Colorectal cancer screening among Hispanics/Latinos in the HCHS/SOL sociocultural ancillary study.

Sheila F Castañeda,Lisa A.P Sanchez-Johnsen,Gregory A Talavera,Samir Gupta,Linda C Gallo,Krista M Perreira,Maria Lopez-Gurrola,Kelly R Evenson,Patricia Gonzalez,Sylvia Smoller-Wassertheil,Frank J Penedo,Jesse Nodora

doi:10.1016/j.pmedr.2019.100947

Abstract

Latino adults are more likely to be diagnosed with colorectal cancer (CRC) at later stages compared to white adults which may be explained by disparities in screening rates. The aim of this study was to examine factors associated with three CRC screening indicators [i.e., 1) any CRC screening ever (via, fecal occult blood test (FOBT), sigmoidoscopy, or colonoscopy); 2) FOBT in last year, 3) sigmoidoscopy/colonoscopy in last 10 years) among US Hispanics/Latinos. We analyzed population-based data collected in 2008–2011 from 2265 adults aged 50–75 from San Diego, Bronx, Miami and Chicago from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. Based on the Behavioral Model of Health Services Use, the following correlates of CRC screening were examined: predisposing (i.e., age, education, income, acculturation), enabling (i.e., recent physician visit, insurance, recent mammogram), and need (i.e., health-related quality of life and family/personal history of cancer) factors. Separate logistic regression models were analyzed for the three CRC screening indicators. Enabling factors associated with all CRC screening indicators included: health insurance, a recent physician visit, and a mammogram in the last year (women only). For women, being older, more acculturated (i.e., English language or foreign-born but in the US for 10 or more years), and having a personal history of cancer was associated with at least one CRC screening. Findings suggest that improving access and utilization of care among Hispanics/Latinos may be critical for earlier CRC diagnosis and survival.

Highlights

In 2009, cancer surpassed heart disease as the leading cause of death for Latinos in the United States (US) (American Cancer Society (ACS), 2012)
This study found that for both men and women, common factors associated with all three Colorectal cancer (CRC) screening indicators (i.e., CRC screening ever, fecal occult blood testing (FOBT) last year, endoscopic exam last 10 years) were enabling factors, including having health insurance, having a physician visit in the last year, and having a recent mammogram
These rates are significantly lower than the Healthy People 2020 and American Cancer Society goal of 80% screening

Summary

Introduction

In 2009, cancer surpassed heart disease as the leading cause of death for Latinos in the United States (US) (American Cancer Society (ACS), 2012). Latinos are more likely to exhibit late-stage invasive cancer (National Cancer Institute, 2007), and significantly reduced rates of survival (Vernon et al, 2010; Mandelblatt et al, 2009) than are other ethnic/racial groups (Zambrana et al, 1999). Screening tests include: high-sensitivity guaiac fecal occult blood testing (FOBT) annually, fecal immunochemical testing (FIT) annually, FIT-DNA every three years, sigmoidoscopy every five years alone or every 10 years with annual FIT, or colonoscopy every 10 years (U.S Preventive Services Task Force, 2016). Latinos, especially those without health insurance, have lower screening rates than other racial/ethnic groups nationwide (American Cancer Society (ACS), 2012). The 2015 National Health Interview Survey (NHIS) indicate that Latinos (47%) are less likely to be adherent with current CRC screening guidelines as compared to non-Hispanic

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