Disparities in the receipt of fecal occult blood test versus endoscopy among Filipino American immigrants.
BACKGROUND
This report examines disparities associated with the type of colorectal screening test, fecal occult blood test versus endoscopy, within a particular racial/ethnic group, Filipino American immigrants.


METHODS
Between July 2005 and October 2006, Filipino Americans aged 50 to 75 years from 31 community organizations in Los Angeles completed a 15-minute survey in English (65%) or Filipino (35%).


RESULTS
Of the 487 respondents included in this analysis, 257 (53%) had never received any type of colorectal cancer screening. Among the 230 subjects who had ever received a routine screening test, 78 had fecal occult blood test only (16% of the total sample), and 152 had endoscopy with or without fecal occult blood test (31% of the total sample). After controlling for access to care and key demographic variables in a multivariate analysis, only two characteristics distinguished between respondents who had fecal occult blood test only versus those who had endoscopy: acculturation, assessed by percent lifetime in the United States and language of interview, and income.


CONCLUSIONS
Our data suggest a two-tier system, fecal occult blood test for less acculturated Filipino Americans with lower income versus endoscopy for Filipino immigrants with higher levels of acculturation and income. The disparity persists after adjusting for access to care. Instead of treating minority groups as monolithic, differences within groups need to be examined so that interventions can be appropriately targeted.
Maxwell
Annette E
AE
Division of Cancer Prevention and Control Research, School of Public Health/Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California,USA. amaxwell@ucla.edu
Danao
Leda L
LL
Crespi
Catherine M
CM
Antonio
Cynthia
C
Garcia
Gabriel M
GM
Bastani
Roshan
R
D000368:Aged; D001213:Asian / Q000706:statistics & numerical data*; D004641:Emigration and Immigration; D016099:Endoscopy, Gastrointestinal; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D010679:Philippines / Q000208:ethnology; D012959:Socioeconomic Factors; D014481:United States