Colorectal cancer (CRC) is one of the most predominant cancers in the USA and ranks third among all cancers in incidence and mortality. Vietnamese Americans exhibit persistently lower screening rates compared to the general U.S. population, due to cultural, economic, and environmental barriers. The impact of environmental factors in particular is not well known, and lack of geographical access may be a significant barrier to accessing screening. This study aims to elucidate build and neighborhood environmental factors affecting CRC screening rates among Vietnamese Americans. A total of 517 Vietnamese Americans 50 years and older residing in Philadelphia County were included in the study. Surveys were collected to determine CRC screening behavior and sociodemographic characteristics. Individual neighborhood characteristics, which included the Walk Score, was obtained based on the participant's address. Neighborhood characteristics were calculated using census-tract level data for the social deprivation index, ethnic composition, and presence of hospitals or federally qualified health centers (FQHC). The generalized linear mixed model revealed that residing in an ethnically dense neighborhood was negatively associated with CRC screening (β = -0.67, SE = 0.29, p = .01), while social deprivation (β = 0.30, SE = 0.27, p = .27) and presence of FQHCs or hospitals (β = 0.16, SE = 0.30, p = .58) were not. Individual neighborhood characteristics including the Walk Score (β = 0.21, SE = 0.26, p = .43) was not associated with CRC screening behavior. Neighborhood characteristics, specifically ethnic density is associated with lower uptake of screening in this population. Future interventions should aim to target specific Vietnamese American and other Asian ethnic neighborhoods that may experience disparities in screening.
Keywords: Asian American; Cancer screening; Colorectal cancer; Neighborhood environment.
Colorectal cancer (CRC) is one of the most common cancers in the USA and ranks third among all cancers as the leading cause of death. CRC screening is key for early detection and better patient outcomes and is recommended for individuals between ages 50 and 75. Vietnamese Americans are an Asian ethnic group that engages in low levels of colorectal cancer screening. This study aimed to determine how the environment plays a role in being able to obtain CRC screenings. A total of 517 Vietnamese Americans aged 50 years and older residing in Philadelphia County were included in the study. This study found that individuals who live in a neighborhood with greater composition of Asians were less likely to have been screened. Other neighborhood characteristics such as neighborhood walkability, social deprivation, and the presence of Federally Qualified Health Centers and Hospitals in one’s neighborhood were not linked to screening. Future interventions should aim to target specific Asian neighborhoods that experience disparities in screening.
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