Limited English Proficiency and Self-Reported Lifetime Use of Colorectal Cancer Screening Tests Among Asian Origin Groups in California: A Cross-Sectional Study.

IntroductionAsian Americans have lower colorectal cancer (CRC) screening rates compared with other racial/ethnic groups in the United States (U.S.). Moreover, individuals with limited English proficiency (LEP) face additional challenges in understanding and accessing healthcare. We examined the association between seven Asian origin groups and lifetime use of CRC screening [home fecal occult blood test (FOBT) and endoscopy], stratified by LEP status.MethodsData from the 2021-2022 California Health Interview Survey were analyzed (n=23,785 respondents aged 50-75 years). Asian origin groups (Chinese, Filipino, Japanese, Korean, South Asian, Vietnamese, Others) and LEP were exposures of interest. Ever having lifetime use of FOBT and endoscopy screening were outcomes of interest. Weighted multivariable logistic regression was performed.ResultsThe highest prevalence of FOBT screening use were observed in Vietnamese respondents with LEP (57.6%); however, the lowest prevalence of FOBT screening use was found among Filipino (16.6%) respondents with LEP (p-value=0.014). In adjusted analysis, Chinese and Filipino with LEP had 50% (OR, 0.50; 95%, 0.28-0.90) and 90% (OR, 0.10; 95%, 0.03-0.27) lower odds of having lifetime FOBT use, respectively. For those without LEP, South Asians had 46% (OR, 0.54; 95%, 0.38-0.77) lower odds of having lifetime FOBT use, and Chinese and Korean had 35% (OR, 0.65; 95%, 0.51-0.84) and 52% (OR, 0.48; 95%, 0.33-0.69) lower odds of having lifetime endoscopy use, respectively.ConclusionFOBT screening disparities are evident among Chinese and Filipino Americans with LEP. These findings highlight the complexity of CRC screening disparities across Asian origin groups and suggest the need for further investigation.