title: Ethnic differences and predictors of colonoscopy, prostate-specific antigen, and mammography screening participation in the multiethnic cohort.
abstract: OBJECTIVE
  Given the relation between screening and improved cancer outcomes and the persistence of ethnic disparities in cancer mortality, we explored ethnic differences in colonoscopy, prostate-specific antigen (PSA), and mammography screening in the Multiethnic Cohort Study.
  
  
  METHODS
  Logistic regression was applied to examine the influence of ethnicity as well as demographics, lifestyle factors, comorbidities, family history of cancer, and previous screening history on self-reported screening participation collected in 1999-2002.
  
  
  RESULTS
  The analysis included 140,398 participants who identified as white, African American, Native Hawaiian, Japanese American, US born-Latino, or Mexican born-Latino. The screening prevalences overall were mammography: 88% of women, PSA: 45% of men, and colonoscopy: 35% of men and women. All minority groups reported 10-40% lower screening utilization than whites, but Mexican-born Latinos and Native Hawaiian were lowest. Men were nearly twice as likely to have a colonoscopy (OR=1.94, 95% CI=1.89-1.99) as women. A personal screening history, presence of comorbidities, and family history of cancer predicted higher screening utilization across modalities, but to different degrees across ethnic groups.
  
  
  CONCLUSIONS
  This study confirms previously reported sex differences in colorectal cancer screening and ethnic disparities in screening participation. The findings suggest it may be useful to include personal screening history and family history of cancer into counseling patients about screening participation.
authors.affiliation: University of Hawaii Cancer Center, 701 Ilalo Street, Suite 500, Honolulu, HI 96822, USA. Electronic address: bharmon@cc.hawaii.edu.
authors.forename: Brook E
authors.initials: BE
authors.lastname: Harmon
authors.affiliation: University of Hawaii Cancer Center, 701 Ilalo Street, Suite 500, Honolulu, HI 96822, USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Little
authors.affiliation: University of Hawaii Cancer Center, 701 Ilalo Street, Suite 500, Honolulu, HI 96822, USA.
authors.forename: Erica D
authors.initials: ED
authors.lastname: Woekel
authors.affiliation: University of Hawaii Cancer Center, 701 Ilalo Street, Suite 500, Honolulu, HI 96822, USA.
authors.forename: Reynolette
authors.initials: R
authors.lastname: Ettienne
authors.affiliation: University of Hawaii Cancer Center, 701 Ilalo Street, Suite 500, Honolulu, HI 96822, USA.
authors.forename: Camonia R
authors.initials: CR
authors.lastname: Long
authors.affiliation: University of Hawaii Cancer Center, 701 Ilalo Street, Suite 500, Honolulu, HI 96822, USA.
authors.forename: Lynne R
authors.initials: LR
authors.lastname: Wilkens
authors.affiliation: University of Hawaii Cancer Center, 701 Ilalo Street, Suite 500, Honolulu, HI 96822, USA.
authors.forename: Loic
authors.initials: L
authors.lastname: Le Marchand
authors.affiliation: University of Southern California, Health Sciences Campus, NRT Lg 1502, Los Angeles, CA 90089, USA.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Henderson
authors.affiliation: University of Hawaii Cancer Center, 701 Ilalo Street, Suite 500, Honolulu, HI 96822, USA.
authors.forename: Laurence N
authors.initials: LN
authors.lastname: Kolonel
authors.affiliation: University of Hawaii Cancer Center, 701 Ilalo Street, Suite 500, Honolulu, HI 96822, USA.
authors.forename: Gertraud
authors.initials: G
authors.lastname: Maskarinec
mesh_terms: D001741:Black or African American; D001943:Breast Neoplasms / Q000175:diagnosis / Q000208:ethnology*; D015331:Cohort Studies; D003113:Colonoscopy / Q000379:methods; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000208:ethnology*; D005260:Female; D006254:Hawaii / Q000208:ethnology; D006801:Humans; D007564:Japan / Q000208:ethnology; D007610:Kallikreins / Q000032:analysis; D008297:Male; D008327:Mammography / Q000379:methods; D008403:Mass Screening / Q000379:methods; D017058:Mexican Americans; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000208:ethnology*; D014481:United States
chemical_list: C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
keywords: Cancer screening; Colonoscopy; Ethnic differences; Mammogram; PSA