Use of Cancer Screening Practices by Hispanic Women: Analyses by Subgroup

Jackson Heart Study, Jackson State University, Jackson, Mississippi, 39216-4506
Preventive Medicine (Impact Factor: 3.09). 01/2000; 29(6):466-477. DOI: 10.1006/pmed.1999.0566
Source: PubMed


Objectives. This study compares the use of three cancer screening practices (Pap smear, mammogram, and clinical breast examination) 3 years prior to interview among five subgroups of Hispanic women, and examines whether sociodemographic; access; health behavior, perception, and knowledge; and acculturation factors predict screening practices for any subgroup.Methods. Descriptive and multiple logistic regression analyses were conducted with data pooled from the 1990 and 1992 National Health Interview Surveys on women who reported that they were Hispanic. The study sample includes 2,391 respondents: 668 Mexican-American, 537 Mexican, 332 Puerto Rican, 143 Cuban, and 711 other Hispanic women.Results. Subgroup profiles reveal differences in education, health insurance, use of English language, and screening use. Mexican women were the least likely to be screened with any procedure. Logistic regression results for each screening practice show that having a usual source of care was a positive predictor for obtaining each of the three screening practices within the last 3 years. Being married, being more than 50 years of age, and having knowledge of breast self-examination were all predictors of having a Pap smear. Having health insurance and ever having had a clinical breast examination and Pap smear were predictors of having a mammography, while age, knowledge of breast self-examination, ever having had a Pap smear and mammogram, and being a nonsmoker all predicted having a clinical breast examination.Conclusions. We conclude that access factors and prior screening are more strongly associated with current screening than are language and ethnic factors. Our data confirm that a disproportionate percentage of Hispanic women are low income and at risk of being underscreened. Our findings from a nationally representative sample of Hispanics have implications for provider practices, ethnic-specific community interventions, and future development of measures and data collection approaches.

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Available from: Ruth E Zambrana,
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    • "Physicians play a key role in informing women of the benefits of screening (O'Malley , 2001) . Similar results were observed in previous evidence (Zambrana et al , 1999). The respect for authority is an important characteristic of Hispanic culture. "
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    ABSTRACT: Minority ethnic groups in the UK have worse outcomes for some cancer types compared with the white majority. Black males have worse staging at diagnosis of prostate cancer and often present as emergencies, suggesting possible delays in the diagnostic pathway. Delay may arise from lower awareness of cancer symptoms, reluctance to report symptoms, reduced desire for investigation, or a combination of these. Reduced desire for investigation was examined in this study To investigate whether black males in the UK would choose to be tested for prostate cancer compared with the white majority. A vignette (hypothetical scenario)-based, electronic survey of male patients aged ≥40 years from four general practices in Bristol, UK. The vignettes described possible prostate cancer symptoms (equating to risk levels of 2%, 5%, and 10%), investigative procedures, and possible outcomes. Participants indicated whether they would choose investigation in these scenarios. Analysis used logistic regression, with preference for investigation as the outcome variable and ethnicity as the main explanatory variable. In total, 449 (81%) of 555 participants opted for investigation, regardless of risk levels; of these, the acceptance rate was 94% (251 out of 267) among white males and 70% (198 out of 285) among black males. In multivariable analyses, preference for investigation was lower in black males, even after controlling for relevant confounding factors including specific risk level (odds ratio 0.13; 95% confidence interval = 0.07 to 0.25; P<0.001). Black males are less likely to opt for investigation at any risk level of prostate cancer compared with white males. This may explain some of their late-stage presentation at diagnosis and subsequent poorer outcomes. © British Journal of General Practice 2015.
    British Journal of General Practice 03/2015; 65(632):e161-70. DOI:10.3399/bjgp15X683965 · 2.29 Impact Factor
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    • "Hispanics are a diverse group with respect to socioeconomic characteristics, level of acculturation, national origin, and heritage. These factors have all been linked to cancer [3, 4] and other health outcomes [5–9]. Cancer is the leading cause of death among Hispanics in the US [10]. "
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    06/2014; 2014(5):702683. DOI:10.1155/2014/702683
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    • "Rarely are ethnic/racial groups disaggregated in studies that allow adequate examination of national trends in healthcare practices. The practice of inappropriate aggregation is carried forward into national healthcare reports and " masks " within-Latino disparities in healthcare (Bustamante et al., 2010; Gonzalez et al., 2010; Miranda et al., 2011a; Zambrana et al., 1999). Consequently, national healthcare policies set goals for reducing disparities in healthcare that have missed important healthcare parity targets among the most vulnerable populations. "
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