Barriers to Colorectal Cancer Screening in Latino and Vietnamese Americans

Compared with Non-Latino White Americans


  • Judith M. E. Walsh MD, MPH,

    Corresponding authorSearch for more papers by this author
  • Celia P. Kaplan PH, MA,

  • Bang Nguyen PH,

  • Ginny Gildengorin PhD,

  • Stephen J. McPhee MD,

  • Eliseo J. Pérez-Stable MD

  • Received from the Division of General Internal Medicine, Department of Medicine, University of California (JMEW, CPK, GG, SJMP, EJPS), San Francisco, Calif; Medical Effectiveness Research Center for Diverse Populations (JMEW, CPK, GG, EJPS), San Francisco, Calif; Center for Aging in Diverse Communities (JMEW, GG, EJPS), San Francisco, Calif; Northern California Cancer Center, Union City, Calif (BN).

Address correspondence and requests for reprints to Dr. Walsh: Women's Health Clinical Research Center, 1635 Divisadero Suite 600 BOX 1793, San Francisco, CA 94115 (e-mail:


OBJECTIVE:  To identify current colorectal cancer (CRC) screening practices and barriers to screening in the Latino, Vietnamese, and non-Latino white populations.

METHODS:  We conducted a telephone survey of Latino, non-Latino white, and Vietnamese individuals living in San Jose, California. We asked about demographics, CRC screening practices, intentions to be screened, and barriers and facilitators to screening.

RESULTS:  Seven hundred and seventy-five individuals (40% white, 29.2% Latino, and 30.8% Vietnamese) completed the survey (Response Rate 50%). Overall, 23% of respondents reported receipt of fecal occult blood test (FOBT) in the past year, 28% reported sigmoidoscopy (SIG) in the past 5 years, and 27% reported colonoscopy (COL) in the past 10 years. Screening rates were generally lower in Latinos and Vietnamese. Vietnamese were less likely than whites to have had SIG in the past 5 years (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.09 to 0.72), but ethnicity was not an independent predictor of FOBT or COL. Only 22% of Vietnamese would find endoscopic tests uncomfortable compared with 79% of whites (P < .05). While 21% of Latinos would find performing an FOBT embarrassing, only 8% of whites and 3% of Vietnamese felt this way (P < .05). Vietnamese were more likely than whites to plan to have SIG in the next 5 years (OR, 2.24; 95% CI, 1.15 to 4.38), but ethnicity was not associated with planning to have FOBT or COL.

CONCLUSIONS:  Rates of CRC screening are lower in ethnic minority populations than in whites. Differences in attitudes and perceived barriers suggest that culturally tailored interventions to increase CRC screening will be useful in these populations