Hispanic Women In California Research Articles

Delivering information about retirement saving among Hispanic women: two Facebook experiments.

We conducted two Facebook experiments (the first one during July 21-25, 2016, and the second during April 22-25, 2018) to determine what type of message related to injunctive norms is more effective in getting Hispanic women interested in learning about financial planning for retirement. We also explore how social media tools could be used in future interventions to promote retirement saving among Hispanic women. In both experiments, we found that a message centered on peer influence may be more successful than a message centered on familism in getting Hispanic women interested in learning more about financial planning for retirement. When we disaggregate our data by age and state, we find that click-through rates were higher among Hispanic women between 45 and 55 years old, and the largest numbers of impressions were among Hispanic women in California and Texas. When we disaggregate our data by device, we find that most study participants were reached through an Android smartphone.

Air pollution, neighborhood acculturation factors, and neural tube defects among Hispanic women in California.

Neural tube defects (NTDs) are one of the most common types of birth defects. Environmental pollutants and acculturation have been associated with NTDs independently. The potential effect modification of acculturation in the relationship between ambient air pollution and risks of NTDs is not well understood. We investigated whether associations between traffic-related air pollutant exposure in early gestation and NTDs, and more specifically spina bifida, were modified by individual and neighborhood acculturation factors among 139 cases and 466 controls born in the San Joaquin Valley of California, 1997 to 2006. Five criteria pollutant exposures in tertiles, two outcomes, and seven neighborhood acculturation factors from the U.S. Census at the block group level were included for a total of 280 investigated associations. Estimates were adjusted for maternal education and multivitamin use in the first 2 months of pregnancy. Additional analyses were stratified by nativity. Increased odds of NTDs were observed for individuals who had high exposures to carbon monoxide, nitrogen oxide, or nitrogen dioxide and lived in neighborhoods that were more acculturated. Conversely, there were increased odds of NTDs for those who had high prenatal exposure to PM10 and lived in neighborhoods that were less acculturated. The results of spina bifida alone were generally stronger in magnitude. When stratified by individual nativity (U.S.- vs. foreign-born), carbon monoxide, nitrogen oxide, and nitrogen dioxide were more strongly associated with NTDs among U.S.-born Hispanic mothers. Neighborhood acculturation factors were modifiers of the relationship between air pollution and NTDs in California, though not in a consistent direction for all pollutants. Birth Defects Research 109:403-422, 2017. © 2017 Wiley Periodicals, Inc.

Assessment of mediators of racial disparities in cervical cancer survival in the United States.

Cervical cancer (CC) morbidity and mortality have decreased in the United States, but they remain high among black women. We assessed racial disparities in CC mortality, accounting for socioeconomic status (SES). We linked data from the 1988 to 2007 Surveillance Epidemiology and End Results (SEER) database to the US Census. Additional SES information was obtained through linkage with Area Resource Files. We used the Kaplan-Meier method for estimating probabilities following CC diagnosis and Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for CC mortality by race. The models were incrementally adjusted for marital status, registry, period, stage, age at diagnosis, histology, treatment, household income, poverty and unemployment rates. We stratified the analyses by disease stage and American state. A total of 44,554 women with CC were identified. Compared to white women, black women had a higher risk of dying from CC; crude and adjusted HRs were 1.41 (CI: 1.34-1.48) and 1.09 (CI: 1.03-1.15), respectively. Corresponding estimates for Hispanic women were 0.85 (CI: 0.80-0.89) and 0.75 (CI: 0.71-0.80). Black women diagnosed at late disease stages had a higher risk of CC death, whereas Hispanic women diagnosed at early and late stages had significantly lower risks. Black CC patients in California experienced poorer survival relative to white women. Conversely, longer CC survival was seen among Hispanic women in California, Georgia and Utah. While crude estimates indicated an increased CC death risk among black women, risks diminished upon adjustment for clinical and sociodemographic characteristics.

Nativity and neighborhood characteristics and cervical cancer stage at diagnosis and survival outcomes among Hispanic women in California.

