Abstract
The incidence of colorectal cancer (CRC) among Hispanics in the state of New Mexico has increased in the past decade while that among whites has declined significantly. Using the 2006 New Mexico Behavioral Risk Factor Surveillance System (BRFSS) survey, we compared CRC screening among Hispanics and whites by gender to examine the influence of demographic, socioeconomic, preventive health, and clinical measures on the utilization of CRC screening. Although we found no ethnic differences in the prevalence of current breast, cervical and cancer screening, Hispanics were less likely to be current with CRC screening than whites. These differences were observed across a range of socioeconomic and other explanatory measures and in both genders. Hispanics also had a higher prevalence of CRC-related risk factors than whites, including inactivity, obesity, and diabetes, and ranked lower for most socioeconomic measures. Adjusting for healthcare coverage, education, and income in logistic regression models eliminated the Hispanic-white differences in CRC screening among men, and substantially reduced but did not eliminate screening differences among women. Innovative methods are needed to reach Hispanics to raise awareness of and participation in CRC screening. Because many CRC risk factors are potentially modifiable, appropriate cultural and linguistic interventions tailored to specific Hispanic subgroups and aimed at promoting CRC screening and reducing CRC risk factors may decrease ethnic disparities in CRC incidence.
Similar content being viewed by others
References
Edwards, B. K., Ward, E., Kohler, B. A., Eheman, C., et al. (2010). Annual report to the nation on the status of cancer, 1975–2006, featuring colorectal cancer trends and impact of interventions to reduce future rates. Cancer, 116(3), 544–573.
New Mexico Cancer Facts and Figures. (2007). A document for tracking, planning and evaluating. Albuquerque, NM: New Mexico Department of Health. http://www.cancernm.org/cancercouncil/pdf/NMCFF_FINAL_8-28-07_reduced%20size.pdf. Accessed October 9, 2011.
Whitlock, E. P., Lin, J., Liles, E., Beil, T., et al. (2008). Screening for colorectal cancer: An updated systematic review. Rockville, MD: Agency for Healthcare Research and Quality. http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=es65v1. Accessed September 23, 2011.
Cronin, C. N., Klabunde, K. N., Breen, K. A., Waldron, N., Ambs, A. H., & Nadel, M. R. (2011). Trends in colorectal cancer test use among vulnerable populations in the United States. Cancer Epidemiology Biomarkers Prevention, 20(8), 1611–1621.
Zhou, J., Enewold, L., Peoples, G. E., Clifton, G. T., et al. (2010). Trends in cancer screening among Hispanic and white non-Hispanic women, 2000–2005. Journal of Womens Health, 19(12), 2167–2174.
Zhou, J., Enewold, L., Peoples, G. E., McLeod, D. G., et al. (2011). Colorectal, prostate, and skin cancer screening among Hispanic and White non-Hispanic men, 2000–2005. Journal of the National Medical Association, 103(4), 343–350.
Afable-Munsuz, A., Liang, S. Y., Ponce, N. A., & Walsh, J. M. (2009). Acculturation and colorectal cancer screening among older Latino adults: Differential associations by national origin. Journal of General Internal Medicine, 24(8), 963–970.
Flegal, K. M., Carroll, M. D., Ogden, C. L., & Curtin, L. R. (2010). Prevalence and trends in obesity among US adults, 1999–2008. JAMA, 303(3), 235–241.
Centers for Disease Control and Prevention. (2006). Behavioral risk factor surveillance system survey data. Atlanta, GA: US Department of Health and Human Services.
Centers for Disease Control and Prevention (CDC). (2008). Use of colorectal cancer tests—United States, 2002, 2004, and 2006. Morbidity and Mortality Weekly Report, 57(10), 253–258.
Kang-Kim, M., Betancourt, J. R., Ayanian, J. Z., Zaslavsky, A. M., Yucel, R. M., & Weissman, J. S. (2008). Access to care and use of preventive services by Hispanics: State-based variations from 1991 to 2004. Medical Care, 46(5), 507–515.
Peterson, N. B., Murff, H. J., Ness, R. M., & Dittus, R. S. (2007). Colorectal cancer screening among men and women in the United States. Journal of Womens Health, 16(1), 57–65.
