Korean Americans who traveled to other countries for low-cost medical care are nearly nine times more likely to be up-to-date with colorectal cancer screening compared to those who did not engage in medical tourism, say researchers from the University of Washington School of Public Health and the Fred Hutchinson Cancer Research Center.

Researchers found that Korean American patients who travel to South Korea for care tend to be without health insurance and less likely to speak English well. Also, they may not have a usual place of care and may have immigrated to the U.S. at an older age.

“Health care providers in the U.S. need to be aware that immigrant populations may be engaging in medical tourism and receiving cancer screening outside of the U.S.,” said Linda Ko, assistant professor of health services at the School and researcher in the Cancer Prevention Program at Fred Hutch's Public Health Sciences Division. “Health care providers also need to be aware that people who engage in medical tourism may be following a set of cancer screening guidelines different from the U.S., making communication with these patients critical to avoid mistrust with our medical system.”

Ko and her research team conducted a community-based, cross-sectional study in 2013 over a three-month period, from August to October. Data was collected on 193 Korean American patients, ages 50-75, residing in the Seattle area. Participants completed an in-person, self-administered survey.

The findings, published December 2016 in the open-access journal BMC Cancer, showed that one third of the participants surveyed reported traveling to South Korea for medical care. Those who engaged in medical tourism had 8.91 greater odds of being up-to-date with colorectal cancer screening compared to those who did not travel for health care. Medical tourism, therefore, emerged as the strongest predictor of colorectal cancer screening.

“Health care providers may want to take the time to assess medical tourism, especially when screening tests show positive results and treatment with the U.S. oncologist becomes critical,” said Ko.

Colorectal cancer remains the most commonly diagnosed cancer among Korean Americans in part due to low screening rates, according to the study. “Prevention and early detection of colorectal cancer through the use of screening tests have resulted in better prognosis and longer survival and reduced disease incidence and mortality,” researchers wrote.

“Public health professionals may want to discuss with those engaging in medical tourism about the importance of timely care and the negative consequences of delayed care with medical tourism, as well as finding a health care provider in the US so that they can avoid challenges with receiving a  continuous cancer care  in the U.S. if screening tests show positive results,” Ko added.

Victoria Taylor, Jihye Yoon, Wade Copeland, Joo Ha Hwang, Eun Jeong Lee and John Inadomi also contributed to the study.