We examined stage of diagnosis and survival after cervical cancer among Hispanic women, and their associations with Hispanic nativity, and explored whether neighborhood socioeconomic status (SES) and residence in a Hispanic enclave modify the association of nativity with stage and survival. We used California Cancer Registry data (1994-2009) to identify 7958 Hispanic women aged 21 years and older with invasive cervical cancer. We used logistic and Cox proportional hazards models to estimate the associations between stage and mortality with nativity, neighborhood factors, and other covariates. Foreign-born women had similar adjusted relative odds of being diagnosed with stages II through IV (vs stage I) cervical cancer compared with US-born Hispanic women. However, among foreign-born women, those in low-SES-low-enclave neighborhoods were more likely to have late-stage disease than those in high-SES-low-enclave neighborhoods (adjusted odds ratio=1.91; 95% confidence interval=1.18, 3.07). Foreign-born women had lower cervical cancer mortality (adjusted hazard ratio=0.67; 95% confidence interval=0.58, 0.76) than US-born women, but only in high enclaves. Among Hispanic women, nativity, neighborhood enclaves, and SES interact in their influence on stage and survival of cervical cancer.

Abstract A73: Breast cancer subtype distribution and survival among Hispanic women in California

Abstract Background: Evidence on the burden of breast cancer subtypes among Hispanic women is limited, as prior research suggests that Hispanics may be prone to develop those subtypes that are associated with poor prognosis. Additionally, few studies have characterized the population-based distribution of breast cancer subtypes among Hispanic women, by the joint expression of hormone receptors (HR: estrogen receptor (ER) and/or progesterone receptor (PR)), and human epidermal growth factor receptor 2 (HER2). Purpose: Our objective was to assess the distribution and survival of breast cancer subtypes among Hispanic women diagnosed with primary, invasive breast cancer between 2005 and 2010 in California. Methods: Based on information from the California Cancer Registry, breast cancer subtypes were defined as: HR positive/HER2 negative (HR+/HER2-); HR+/HER2+; HR-/HER2+; and triple negative (HR-/HER2-). We calculated frequency distributions of breast cancer subtypes and used polytomous multivariate logistic regression to evaluate their associations with clinical and demographic factors, including socioeconomic status (SES) and Hispanic enclave (based on quintile distribution across the state of California), and nativity. Kaplan-Meier and Cox proportional hazards regression methods were used to assess breast cancer-specific survival and mortality. Results: Among 16,380 Hispanic breast cancer patients, HR+/HER- was the predominant subtype (62.6%), followed by triple negative (15.6%), HR+/HER2+ (13.8%) and HR-/HER2+ (8.1%). Women living in lower SES neighborhoods had a greater risk of triple negative (p<0.01) and HR-/HER2+ (p<0.01) subtypes. Hispanic women diagnosed with triple negative and HR-/HER2+ tumors were substantially more likely to die from the disease (HR=5.00, 95% CI:4.19-5.96 and HR=2.74, 95% CI:2.20-3.41, respectively) than patients with the HR+/HER- subtype. Breast cancer-specific mortality increased with decreasing SES, from HR=1.37 (95% CI:0.97-1.93) for quintile 4 to HR=1.77 (95% CI:1.25-2.51) for quintile 1 (lowest neighborhood SES level). Conclusion: In the most comprehensive analysis of breast cancer subtypes among Hispanic women in the United States to date, our findings indicate that low SES was significantly associated with increased risk of developing and dying from breast cancer subtypes with poor prognosis. Foreign-born women were at greater risk than US-born of HR-/HER2+ tumors, although nativity was not associated with other subtypes. Hispanic women diagnosed with HR- breast cancer subtypes were at significantly increased risk of death; especially, those with triple negative breast cancer. While these results indicate that the distribution and burden of breast cancer subtypes among California Hispanic women are similar to other racial/ethnic populations, it is imperative to better understand the impact of SES on risk factor exposures that increase the risk of developing specific breast cancer subtypes. Citation Format: Matthew P. Banegas, Li Tao, Sean Altekruse, William F. Anderson, Esther M. John, Christina A. Clarke, Scarlett L. Gomez. Breast cancer subtype distribution and survival among Hispanic women in California. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A73. doi:10.1158/1538-7755.DISP13-A73

Consumption habits of pregnant women and implications for developmental biology: a survey of predominantly Hispanic women in California.

