Colorectal cancer screening in Filipino-born Australians: knowledge, attitudes and practices

Background

Filipino-born Australians are eligible for Australia’s National Bowel Cancer Screening Program (NBCSP), yet colorectal cancer (CRC) knowledge, attitudes and practices (KAP) are poorly characterised in this migrant community. CRC-related KAP and correlates relevant to health literacy and primary care engagement were assessed.

Methods

Community-based cross-sectional survey of Filipino-born Australians aged ≥40 years (n = 578). Outcomes were CRC knowledge (0–24), attitudes (including communication confidence) and screening practices (0–8). Predictors included sociodemographics, self-rated health, general practice (GP) engagement and CRC risk history. Associations were estimated using robust M-estimation (Stata rreg).

Results

Mean age was 57±10 years; 70.2% were female. Knowledge was moderate–high (mean 16.7±3.9/24): 56.2% adequate and 35.1% excellent. Global attitudes were mostly negative (10.7% very negative, 61.8% negative), while practices were high (mean 7.9±0.9/8) and all met the “healthy” threshold. Confidence was lowest for following up NBCSP results (55.4%) versus asking about prevention/early detection (74.0%) and personal risk (71.6%). In multivariable models for knowledge, longer residence was associated with higher scores (B = 0.52 per year, 95% CI 0.46–0.58, p<.001) and not living alone with higher scores (B = 2.95, 95% CI 2.61–3.30, p<.001); older age and not having a regular GP were associated with lower knowledge (B = −0.06 per year and B = −3.67, both p<.001).

Conclusions

The findings support an enhanced NBCSP prevention activity in primary care: culturally tailored, health-literacy–responsive counselling that prioritises (i) CRC burden and (ii) confidence to follow up NBCSP results and discuss personal risk. A practical implementation focus is improving result follow-up confidence in the ∼45% not confident/extremely confident.

Key messages

• Filipino-born Australians reported high NBCSP screening practices but mostly negative attitudes and low confidence to follow up results.

• Primary care should use culturally tailored, health-literacy counselling to improve results follow-up and risk discussions in this migrant community.