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Updated: Jun 19, 2026

E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Translated Educational Infographics Increase Colorectal Cancer Screening Rates in Non-Native English Speakers
Alex Zhornitskiy1, Bao Sean Nguyen2, Christine Shieh3
1Division of Gastroenterology and Hepatology, UC Davis Medical Center, Sacramento, California.
Introduction:
Language barriers hinder colorectal cancer screening in underserved populations of non-native English speakers, particularly in Asian American and Pacific Islander communities; however, patient educational materials are not readily available in languages other than English and Spanish.
Methods:
In this pilot study, American College of Gastroenterology infographics were translated into Chinese (traditional/simplified), Hmong, and Vietnamese and distributed along with a translated pre-post survey to average-risk patients aged 45-75 years at a safety-net clinic. Primary outcomes were colorectal cancer screening rates and secondary outcomes were patients' perceptions of colorectal cancer screening.
Results:
Colorectal cancer screening rates increased from 19.5% to 54.3% (p<0.01), whereas >80.0% patients noted increased understanding of colorectal cancer and plans to pursue screening.
Conclusions:
These findings demonstrate that providing translated and language-concordant infographics significantly increased colorectal cancer screening rates and patient understanding among non-native English speakers. Creating and integrating the use of culturally and linguistically tailored educational materials in resource-limited clinics can help eliminate disparities and narrow the colorectal cancer screening gap in Asian American and Pacific Islander communities.
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