Barriers and facilitators to colorectal cancer screening in Vietnamese Americans: a qualitative analysis

Vietnamese Americans are the fourth largest Asian ethnic group in the USA. Colorectal cancer (CRC) ranks as one of the most common cancers in Vietnamese Americans. However, CRC screening rates remain low among Vietnamese Americans, with 40 % of women and 60 % of men reporting never having a sigmoidoscopy, colonoscopy, or fecal occult blood test (FOBT). We partnered with a Federally Qualified Health Center (FQHC) in Seattle, WA, to conduct focus groups as part of a process evaluation. Using interpreters, we recruited and conducted three focus groups comprised of six women screened for CRC, six women not screened for CRC, and seven men screened for CRC, which made up a total of 19 FQHC patients of Vietnamese descent between 50 and 79 years old. Three team members analyzed transcripts using open coding and axial coding. Major themes were categorized into barriers and facilitators to CRC screening. Barriers include lack of health problems, having comorbidities, challenges with medical terminology, and concerns with the colonoscopy. Participants singled out the risk of perforation as a fear they have toward colonoscopy procedures. Facilitators include knowledge about CRC and CRC screening, access to sources of information and social networks, and physician recommendation. Our focus groups elicited information that adds to the literature and has not been previously captured through published surveys. Findings from this study can be used to develop more culturally appropriate CRC screening interventions and improve upon existing CRC screening programs for the Vietnamese American population.