Vargas Bustamante, A., Chen, J., Rodriguez, H. P., Rizzo, J. A., & Ortega, A. N. (2010). Use of preventive care services among Latino subgroups. American Journal of Preventive Medicine, 38(6), 610–619.
Swan, J., Breen, N., Coates, R. J., Rimer, B. K., & Lee, N. C. (2003). Progress in cancer screening practices in the United States: Results from the 2000 national health interview survey. Cancer, 97(6), 1528–1540.
Shokar, N. K., Vernon, S., & Weller, S. C. (2005). Cancer and colorectal cancer: Knowledge, beliefs, and screening preferences of a diverse patient population. Family Medicine, 37(5), 341–347.
Ogedegbe, G., Cassells, A. N., Robinson, C. M., et al. (2005). Perceptions of barriers and facilitators of cancer early detection among low-income minority women in community health centers. Journal of the National Medical Association, 97(2), 162–170.
Jerant, A. F., Arellanes, R. E., & Franks, P. (2008). Factors associated with Hispanic/non-Hispanic white colorectal cancer screening disparities. Journal of General Internal Medicine, 23(8), 1241–1245.
Bolen, J. C., Rhodes, L., Powell-Griner, E. E., Bland, S. D., & Holtzman, D. (2000). State-specific prevalence of selected health behaviors, by race and ethnicity-behavioral risk factor surveillance system, 1997. Morbidity and Mortality Weekly Report Surveillance Summaries, 49(2), 1–60.
Colorectal Cancer Prevention (PDQ®). (2011). National Institutes of Health, National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/prevention/colorectal/HealthProfessional/page2. Updated July 15, 2011. Accessed September 24, 2011.
Larsson, S. C., Orsini, N., & Wolk, A. (2005). Diabetes mellitus and risk of colorectal cancer: a meta-analysis. Journal of the National Cancer Institute, 97(22), 1679–1687.
Barbeau, E. M., Krieger, N., & Soobader, M.-J. (2004). Working class matters: socioeconomic disadvantage, race/ethnicity, gender, and smoking in NHIS 2000. American Journal of Public Health, 94(2), 269–278.
Clegg, L., Reichman, M. E., Miller, B. A., et al. (2009). Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: National Longitudinal Mortality Study. Cancer Causes and Control, 20(4), 417–435.
Dubowitz, T., Heron, M., Bird, C. E., et al. (2008). Neighborhood socioeconomic status and fruit and vegetable intake among whites, blacks, and Mexican Americans in the United States. American Journal of Clinical Nutrition, 87(6), 1883–1891.
Huckle, T., You, R. Q., & Casswell, S. (2010). Socio-economic status predicts drinking patterns but not alcohol-related consequences independently. Addiction, 105(7), 1192–1202.
Tucker-Seeley, R. D., Subramanian, S. V., Li, Y., & Sorensen, G. (2009). Neighborhood safety, socioeconomic status, and physical activity in older adults. American Journal of Preventive Medicine, 37(3), 207–213.
Zhang, Q., & Wang, Y. (2004). Socioeconomic inequality of obesity in the United States: do gender, age, and ethnicity matter? Social Science and Medicine, 58(6), 1171–1180.
Hoffman, R. M., Rhyne, R. L., Helitzer, D. L., et al. (2011). Barriers to colorectal cancer screening: physician and general population perspectives, New Mexico, 2006. Preventing Chronic Disease, 8(2), A35.
Hoffman, R. M., Lewis, L. C., Pignone, M. P., et al. (2010). Decision-making processes for breast, colorectal, and prostate cancer screening: the DECISIONS survey. Medical Decision Making, 30(5 Suppl), 53S–64S.
Shike, M., Schattner, M., Genao, A., et al. (2011). Expanding colorectal cancer screening among minority women. Cancer, 117(1), 70–76.
Acknowledgments
We wish to thank Wayne Honey, MPH, at the New Mexico Department of Health for providing the New Mexico BRFSS data for this analysis. Dr. Gonzales was supported by the National Institute of Environmental Health Sciences K01 ES014003.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gonzales, M., Nelson, H., Rhyne, R.L. et al. Surveillance of Colorectal Cancer Screening in New Mexico Hispanics and Non-Hispanic Whites. J Community Health 37, 1279–1288 (2012). https://doi.org/10.1007/s10900-012-9568-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10900-012-9568-6