The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62064

John H. Choe, MD, MPH¹, Jeanette M Lim, MPH², Nancy J. Burke, PhD³, Elizabeth Acorda, BA⁴, Victoria M. Taylor, MD, MPH⁴, and S.P. Tu⁵. (1) Biobehavioral Cancer Prevention and Control Training Program, University of Washington, Fred Hutchinson Cancer Research Center, P.O. Box 19024, 1100 Fairview Ave. N., MP-702, Seattle, WA 98109, (206) 667-7802, johnchoe@u.washington.edu, (2) ICHS NW Office, Harborview Medical Center/University of Washington, P.O. Box 3007, Seattle, WA 98114, (3) Comprehensive Cancer Center, University of California, San Francisco, 74 New Montgomery, Suite 200, Box 0981, San Francisco, CA 94143 -0981, (4) Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, PO Box 19024, MP702, 1100 Fairview Avenue N, Seattle, WA 98109-1024, (5) Harborview Medical Center, 325 Ninth Avenue, Seattle, WA 98104

BACKGROUND: Detailed information regarding disease prevention among Asian American populations has been limited. The purpose of our study was to explore the knowledge and beliefs of Chinese patients toward colorectal cancer (CRC) screening modalities such as fecal occult blood testing (FOBT).

METHODS: We conducted 30 qualitative interviews focusing on CRC and health-seeking behavior. Participants were Chinese patients older than 50 from a community clinic in Seattle. Interviews were conducted in Mandarin or Cantonese, translated into English, and then reviewed for themes and relationships among concepts.

RESULTS: Participants often expressed a holistic view of health when asked about CRC prevention; generally, health promotion was defined as maintenance of positive “qi” (energy) and balanced “jing shen” (spirit) through exercise and diet moderation. Until prompted, participants usually did not mention FOBT, flexible sigmoidoscopy or colonoscopy. Many expressed belief in a causal pathway that differed from biomedical models of CRC (i.e. colon polyps as precursor lesions). These participants believed that unhealthy diet leads to constipation, and that the resultant rise in “toxins” or “heat” leads to CRC. This may have led to some participants presuming that a lack of symptoms renders them safe from cancer, and to others believing other non-FOBT stool tests were forms of CRC screening.

CONCLUSION: Patients in our study expressed beliefs of health and CRC that differed from “Western” biomedical concepts. Failure to recognize these ideas may create confusion among elderly Chinese patients. Programs to increase CRC screening must incorporate these concepts to improve cultural relevance for Chinese American patients.

Learning Objectives:

• After this presentation, audience members will understand several health beliefs among Chinese American patients that may affect programs to increase colorectal cancer screening

Keywords: Asian Americans, Cancer

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.