Comparison Study of Uptake of Colorectal Cancer Testing between Ethnic Minorities and the General Population in Hong Kong

  • Choi, Kai-Chow (The Nethersole School of Nursing, The Chinese University of Hong Kong) ;
  • So, Winnie Kwok-Wei (The Nethersole School of Nursing, The Chinese University of Hong Kong) ;
  • Chen, Joanne Man-Ting (The Nethersole School of Nursing, The Chinese University of Hong Kong) ;
  • Lau, Grace Chieh (The Nethersole School of Nursing, The Chinese University of Hong Kong) ;
  • Lee, Paul Chi-Wai (The Nethersole School of Nursing, The Chinese University of Hong Kong) ;
  • Chan, Carmen Wing-Han (The Nethersole School of Nursing, The Chinese University of Hong Kong)
  • Published : 2015.12.03


Background: Colorectal cancer (CRC) is one of the most common cancers. This study aimed to compare the uptake of CRC testing in the general public and in ethnic minorities in Hong Kong. Materials and Methods: This cross-sectional survey covered 2,327 South Asian and Chinese adults aged over 50, recruited from two separate studies. A structured questionnaires were administered by research staff over the telephone or in faceto-face interviews. Results: The uptake rate of CRC testing among South Asians was significantly lower than that of the general population in Hong Kong. Factors associated with the uptake rate were health professional's recommendation, perception of regular visits to doctor, use of complementary therapy, ethnicity, perceived susceptibility to cancer, presence of chronic illness, and education level. In addition, a significant interaction (p<0.05) between ethnicity and health professionals' recommendations was found, after adjustment for the main independent factors identified. Conclusions: Older people with lower educational attainment, without chronic illness and those have lower perceived susceptibility to cancer may be targeted for CRC testing promotion in the society. In addition, health professionals can play a highly influential role in promoting such testing, particularly among ethnic minorities.


Colorectal cancer;cancer testing;ethnic minorities;Hong Kong


  1. American Cancer Society. 2014. Colorectal cancer facts & figures 2014-2016 [Online].
  2. Austin KL, Power E, Solarin I, et al (2009). Perceived barriers to flexible sigmoidoscopy screening for colorectal cancer among UK ethnic minority groups: A qualitative study. J Med Screen, 16, 174-9.
  3. Cancer Expert Working Group on Cancer Prevention and Screening & Department of Health. 2014. Prevention and screening for colorectal cancer [Online].
  4. Census and Statistics Department. 2012a. 2011 population census. Summary results [Online].
  5. Census and Statistics Department. 2012b. 2011 population census. Thematic report: Ethnic minority. [Online].
  6. Centres for Disease Control and Prevention. 2006. 2005 National Health Interview Survey (NHIS): NHIS survey description [Online].
  7. Deutekom M, van Rijn AF, Dekker E, et al (2009). Uptake of faecal occult blood test colorectal cancer screening by different ethnic groups in the Netherlands. Eur J Public Health, 19, 400-2.
  8. Etzioni DA, Ponce NA, Babey SH, et al (2004). A populationbased study of colorectal cancer test use: results from the 2001 California Health Interview Survey. Cancer, 101, 2523-32.
  9. Fernandez ME, Wippold R, Torres-Vigil I, et al (2008). Colorectal cancer screening among Latinos from U.S. cities along the Texas-Mexico border. Cancer Causes Control, 19, 195-206.
  10. Food and Health Bureau. 2010. Primary care development in Hong Kong: Strategy document [Online].
  11. Griffith KA (2009). Biological, psychological and behavioral, and social variables influencing colorectal cancer screening in African Americans. Nurs Res, 58, 312-20.
  12. Guerra CE, Schwartz JS, Armstrong K, et al (2007). Barriers of and facilitators to physician recommendation of colorectal cancer screening. J Gen Intern Med, 22, 1681-8.
  13. Gwede CK, Jean-Francois E, Quinn GP, et al (2011). Perceptions of colorectal cancer among three ethnic subgroups of US blacks: A qualitative study. J Natl Med Assoc, 103, 669-80.
  14. International Agency for Research on Cancer 2015. World cancer report 2014, Geneva, World Health Organization.
  15. Lane DS, Messina CR, Cavanagh MF, et al (2008). A provider intervention to improve colorectal cancer screening in county health centers. Med Care, 46, 109-16.
  16. Naylor K, Ward J, Polite BN (2012). Interventions to improve care related to colorectal cancer among racial and ethnic minorities: A systematic review. J Gen Intern Med, 27, 1033-46.
  17. Palmer RC, Chhabra D, McKinney S (2011). Colorectal cancer screening adherence in African-American men and women 50 years of age and older living in Maryland. J Community Health, 36, 517-24.
  18. Robb KA, Solarin I, Power E, et al (2008). Attitudes to colorectal cancer screening among ethnic minority groups in the UK. BMC Public Health, 8, 34.
  19. Sewitch MJ, Burtin P, Dawes M, et al (2006). Colorectal cancer screening: Physicians' knowledge of risk assessment and guidelines, practice, and description of barriers and facilitators. Can J Gastroenterol Hepatol, 20, 713-8.
  20. So WK, Chan CW, Choi KC, et al (2013). Perspectives on the use of and service needs of cancer preventive services for ethnic minorities in Hong Kong: A study protocol. J Adv Nurs, 69, 2116-22.
  21. So WK, Choi KC, Chan DN, et al (2012a). Colorectal cancer testing and associated factors among older Chinese adults. Prev Med, 54, 104-5.
  22. So WK, Choi KC, Chan DN, et al (2012b). Colorectal cancer screening behaviour and associated factors among Chinese aged 50 and above in Hong Kong - A population-based survey. Eur J Oncol Nurs, 16, 413-8.
  23. Sung JJ, Lau JY, Young GP, et al (2008). Asia Pacific consensus recommendations for colorectal cancer screening. Gut, 57, 1166-76.
  24. Szczepura A (2005). Access to health care for ethnic minority populations. Postgrad Med J, 81, 141-7.
  25. The Royal Australian College of General Practitioners. 2012. Guidelines for preventive activities in general practice [Online].
  26. U.S. Preventive Services Task Force. 2008. Colorectal cancer: Screening. Screening recommendation. [Online].
  27. von Wagner C, Baio G, Raine R, et al (2011). Inequalities in participation in an organized national colorectal cancer screening programme: Results from the first 2.6 million invitations in England. Int J Epidemiol, 40, 712-8.
  28. Walsh JE, Terdiman JP (2003). Colorectal cancer screening: Scientific review. JAMA, 289, 1288-96.
  29. Wong BC, Chan AO, Wong WM, et al (2006). Attitudes and knowledge of colorectal cancer and screening in Hong Kong: A population-based study. J Gastroenterol Hepatol, 21, 41-6.
  30. World Health Organization 2014. Global health estimates 2014 summary table: DALY by cause, age and sex, 2000-2012, Geneva, World Health Organization.
  31. World Health Organization. 2015. Screening for colorectal cancer [Online].

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