BackgroundHealthy post-pregnancy outcomes are contingent upon an informed regimen of prenatal care encouraging healthy maternal consumption habits. In this article, we describe aspects of maternal intake of food, drink, and medication in a population of predominantly Hispanic women in Southern California. Potential implications for unhealthy prenatal dietary choices are discussed.MethodsThe Food, Beverage, and Medication Intake Questionnaire (FBMIQ) measures common practices of maternal consumption during pregnancy. The FBMIQ was administered to English and Spanish speaking pregnant and recently pregnant (36 weeks pregnant - 8 weeks post-partum) women over the age of 18 who were receiving care from a private medical group in Downey CA.ResultsA total of 200 women completed the FBMIQ. Consumption habits of healthy foods and beverages, unhealthy foods, unhealthy beverages, and medication are characterized in this article. Data indicate widespread consumption of fresh fruit, meats, milk and juice and indicate most women used prenatal vitamin supplements. Studies in developmental neuroscience have shown that certain substances may cause teratogenic effects on the fetus when ingested by the mother during pregnancy. Those potentially harmful substances included in our study were Bisphenol-A (BPA), methylmercury, caffeine, alcohol and certain medications. Our results show that a proportion of the women surveyed in our study consumed BPA, methylmercury, caffeine, alcohol, and certain medications at varied levels during pregnancy. This represents an interesting finding and suggests a disconnect between scientific data and general recommendations provided to pregnant mothers by obstetricians.ConclusionsThe results of our study demonstrate that a proportion of pregnant women consume substances that are potentially teratogenic and may impact the health and well being of the offspring. It is important to appraise healthy and unhealthy consumption habits in order to encourage healthy practices and alleviate future effects of preventable, toxin-induced developmental issues. Prenatal advising should discourage the consumption of dangerous foods, beverages, and medications that women commonly report eating during pregnancy.

Abstract LB-325: Characterization of triple negative breast cancer patients among Hispanics in Puerto Rico

Abstract Introduction: Hormone receptor status had been correlated with prognosis in breast cancer patients. Breast cancer patients with no expression of estrogen receptor (ER), progesterone receptor (PR) and her-2 neu (her-2) have been grouped in the Triple Negative Breast Cancer (TNBC) category. At present, these patients have very limited adjuvant therapy alternatives. TNBC has been correlated with poor prognosis among African-American and Hispanic populations. However, there is very few data regarding the prevalence and characterization of TNBC among Hispanics groups (e.g. Puerto Ricans, Cubans, etc.). The objective of this study is to characterize the TNBC population among the Puerto Rican population and to assess whether expression of ER changes the characteristics of the disease in this group. We hypothesize that expression of ER+ in her-2 negative breast cancer tumors will change the initial presentation of the disease. Methods: This cross-sectional study analyzed data from female patients with breast cancer diagnosed between 2000 and 2005, at the I. Gonzalez Martinez Hospital and the Auxilio Mutuo Hospital (n=1,082) in San Juan, Puerto Rico. Information on Her-2 status and other clinical characteristics were retrieved from the hospital's cancer registries and from medical record review. This study was approved by the Institutional Review Boards of the participating hospitals. Logistic regression models were used to evaluate the associations between relevant clinical characteristics and TNBC. We also evaluated whether there were any interaction between age, tumor size and receptor status. Results: The prevalence of TNBC in our study was 16.3% and 58.7% for the Her-2-ER+s phenotype. Patients in the TNBC group have a younger age (<50 yr.) at diagnosis (24.3% vs 75.7%), larger tumor size (>2cm) (70.3% vs 45.6%), invasive ductal histology (87.3% vs 68.7%), and higher tumor grades (III-IV) (49.7% vs 13.2%) compared to Her-2-ERs+. Using multinomial models, we found that, compared to TNBC, women with Her-2-ER+PR- and those with Her-2-ER+PR+ were 1.99 (CI95%=1.15,3.44) and 1.66 (CI95%= 1.11, 2.46) times more likely to have > 50 years at diagnosis as compared to those with <50 years. This relationship is not seen in women with Her-2-ER-PR+ tumors. Furthermore, compared to TNBC, women with Her-2-ER+PR- are 0.4 (IC95%=0.24-0.67) times more likely to have tumors > 2cm. There was no interaction between receptor status, age and tumor size (p=0.582). Conclusions: TNBC in Hispanics from Puerto Rican origin showed the same prevalence of Hispanic women in California. Furthermore, disease characteristics (early age at diagnosis, tumor size, histology and tumor grade) were also similar, suggesting that race has a significant effect in the presentation of TNBC in Hispanic women. In addition, the expression of ER, but not PR in Her-2 negative patients dramatically changes the initial presentation of the disease. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr LB-325. doi:1538-7445.AM2012-LB-325

Nativity and papillary thyroid cancer incidence rates among Hispanic women in California

Overall, the incidence of papillary thyroid cancer in Hispanic women residing in the United States (US) is similar to that of non-Hispanic white women. However, little is known as to whether rates in Hispanic women vary by nativity, which may influence exposure to important risk factors. Nativity-specific incidence rates among Hispanic women were calculated for papillary thyroid cancer using data from the California Cancer Registry (CCR) for the period 1988-2004. For the 35% of cases for whom birthplace information was not available from the CCR, nativity was statistically imputed based on age at Social Security number issuance. Population estimates were extracted based on US Census data. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were also estimated. In young (age <55 years) Hispanic women, the incidence of papillary thyroid cancer among US-born women (10.65 per 100,000) was significantly greater than that for foreign-born women (6.67 per 100,000; IRR, 1.60 [95% CI, 1.44-1.77]). The opposite pattern was observed in older women. The age-specific patterns showed marked differences by nativity: among foreign-born women, rates increased slowly until age 70 years, whereas among US-born women, incidence rates peaked during the reproductive years. Incidence rates increased over the study period in all subgroups. Incidence rates of papillary thyroid cancer vary by nativity and age among Hispanic women residing in California. These patterns can provide insight for future etiologic investigations of modifiable risk factors for this increasingly common and understudied cancer.

An examination of cesarean and vaginal birth histories among Hispanic women entering prenatal care in two California counties with large immigrant populations.

Repeat cesarean delivery (CD) rates among US Hispanic women are the highest of all racial/ethnic groups (90%). Vaginal birth after cesarean (VBAC) is an alternative delivery method, but requires medical records documentation of a non-vertical incision and favorable conditions in the current pregnancy. VBAC rates for Hispanic women are extremely low. This study explores the birth histories and medical records access among Hispanic women in California, taking into account the potential role of immigration on access to VBAC. Study aims are to describe for a sample of Hispanic women: (1) CD and VBAC histories as well as history of vaginal delivery preceding CD; and (2) medical records access, among women who had previous births in Mexico. Chart review was conducted for prenatal patients from three safety net clinics in two California counties with large Mexican migrant populations between August, 2003 and February 2004—during which VBAC was widely available in these two counties to determine: obstetric histories, CD details, birthplace and whether or not medical records had been requested/obtained for CD. 355 multiparous Hispanic women were included. Thirty-three percent had a previous CD, almost two-thirds (64%) had only one CD. Over half of the women (55%) with 2+ births and CD history also reported a vaginal birth history. Medical records for CD were infrequently requested (29%). Of those requested, records were received for 77% of women with a US CD, compared with 13% of women with Mexican CD histories. Policies to address: (1) VBAC opportunities for low risk women, such as those with prior vaginal births and one CD, and (2) overcoming limited medical records access, could mitigate against unnecessary CD and associated medical expenditures and risks for future complications.

Breast Cancer Incidence Patterns among California Hispanic Women: Differences by Nativity and Residence in an Enclave

Breast cancer incidence is higher in U.S.-born Hispanic women than foreign-born Hispanics, but no studies have examined how these rates have changed over time. To better inform cancer control efforts, we examined incidence trends by nativity and incidence patterns by neighborhood socioeconomic status (SES) and Hispanic enclave (neighborhoods with high proportions of Hispanics or Hispanic immigrants). Information about all Hispanic women diagnosed with invasive breast cancer between 1988 and 2004 was obtained from the California Cancer Registry. Nativity was imputed from Social Security number for the 27% of cases with missing birthplace information. Neighborhood variables were developed from Census data. From 1988 to 2004, incidence rates for U.S.-born Hispanics were parallel but lower than those of non-Hispanic whites, showing an annual 6% decline from 2002 to 2004. Foreign-born Hispanics had an annual 4% increase in incidence rates from 1995 to 1998 and a 1.4% decline thereafter. Rates were 38% higher for U.S.- than foreign-born Hispanics, with elevations more pronounced for localized than regional/distant disease, and for women>50 years of age. Residence in higher SES and lower Hispanic enclave neighborhoods were independently associated with higher incidence, with Hispanic enclave having a stronger association than SES. Compared with foreign-born, U.S.-born Hispanic women in California had higher prevalence of breast cancer risk factors, suggesting that incidence patterns largely reflect these differences in risk factors. Further research is needed to separate the effects of individual- and neighborhood-level factors that affect incidence in this large and growing population.

