title: Is Colorectal Cancer A Western Disease? Role of Knowledge and Influence of Misconception on Colorectal Cancer Screening among Chinese and Korean Americans: A Mixed Methods Study
abstract: Background: Chinese and Korean Americans have lower colorectal cancer (CRC) screening rates than other racial/
  ethnic groups, which may be explained by a low level of CRC knowledge and a high level of misconceptions. This
  study explores the role of knowledge in CRC screening among these groups. Methods: Chinese (N=59) and Korean
  (N=61) Americans older than 50 were recruited from the Washington D.C. Metropolitan area. They completed a detailed
  survey and participated in focus groups to discuss their knowledge on CRC and CRC screening. Seventeen physicians,
  community leaders, and patient navigators participated in key informant interviews. Using a mixed methods approach,
  data were analyzed quantitatively and qualitatively. Results: Participants lacked knowledge about CRC and CRC
  screening. More than half did not know that screening begins at age 50 and there are several types of tests available.
  More than 30% thought CRC screening was not necessary if there were no symptoms or there was nothing they could
  do to prevent CRC. Focus group findings suggested understanding about CRC was limited by an inadequate source of
  linguistically and culturally relevant health information. For example, many participants considered CRC a western
  condition mainly caused by unhealthy diet. This led to under-estimations about their susceptibility to CRC. Knowledge
  was positively associated with self-reported screening. Participants who had higher knowledge scores were more likely
  to report ever having had a colonoscopy and confidence in ability to have CRC screening. Conclusions: Mixed-methods
  analysis provides multi-faceted perspectives on CRC knowledge and its influence on screening. Study findings can
  help inform interventions to increase CRC screening among Chinese and Korean Americans.
authors.affiliation: Department of Epidemiology and Biostatistics, University of Maryland, School of Public Health, Atlanta, Georgia, United States. Email: sunmin@umd.edu
authors.forename: Xiaoxiao
authors.initials: X
authors.lastname: Lu
authors.forename: Cheryl L
authors.initials: ChL
authors.lastname: Holt
authors.forename: Julia C
authors.initials: JC
authors.lastname: Chen
authors.forename: Daisy
authors.initials: D
authors.lastname: Le
authors.forename: Jingjing
authors.initials: J
authors.lastname: Chen
authors.forename: Gil-yong
authors.initials: GY
authors.lastname: Kim
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Sunmin
authors.initials: S
authors.lastname: Lee
keywords: Colorectal cancer; screening; knowledge; chinese; korean