Colorectal cancer screening among underserved Korean Americans in Los Angeles county

Objectives: Use of colorectal cancer screening is extremely low among Korean Americans. The objective of this study was to gather information on predictors, facilitators, barriers, and intervention preferences with respect to colorectal cancer screening that may inform the development of future interventions for underserved Korean Americans. Design: We developed a questionnaire guided by the Health Behavior Framework and administered it to a convenience sample of 151 Korean Americans aged 40-70 recruited through a community based organization in Los Angeles. Results: In our sample in which 60% of the subjects did not have health insurance, only 17% reported having received a stool blood test within the past year or sigmoidoscopy or colonoscopy within the past 5 years. Having received a physician recommendation was significantly associated and having symptoms of the disease was marginally associated with the outcome variable. Although 64% of respondents reported having a primary care physician, only 29% received a screening recommendation from a physician. Barriers to colorectal cancer screening were lack of health insurance and inability to afford testing, not knowing where to go for testing, language barrier, and fear of being a burden to the family. Intervention preferences included educational seminars, media campaigns, and print materials. Conclusion: Our findings point to the need for a multi-faceted approach that includes educational seminars at community venues, a media campaign, and physician education to increase colorectal cancer screening in this underinsured Korean American population.