Colorectal Cancer Screening among Korean Americans in Chicago: Does It Matter Whether They had the Screening in Korea or the US?

Background: Colorectal cancer (CRC) is one of the most common cancers in Korean Americans (KAs) and CRC
screening can detect CRC early and may reduce the incidence of CRC by leading to removal of precancerous polyps.
Many KAs in the US leave the country, primarily to travel to Korea, for health screening. The aim of this study was
to (a) assess CRC screening rates, including fecal occult blood test (FOBT), flexible sigmoidoscopy, and colonoscopy
and (b) explore factors related to these tests among KAs by location of CRC screening. Methods: Descriptive and
correlational research design with cross-sectional surveys was used with 210 KAs. Socio-demographics (age, gender,
years in the US, marital status, education, employment, household income, and proficiency in spoken English),
access to health care (health insurance and usual source of health care), and location of CRC screening utilization
(Korea, the US, or both Korea and US) were measured and analyzed using descriptive statistics and multinominal
logistic regression. Results: Out of 133 KA participants who had had lifetime CRC screening (i.e., had ever had FOBT,
flexible sigmoidoscopy, or colonoscopy), 19% had visited Korea and undergone CRC screening in their lifetimes. Among
socio-demographic factors and access to health care factors, having a usual source of health care in the US (OR=8.45)
was significantly associated with having undergone lifetime CRC screening in the US. Having health insurance in the
US and having had lifetime CRC screening in the US were marginally significant (OR=2.54). Conclusion: Access to
health care in the US is important for KAs to have CRC screening in the US. As medical tourism has been increasing
globally, the location of CRC screening utilization must be considered in research on cancer screening to determine
correlates of CRC screening.