Cancer Prevention & Control
Is Colorectal Cancer A Western Disease? Influence of misconception on colorectal cancer screening: A mixed methods study
(School of Public Health (UMD) Behavioral and Community Health Doctoral Student)
PURPOSE Chinese and Korean Americans have lower colorectal cancer (CRC) screening rates than other racial/ethnic groups, which may be explained by a low level of CRC knowledge and misconceptions. This study explores the role of knowledge on CRC screening among these groups. METHODS Chinese (N=59) and Korean Americans (N=61) older than 50 were recruited from the Washington D.C. Metropolitan area. They completed a detailed survey and participated in focus groups to discuss their knowledge on CRC and CRC screening. Using a mixed methods approach, data were analyzed quantitatively and qualitatively. FINDINGS Participants lacked knowledge about CRC and screening. About 70% of participants thought CRC fatal. More than half did not know that CRC screening begins at age 50 and there are several tests. Focus group findings suggested understanding about CRC risk factors is limited by an inadequate source of linguistically and culturally relevant health information. For example, many participants considered CRC a western condition caused by unhealthy diet. This led to inappropriate estimations about their susceptibility to CRC. Knowledge was positively associated with screenings. Especially, those who believed ‘finding CRC early saves one’s life’ were six times more likely to get CRC screening compared to those who did not. Qualitative data indicated participants’ level of knowledge on CRC depended on their interaction with friends/families who had CRC or CRC screening. CONCLUSION Mixed-methods analysis provides multi-faceted perspectives on CRC knowledge and its influence on screening. This study will help design interventions to improve the screening outcome among Chinese and Korean Americans.