Abstract B77: Cancer screening in older South Asian immigrants in United States

Background: While South Asians (SA) are among the fastest growing immigrant groups in the U.S., there is a lack of disaggregated data on their health issues.

Aim: Describe demographic characteristics, cancer beliefs (perceived risk, benefits, barriers), acculturation, access to care, and factors associated with breast, cervical and colorectal cancer screening among SA in the US.

Methods: A cross sectional study was conducted in English, Hindi, and Gujarati among SAs aged 40 or older. Sample: Of the total 331 respondents, 84% were born in India and 14% in Pakistan. Their mean age was 61.60 (S.D. 10.62) years, 61% were female, 45% were Muslims, and 44% Hindus, and 48% reported less than high school education. While 57% had lived in the U.S. for a decade or more, only 65% had a regular family doctor and 43% reported having no health insurance.

Results: Demographic factors: Age and being of Pakistani descent was related to breast cancer screening (BCS); (t=3.526, p<0.001),(chi. sq.=7.758, p<0.021). Gender and education were related to colon cancer screening (CRCS)(chi. sq.=9.040, p<0.003; chi. sq.=23.478, p<0.001). The perceived barriers significantly associated with not being screened for breast cancer were 1) wanting to know if one has cancer , 2) family not wanting the individual to get tested, 3) embarrassment, fear losing a job, 4) language difficulties, and 5) not knowing where to get tested (all significant at p<.05). Not being screened for cervical cancer was associated only with not having any family history (p<.05). Three barriers were significantly related to not being screened for colon cancer: no family history, not knowing where to get tested, and transportation (all significant at p<.05). Cancer not being “in one's fate” was significantly related to all three screenings. Significant reasons for BCS were 1) family encouraged testing, 2) friends encouraged testing, 3) belief in treatment for cancer, and 4) insurance paying for screening (all significant at p<.05); and for cervical cancer screening, a significant reason was having a symptom. Higher number of years in the U.S. (p<.01) was significantly related to all three screening and cultural identity (considering oneself South Asian versus Asian, Asian American, Indian/Pakistani American, or American) (p<.01) was significantly related to CRCS. Having health insurance was significantly related to BCS (p<.05) and CRCS (p<.001); having a regular doctor was related to BCS (p<.01) and CCS (p<.05). Interpersonal treatment by the doctor was only related to CRCS tests (p<.05).

Recommendations: Certain barriers were unique to specific cancer testing while a few were common to all screening. Results will inform the development of community-based cancer screening educational intervention.