Language and utilization of women's cancer screening: The association of Spanish language with receipt of mammography and Pap smear testing

Abstract

1543 Background: Latina women are more likely to be diagnosed with advanced breast cancer and have higher mortality rates than non-Latina White women. Latinas’ cervical cancer rates are nearly twice that of non-Latina Whites and mortality rates are 50% higher. Some data suggest that low English proficiency is a barrier to cancer screening. The goal of this study was to examine the relationship between language and receipt of women's cancer screening tests among Latinas and non-Latinas using a geographically diverse, population-based sample of women. Methods: Cross-sectional analysis of the CDC's Behavioral Risk Factor Surveillance System (BRFSS) 2006 survey was conducted. Women completing the survey in a state recording data from English and Spanish-speaking participants were included. Women aged 21–64 and without hysterectomy were included in the study sample for Pap smear testing. The mammography sample was limited to women aged 40–64 years. We estimated crude and adjusted odds ratios of respondents’ reported test receipt by self-reported Latina/non-Latina ethnicity and language. Results: Of 53,598 respondents, 70% of Latinas responding in Spanish (LRS) reported having had mammography within the last 2 years, compared to 66% of Latinas responding in English (LRE) and 74% of English-speaking non-Latinas (NL). In multivariable analyses, LRS had 2.25 times the odds (AOR=2.25, 95% CI, 1.65–3.07), and LRE had 1.05 times the odds of having received mammography (AOR=1.05, 95% CI, 0.86–1.28) compared to NL. Of 60,363 respondents, 79% of LRS reported having had Pap smear testing within the last 3 years, compared to 77% of LRE and 84% of English-speaking NL. In multivariable analysis, compared to NL, LRS had 1.91 times the odds (AOR=1.91, 95% CI, 1.42–2.59) of having received Pap smear testing. LRE had the same odds of receiving Pap smear testing as NL (AOR=1.00, 95% CI, 0.82–1.81). Conclusions: Spanish-speaking Latinas had higher adjusted odds of receiving women's cancer screening tests as compared to English-speaking Latinas and English-speaking non-Latinas. Further investigation is needed to determine if these results are an accurate reflection of increased utilization of cancer screening services among Spanish-speaking Latina women. No significant financial relationships to disclose.