Barriers and Facilitators to Colorectal Cancer Screening in Vietnamese Americans: A Qualitative Analysis

Abstract

<bold>Background:</bold> Vietnamese Americans are the third largest Asian ethnic group in Washington State. Colorectal cancer (CRC) ranked as one of the most common cancers in Vietnamese Americans. However, CRC screening rates remain low among Vietnamese Americans. In one study, Vietnamese American participants reported screening rates of 48% for Fecal Occult Blood Test (FOBT), 20% for sigmoidoscopy, and 26% for colonoscopy. <bold>Methods:</bold> We partnered with a Federally Qualified Health Center (FQHC) in Seattle, Washington, to conduct focus groups as part of a process evaluation of an intervention to improve CRC screening rates. Using interpreters, we recruited and conducted three focus groups with 19 FQHC patients of Vietnamese descent who were between 50 and 79 years old. Transcripts were analyzed by three team members using open coding and axial coding. Major themes that emerged consisted of barriers and facilitators to CRC screening. <bold> Results:</bold> Barriers included the lack of health problems, comorbidities, challenges with medical terminology, and colonoscopy complications. Participants singled out the risk of perforation as a fear they have towards colonoscopy procedures. Facilitators included knowledge about CRC and CRC screening, sources of information and social networks, and physician recommendation. <bold> Conclusion:</bold> These findings can be used to develop more culturally appropriate CRC screening interventions and improve upon existing CRC screening programs for the Vietnamese American population and other similar immigrant groups.