Kevin Lin1, Yuhe Xia, MS2, Neha Nagpal, MD3, Matthew Glenn, MS1, Sandy Ng, MD3, Peter S. Liang, MD, MPH2
1New York University School of Medicine, New York, NY; 2New York University Langone Health, New York, NY; 3New York University Langone Medical Center, New York, NY
Introduction: Colorectal cancer (CRC) is a leading cause of cancer death among Asian Americans, who also have one of lowest rates of CRC screening. Chinese Americans are the largest Asian American subgroup in the United States (US), but there is a paucity of data examining predictors of CRC screening in this population. We used the New York City Community Health Survey (NYCCHS) to study factors associated with up-to-date colonoscopy use among Chinese Americans.
Methods: The NYCCHS is an annual population-based telephone survey. For this analysis, we included all Chinese Americans aged ≥50 years who participated in the survey from 2003-2016. We calculated up-to-date CRC screening uptake by colonoscopy, defined as colonoscopy within the last 10 years. To evaluate sociodemographic and medical predictors of colonoscopy use over four consecutive time periods, we entered age, sex, and any additional factors with p< 0.10 on univariate analysis into a multivariable model and reached the final model for each period using stepwise backward selection.
Results: During the study period, 2,577 Chinese Americans were surveyed and 62.4% had received a colonoscopy within 10 years. On multivariable analysis, receiving a flu shot was the only consistent positive predictor of up-to-date colonoscopy use from 2009-2016 (OR 2.06-2.36, Table). Individuals without a primary care provider were less likely to have received a colonoscopy from 2003-2012 (OR 0.25-0.42), and the risk estimate remained consistent but was no longer statistically significant from 2015-2016. Similarly, being born outside of the US was associated with lower colonoscopy uptake from 2009-2014 (OR 0.06-0.22). Compared to never smokers, current but not former smokers were significantly less likely to have received up-to-date colonoscopy (OR 0.37 in 2003-2008; OR 0.16 in 2013-2014). Age, sex, borough of residence, and exercise activity were not consistent predictors of up-to-date colonoscopy uptake.
Discussion: Among Chinese Americans older than age 50 living in NYC, those who had a primary care provider and received annual flu shots were most likely to be up-to-date with colonoscopy. Foreign-born Chinese Americans and current smokers were less likely to have received colonoscopy. These findings highlight the importance of primary care for CRC prevention and provide insight into the vulnerable populations within the Chinese American community.
Citation: Kevin Lin; Yuhe Xia, MS; Neha Nagpal, MD; Matthew Glenn, MS; Sandy Ng, MD; Peter S. Liang, MD, MPH. P1143 - PREDICTORS OF COLONOSCOPY USE AMONG CHINESE AMERICANS: AN ANALYSIS OF THE NEW YORK CITY COMMUNITY HEALTH SURVEY (2003-2016). Program No. P1143. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.