts of interest to disclose.

Correspondence: Usha Menon, PhD, RN, FAAN, College of Nursing, The Ohio State University, 1585 Neil Ave, Columbus, OH 43210 (

Accepted for publication February 13, 2013.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins