Korean Americans; Koreans; Asian Americans; Bay Area; California; cancer screening; cancer risk factors; mammogram; Pap smear; colorectal cancer screening


Community Health and Preventive Medicine


Background: Korean Americans (KA) have the highest prevalence of death from cancer among Asian American ethnic groups in the U.S. This KA prevalence rate is also substantially higher than that of non-Hispanic whites, yet little is known about their cancer risk factors. This paper is one of the first studies to explore cancer risk factors and screening behaviors of Korean Americans in the San Francisco Bay Area.

Methods: A survey instrument was created using items from the California Health Interview Survey (CHIS) from 2009-2012, which were translated into Korean. A cross-sectional survey assessing the prevalence of cancer risk factors and screening behaviors was conducted in-person, through telephone, and online using a community-based sampling strategy of 342 KAs across the SF Bay Area. These results were then compared to the results of CHIS 2007-2012 for Koreans, all Asians in California, and all of California. Simple and multiple logistic regression were also conducted to evaluate the association between several socioeconomic and cultural factors and cancer screening outcomes for colorectal cancer screening, mammography, and Pap smears.

Results: In this sample, 30% of women 21 years and older had never received a Pap smear, 18% of women 40 years and older had never received a mammogram, and 24% of participants 50 years and older had never received colorectal cancer screening. Further analyses found that among women who are aged 21 years and older, not being a college graduate (Odds Ratio (OR): 3.59, 95% Confidence Interval [95% CI] 1.22, 10.57) was associated with higher odds of not receiving a Pap smear. Younger age was associated with never receiving colorectal screening (OR: 0.39, 95% CI 0.19, 0.79). Not having insurance (OR: 3.22, 95% CI 1.36, 7.62) and preference for a Korean physician (OR: 9.89, 95% CI 1.30, 75.18) were associated with higher odds of receiving no colorectal screening. Sex, having a college degree, or Limited English Proficiency (LEP) were not found to have any association with never receiving colorectal cancer screening.

Conclusions: Very few studies assessing health disparities such as cancer risk factors and screening prevalence in KAs exist. Further studies in this vulnerable group exploring risk factors and screening rates for other cancers are encouraged to identify specific areas that can be targeted for improved health outcomes.