title: Acculturation and cancer screening among Asian Americans: role of health insurance and having a regular physician.
abstract: Cancer is the leading cause of death among Asian Americans, but screening rates are significantly lower in Asians than in non-Hispanic Whites. This study examined associations between acculturation and three types of cancer screening (colorectal, cervical, and breast), focusing on the role of health insurance and having a regular physician. A cross-sectional study of 851 Chinese, Korean, and Vietnamese Americans was conducted in Maryland. Acculturation was measured using an abridged version of the Suinn-Lew Asian Self-Identity Acculturation Scale, acculturation clusters, language preference, length of residency in the US, and age at arrival. Age, health insurance, regular physician, gender, ethnicity, income, marital status, and health status were adjusted in the multivariate analysis. Logistic regression analysis showed that various measures of acculturation were positively associated with the odds of having all cancer screenings. Those lived for more than 20 years in the US were about 2-4 times [odds ratio (OR) and 95 % confidence interval (CI) colorectal: 2.41 (1.52-3.82); cervical: 1.79 (1.07-3.01); and breast: 2.11 (1.25-3.57)] more likely than those who lived for less than 10 years to have had cancer screening. When health insurance and having a regular physician were adjusted, the associations between length of residency and colorectal cancer [OR 1.72 (1.05-2.81)] was reduced and the association between length of residency and cervical and breast cancer became no longer significant. Findings from this study provide a robust and comprehensive picture of AA cancer screening behavior. They will provide helpful information on future target groups for promoting cancer screening.
authors.affiliation: Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, 2234C SPH Bldg, College Park, MD, 20742, USA, sunmin@umd.edu.
authors.forename: Sunmin
authors.initials: S
authors.lastname: Lee
authors.forename: Lu
authors.initials: L
authors.lastname: Chen
authors.forename: Mary Y
authors.initials: MY
authors.lastname: Jung
authors.forename: Lourdes
authors.initials: L
authors.lastname: Baezconde-Garbanati
authors.forename: Hee-Soon
authors.initials: HS
authors.lastname: Juon
mesh_terms: D000069:Acculturation; D000328:Adult; D000367:Age Factors; D000368:Aged; D001213:Asian / Q000208:ethnology / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000208:ethnology; D002681:China / Q000208:ethnology; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000208:ethnology; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D008396:Maryland; D008875:Middle Aged; D018802:Patient-Centered Care / Q000706:statistics & numerical data*; D056910:Republic of Korea / Q000208:ethnology; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000208:ethnology; D014744:Vietnam / Q000208:ethnology