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Factors Associated with Hispanic/non-Hispanic White Colorectal Cancer Screening Disparities

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Abstract

Background

In the United States, Hispanics are less likely to undergo colorectal cancer (CRC) screening than non-Hispanic whites (whites).

Objective

To examine factors associated with disparities in CRC screening between whites and Hispanic national origin subgroups.

Design

Cross-sectional analysis of 1999–2005 Medical Expenditure Panel Survey data.

Participants

Respondents aged >50 years self-identifying as non-Hispanic white (18,733) or Hispanic (3686)—the latter of Mexican (2779), Cuban (336), Puerto Rican (376), or Dominican (195) origin.

Measurements

Dependent variable: self-report of up to date CRC screening, defined as fecal occult blood testing within 2 years and/or lower endoscopy at any time. Independent variables: ethnicity/race, country of origin, interview language, socio-demographics, and access to care.

Results

Unadjusted CRC screening rates were highest in whites [mean (standard error), 55.9 (0.6) %], and lowest in Dominicans [28.5 (4.2) %]. After demographic adjustment, CRC screening was significantly lower for Mexicans [adjusted odds ratio (95% confidence interval), 0.46 (0.40, 0.53), p < 0.001)], Puerto Ricans [0.65 (0.47, 0.91), p = 0.01], and Dominicans [0.30 (0.19, 0.45), p < 0.001] versus whites. With further adjustment for language, socioeconomic factors, and access, Hispanic/white disparities were not significant, while among Hispanics, Cubans were more likely to be screened [1.57 (1.15, 2.14), p = 0.01].

Conclusions

Factors associated with CRC screening disparities between Hispanics and non-Hispanic whites appear similar among Hispanic sub-groups. However, the relative contribution of these factors to disparities varies by Hispanic national origin group, suggesting a need for differing approaches to increasing screening for each group.

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Conflicts of interest

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Authors and Affiliations

  1. Department of Family and Community Medicine, University of California Davis School of Medicine, Sacramento, CA, USA

    Anthony F. Jerant M.D., Rose E. Arellanes M.D.M.P.H. & Peter Franks M.D.

  2. Center for Healthcare Policy and Research, University of California Davis School of Medicine, Sacramento, CA, USA

    Peter Franks M.D.

Authors
  1. Anthony F. Jerant M.D.
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  2. Rose E. Arellanes M.D.M.P.H.
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  3. Peter Franks M.D.
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Correspondence to Anthony F. Jerant M.D..

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Jerant, A.F., Arellanes, R.E. & Franks, P. Factors Associated with Hispanic/non-Hispanic White Colorectal Cancer Screening Disparities. J GEN INTERN MED 23, 1241–1245 (2008). https://doi.org/10.1007/s11606-008-0666-1

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  • DOI: https://doi.org/10.1007/s11606-008-0666-1

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