Abstract LB-393: Characterization of triple-negative breast cancer patients among Hispanics in Puerto Rico

Abstract Introduction: Hormone receptor status had been correlated with prognosis in breast cancer patients. Breast cancer patients with no expression of estrogen receptor (ER), progesterone receptor (PR) and her-2 neu (her-2) have been grouped in the Triple Negative Breast Cancer (TNBC) category. At present, these patients have very limited adjuvant therapy alternatives. TNBC has been correlated with poor prognosis among African-American and Hispanic populations. However, there is very few data regarding the prevalence and characterization of TNBC among Hispanics groups (e.g. Puerto Ricans, Cubans, etc.). The objective of this study is to characterize the TNBC population among the Puerto Rican population and to assess whether expression of ER change the characteristics of the disease in this group. We hypothesize that expression of ER+ in her-2 negative breast cancer tumors will change the initial presentation of the disease. Methods: This cross-sectional study analyzed data from female patients with breast cancer diagnosed between 2000 and 2005, at the I. Gonzalez Martinez Hospital and the Auxilio Mutuo Hospital (n=1,082) in San Juan, Puerto Rico. Information on Her-2 status and other clinical characteristics was retrieved from the hospital's cancer registries and from medical record review. This study was approved by the Institutional Review Boards of the participating hospitals. Logistic regression models were used to evaluate the associations between relevant clinical characteristics and TNBC. We also evaluated whether there were any interaction between age, tumor size and receptor status. Results: The prevalence of TNBC in our study was 16.3% and 58.7% for the Her-2-ER+s phenotype. Patients in the TNBC group have younger age (&amp;lt;50 yr.) at diagnosis (24.3% vs 75.7%), bigger tumor size (&amp;gt;2cm) (70.3% vs 45.6%), invasive ductal histology (87.3% vs 68.7%), and higher tumor grades (III-IV) (49.7% vs 13.2%) compared to Her-2-ERs+. Using multinomial models, we found that, compared to TNBC, women with Her-2-ER+PR- and those with Her-2-ER+PR+ were 1.99 (CI95%= 1.15,3.44) and 1.66 (CI95%= 1.11, 2.46) times more likely to have &amp;gt; 50 years at diagnosis as compared to those with &amp;lt;50 years. This relationship is not seen in women with Her-2-ER-PR+ tumors. Furthermore, compared to TNBC, women with Her-2-ER+PR-are 0.4 (IC95%=0.24-0.67) times more likely to have tumors &amp;gt; 2cm. There was no interaction between receptor status, age and tumor size (p=0.582). Conclusions: TNBC in Hispanics from Puerto Rican origin showed the same prevalence of Hispanic women in California. Furthermore, disease characteristics (early age at diagnosis, tumor size, and histology and tumor grade) were also similar, suggesting that race has a significant effect in the presentation of TNBC in Hispanic women. In addition, the expression of ER, but not PR in Her-2 negative patients dramatically changes the initial presentation of the disease. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr LB-393.

Trends in Smoking Among Hispanic Women in California: Relationship to English Language Use

Research has shown that Hispanic women who speak mostly English have higher smoking rates than those who speak mostly another language. It is unknown how differences in smoking by English language use among adult Hispanic women in California have changed in recent years. We compared current daily (100 or more cigarettes in lifetime, now smokes daily) and current nondaily (100 or more cigarettes in lifetime, now smokes some days) smoking prevalence for adult Hispanic women by English language use at home from population-based, random-digit-dialed California Tobacco Surveys in 1996 (n = 1406, 74% response rate [RR]); 1999 (n = 1379, 69% RR), and 2002 (n = 2912, 64% RR). Current smoking prevalence was at least twice as high among those who speak mostly English compared to those who speak mostly another language in every survey year (1996: 14.7% vs 6.1%; 1999: 14.6% vs 6.1%; 2002: 11.7% vs 4.9%) with the ratio staying constant (2.4:1). There was a decline in current nondaily smoking among those who speak mostly English by 2002 (1996 and 1999 prevalence: approximately 6%, 2002: approximately 4%), but no declines in current daily smoking for either language-use group. There has been no reduction in the English-language-use gap in smoking among Hispanic women in California. There has been a significant decline in current nondaily smoking prevalence among women who speak mostly English, but no significant reduction in current daily smoking for either language-use group. It appears that not much progress has been made in California in reducing daily smoking prevalence among Hispanic women at the population level. Smoking prevention and cessation efforts among Hispanic women remain a priority.

