Trends in Colorectal Cancer Screening Utilization Among Ethnic Groups in California: Are We Closing the Gap?

Background: Given the low prevalence of and racial/ethnic disparities in colorectal cancer screening, it is important to monitor whether prevalence and disparities are increasing or decreasing over time.

Methods: We estimated the prevalence of colorectal cancer screening by year (2001, 2003, and 2005), modality (endoscopy, fecal occult blood test, either), and recency (ever had, up-to-date) for the California population as a whole, major racial/ethnic groups (White, Black, Latino, Asian), and selected Asian subgroups (Chinese, Filipino, Japanese, Korean, Vietnamese) using data from the California Health Interview Survey. All prevalence estimates were age- and gender-standardized.

Results: From 2001 to 2005, prevalence of up-to-date screening increased significantly among Whites and Latinos but not among Blacks and Asian Americans. Screening prevalence varied substantially among Asian subgroups, with Korean, Filipino, and Vietnamese Americans having the lowest prevalence. Korean Americans were the only group in the analysis with a significant decline in screening prevalence from 2001 to 2005. The gap between the highest and the lowest up-to-date screening prevalence using any screening modality, exhibited by Japanese and Korean Americans, increased from 18% in 2001 to 30% in 2005.

Conclusions: Findings suggest that we need to intensify efforts to increase colorectal cancer screening, especially among Korean Americans but also among Filipinos, Vietnamese, and Latinos.