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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1241-1245 |
| Number of pages | 5 |
| Journal | Journal of General Internal Medicine |
| Volume | 23 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 2008 |
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Keywords
- Colorectal neoplasms
- Hispanic Americans
- Mass screening
- Quality of health care
- Socioeconomic factors
ASJC Scopus subject areas
- Internal Medicine
Cite this
Factors associated with Hispanic/non-Hispanic white colorectal cancer screening disparities. / Jerant, Anthony F; Arellanes, Rose E.; Franks, Peter.
In: Journal of General Internal Medicine, Vol. 23, No. 8, 08.2008, p. 1241-1245.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Factors associated with Hispanic/non-Hispanic white colorectal cancer screening disparities
AU - Jerant, Anthony F
AU - Arellanes, Rose E.
AU - Franks, Peter
PY - 2008/8
Y1 - 2008/8
N2 - 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.
AB - 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.
KW - Colorectal neoplasms
KW - Hispanic Americans
KW - Mass screening
KW - Quality of health care
KW - Socioeconomic factors
UR - http://www.scopus.com/inward/record.url?scp=49649126086&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=49649126086&partnerID=8YFLogxK
U2 - 10.1007/s11606-008-0666-1
DO - 10.1007/s11606-008-0666-1
M3 - Article
C2 - 18500503
AN - SCOPUS:49649126086
VL - 23
SP - 1241
EP - 1245
JO - Journal of General Internal Medicine
JF - Journal of General Internal Medicine
SN - 0884-8734
IS - 8
ER -