Journal of Community Health

, Volume 41, Issue 5, pp 903–909 | Cite as

Examining the Impact of Latino Nativity, Migration, and Acculturation Factors on Colonoscopy Screening

  • Rosario Costas-Muñiz
  • Lina Jandorf
  • Errol Philip
  • Noah Cohen
  • Cristina Villagra
  • Pathu Sriphanlop
  • Elizabeth Schofield
  • Katherine DuHamel
Original Paper


Latinos are a diverse population comprised of multiple countries of origin with varying cultural profiles. This study examines differences in colonoscopy completion across place of birth and migration-related factors in a sample of predominantly Dominican and Puerto Rican Latinos living in New York City after receiving a recommendation for colonoscopy screening and navigation services. The sample included 702 Latinos recruited for two cancer screening projects targeting Latinos eligible for colonoscopy who seek healthcare in New York City. Participants completed a survey that included sociodemographic, health-related questions, psychosocial assessments and cancer screening practices, in Spanish or English. Migration, acculturation, and language factors were found to predict colonoscopy completion. The results indicated that Latinos born in the Dominican Republic and Central America were more likely to complete a screening colonoscopy than their counterparts born in the US. Further, those who emigrated at an older age, who have resided in the US for less than 20 years, preferred Spanish and those with lower US acculturation levels were also more likely to complete a screening colonoscopy. The findings suggest that Latinos who are less acculturated to the US are more likely to complete a screening colonoscopy after receiving a physician recommendation for colonoscopy screening. The results provide important information that can inform clinical practice and public health interventions. Continued attention to cultural and migration influences are important areas for cancer screening intervention development.


Colonoscopy Adherence Latinos Cancer screening Immigrant Health 


  1. 1.
    US Census. (2012). The Hispanic population in the United States: 2012. Retrieved from:
  2. 2.
    US Census Bureau. Place of birth for the foreign-born population in the United States, 20062010. Google Scholar
  3. 3.
    American Cancer Society. (2012). Cancer Facts & Figures for Hispanics/Latinos 2012–2014. American Cancer Society.Google Scholar
  4. 4.
    Walsh, J. M., & Terdiman, J. P. (2003). Colorectal cancer screening: Scientific review. JAMA, 289(10), 1288–1296.CrossRefPubMedGoogle Scholar
  5. 5.
    Center, M. M., Jemal, A., Smith, R. A., & Ward, E. (2009). Worldwide variations in colorectal cancer. CA Cancer Journal for Clinicians, 59, 366–378. doi:10.3322/caac.20038.CrossRefGoogle Scholar
  6. 6.
    Lawsin, C., Erwin, D., Bursac, Z., & Jandorf, L. (2011). Heterogeneity in breast and cervical cancer screening practices among female Hispanic immigrants in the United States. Journal of Immigrant and Minority Health, 13(5), 834–841.CrossRefPubMedGoogle Scholar
  7. 7.
    Goel, M. S., Wee, C. C., McCarthy, E. P., Davis, R. B., Ngo-Metzger, Q., & Phillips, R. S. (2003). Racial and ethnic disparities in cancer screening: The importance of foreign birth as a barrier to care. Journal of General Internal Medicine, 18(12), 1028–1035.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Shih, Y. C., Elting, L. S., & Levin, B. (2008). Disparities in colorectal screening between US-born and foreign-born populations: Evidence from the 2000 National Health Interview Survey. Journal of Cancer Education, 23(1), 18–25. doi:10.1080/08858190701634623.CrossRefPubMedGoogle Scholar
  9. 9.
    Shelton, R. C., Jandorf, L., King, S., Thelemaque, L., & Erwin, D. O. (2012). Cervical cancer screening among immigrant Hispanics: An analysis by country of origin. Journal of Immigrant and Minority Health, 14(4), 715–720. doi:10.1007/s10903-011-9541-y.CrossRefPubMedGoogle Scholar
  10. 10.
    Shelton, R. C., Jandorf, L., Thelemaque, L., King, S., & Erwin, D. O. (2012). Sociocultural determinants of breast and cervical cancer screening adherence: An examination of variation among immigrant Latinas by country of origin. Journal of Health Care for the Poor and Underserved, 23(4), 1768–1792.CrossRefPubMedGoogle Scholar
  11. 11.
    Ellison, J., Jandorf, L., Villagra, C., Winkel, G., & DuHamel, K. (2011). Screening adherence for colorectal cancer among immigrant Hispanic women. Journal of the National Medical Association, 103(8), 681–688.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Jibara, G., Jandorf, L., Fodera, M. B., & DuHamel, K. N. (2011). Adherence to physician recommendation to colorectal cancer screening colonoscopy among Hispanics. Journal of General Internal Medicine, 26(10), 1124–1130. doi:10.1007/s11606-011-1727-4.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Jandorf, L., Ellison, J., Villagra, C., Winkel, G., Varela, A., Quintero-Canetti, Z., & Duhamel, K. (2010). Understanding the barriers and facilitators of colorectal cancer screening among low income immigrant Hispanics. Journal of Immigrant and Minority Health, 12(4), 462–469.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Braschi, C. D., Sly, J. R., Singh, S., Villagra, C., & Jandorf, L. (2013). Increasing colonoscopy screening for Latino Americans through a patient navigation model: A randomized clinical trial. Journal of Immigrant and Minority Health,. doi:10.1007/s10903-013-9848-y.Google Scholar
  15. 15.
    O’Malley, A. S., Kerner, J., Johnson, A. E., & Mandelblatt, J. (1999). Acculturation and breast cancer screening among Hispanic women in New York City. American Journal of Public Health, 89(2), 219–227.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Peragallo, N. P., Fox, P. G., & Alba, M. L. (2000). Acculturation and breast self-examination among immigrant Latina women in the USA. International Nursing Review, 47(1), 38–45.CrossRefPubMedGoogle Scholar
  17. 17.
    Savas, L. S., Vernon, S. W., Atkinson, J. S., & Fernandez, M. E. (2014). Effect of acculturation and access to care on colorectal cancer screening in low-income Latinos. Journal of Immigrant and Minority Health,. doi:10.1007/s10903-014-0061-4.Google Scholar
  18. 18.
    Harmon, M. P., Castro, F. G., & Coe, K. (1996). Acculturation and cervical cancer: Knowledge, beliefs, and behaviors of Hispanic women. Women and Health, 24(3), 37–57.CrossRefPubMedGoogle Scholar
  19. 19.
    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. doi:10.1007/s11606-009-1022-9.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Parkin, D. M., & Bray, F. (2006). The burden of HPV-related cancers. Vaccine, 24, S11–S25. doi:10.1016/j.vaccine.2006.05.111.CrossRefGoogle Scholar
  21. 21.
    PAHO/WHO. (2013). Cancer in the Americas. Country profiles. Retrieved from:
  22. 22.
    Jandorf, L., Gutierrez, Y., Lopez, J., Christie, J., & Itzkowitz, S. H. (2005). Use of a patient navigator to increase colorectal cancer screening in an urban neighborhood health clinic. Journal of Urban Health-Bulletin of the New York Academy of Medicine, 82(2), 216–224. doi:10.1093/jurban/jti046.PubMedPubMedCentralGoogle Scholar
  23. 23.
    Marin, G., Sabogal, F., Marin, B. V., Otero-Sabogal, R., et al. (1987). Development of a short acculturation scale for Hispanics. Hispanic Journal of Behavioral Sciences, 9(2), 183–205.CrossRefGoogle Scholar
  24. 24.
    Borrayo, E. A., & Guarnaccia, C. A. (2000). Differences in Mexican-born and U.S.-born women of Mexican descent regarding factors related to breast cancer screening behaviors. Health Care Women International, 21(7), 599–613. doi:10.1080/07399330050151842.CrossRefGoogle Scholar
  25. 25.
    Elder, J. P., Castro, F. G., de Moor, C., Mayer, J., Candelaria, J. I., Campbell, N., & Ware, L. M. (1991). Differences in cancer-risk-related behaviors in Latino and Anglo adults. Preventive Medicine, 20(6), 751–763.CrossRefPubMedGoogle Scholar
  26. 26.
    Johnson-Kozlow, M. (2010). Colorectal cancer screening of Californian adults of Mexican origin as a function of acculturation. Journal of Immigrant and Minority Health, 12(4), 454–461. doi:10.1007/s10903-009-9236-9.CrossRefPubMedGoogle Scholar
  27. 27.
    Hillyer, G. C., Basch, C. E., Schmitt, K. M., & Neugut, A. I. (2011). Feasibility and efficacy of pairing fecal immunochemical testing with mammography for increasing colorectal cancer screening among uninsured Latinas in northern Manhattan. Preventive Medicine, 53(3), 194–198. doi:10.1016/j.ypmed.2011.06.011.CrossRefPubMedGoogle Scholar
  28. 28.
    Lara, M., Gamboa, C., Kahramanian, M. I., Morales, L. S., & Bautista, D. E. (2005). Acculturation and Latino health in the United States: A review of the literature and its sociopolitical context. Annual Review of Public Health, 26, 367–397. doi:10.1146/annurev.publhealth.26.021304.144615.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkUSA
  2. 2.Department of Psychiatry and Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkUSA
  3. 3.Department of Oncological ServicesIcahn School of Medicine at Mount SinaiNew YorkUSA
  4. 4.Notre Dame Laboratory for Psycho-Oncology ResearchUniversity of Notre DameNotre DameUSA
  5. 5.Department of PsychiatryWeill Cornell Medical CollegeNew YorkUSA

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