Use of Prenatal Care by Hispanic Women After Welfare Reform

The 1996 Personal Responsibility Work Opportunity Reconciliation Act (PRWORA, "welfare reform") changed immigrants' eligibility for publicly funded services such as Medicaid. However, implementation of the PRWORA varied by state. Florida implemented the eligibility restrictions, while California and New York preserved eligibility. Our objective was to compare the effect of state of residence and immigration status on use of prenatal care among Hispanic women in the period following the enactment of PRWORA. In 1999-2001, we interviewed 3,242 postpartum Hispanic women in California, Florida, and New York. The dependent variable was use of prenatal care, dichotomized as adequate (initiated during the first trimester and > or = 6 visits, referent) or inadequate (initiated during the first trimester and < 6 prenatal visits or initiated after the first trimester). The primary independent variables were state of residence and maternal immigration status (U.S.-born citizens in New York, reference group). Thirteen percent of women were U.S.-born citizens, 8% were foreign-born citizens, 15% were documented immigrants, and 64% were undocumented immigrants. In Florida, women in all immigration subgroups were 2-4 times more likely to make inadequate use of prenatal care than U.S.-born citizens in New York. Documented immigrant women in New York were 90% more likely to make inadequate use of prenatal care than U.S.-born citizens in New York. Among Hispanic women in California, Florida, and New York, the state of residence, a measure of PRWORA policy changes, was associated with use of prenatal care. II-2.

Unique Challenges to Preventing Perinatal HIV Transmission Among Hispanic Women in California: Results of A Needs Assessment

To identify rates and factors associated with timely prenatal care (PNC) initiation, HIV test counseling, test offering, and test offer acceptance, we conducted a semistructured survey of a convenience sample of pregnant/recently delivered Hispanic women (n=453, 418 with analyzable data) in four California counties in 2000. Only 68.4% and 43.5% of Hispanic women reported receiving an HIV test offer and counseling, respectively, though 88.8% of those offered a test accepted. After controlling for the effects of age, education, years lived in the United States, health insurance coverage, delivery status, and parity, Hispanic women who initiated prenatal care in the first trimester were 1.7 times more likely to be offered an HIV test and almost 3 times more likely to receive counseling than women with a later prenatal care start or no prenatal care. Factors associated with timely PNC initiation on multivariate analysis were private/HMO insurance (OR=10.7, p < .001), Medi-Cal insurance (OR = 4.32, p < .001), being 25-30 years old (OR = 3.0, p = .008), and completion of high school (OR = 2.07, p = .01). Key opportunities to prevent perinatal HIV transmission are being lost for Hispanic women in California. Interventions to increase timely PNC initiation, and to improve test offering by health care providers, may help to improve counseling and testing rates for this population.

Pap smear use in California: are we closing the racial/ethnic gap?

Background Minority women continue to be disproportionately affected by cervical cancer. Minority population groups at high risk for cervical cancer may be failing to fully comply with screening recommendations. The use of Pap smears among women in California was evaluated to identify ethnic groups at higher risk for noncompliance with cervical cancer screening. Methods Cross-sectional analysis of 2001 California Health Interview Survey data. Logistic regression was used to assess the independent contribution of race/ethnicity to the use of Pap smears. Results Hispanic (aPR = 1.03, 95%CI 1.02–1.05) and Black (aPR = 1.03, 95% CI 1.001–1.06) women are more likely to report a Pap smear in the past 3 years as compared to White women. Asians were the least likely to report cervical cancer screening despite a more favorable sociodemographic profile. Screening rates varied among Hispanic or Asian subgroups; Mexicans, Vietnamese, Chinese, and South Asians are particularly underserved. Conclusions In contrast to the country as a whole, Hispanic women in California are more likely to report a recent Pap smear as compared to White women. However, racial/ethnic disparities in Pap smear use persist; Asian women are the least likely to report cervical cancer screening as compared to any other group.