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Limited English Proficiency and Screening for Cervical, Breast, and Colorectal Cancers among Asian American Adults

Journal of Racial and Ethnic Health Disparities volume 10, pages 977–985 (2023)Cite this article

Abstract

Background

Literature shows that limited English proficiency (LEP) influences individual healthcare-seeking behaviors. The Asian population is the fastest-growing racial/ethnic group in the US, and approximately 50% of foreign-born Asians are estimated to live with LEP.

Objective

To examine associations of LEP and patient-provider language concordance (PPLC) with evidence-based cancer screening utilization for cervical, breast, and colorectal cancers among Asian American adults.

Methods

We obtained LEP, PPLC, and up-to-date status on the three types of cancer screening from a nationally representative sample of Asian Americans aged ≥ 18 years in the 2010–2016 and 2018 Medical Expenditure Panel Surveys. We used multivariable logistic regression models with recommended survey weighting to examine associations of LEP and PPLC with the cancer screening uptake based on USPSTF guidelines.

Results

The study population comprised 8953 respondents, representing 8.17 million Asian American adults. Overall, 11.9% of respondents experienced LEP; of those with LEP, 20% were with PPLC. In multivariable models, compared to respondents without LEP, respondents with LEP and without PPLC were significantly less likely to report up-to-date status on breast (OR = 0.44; 95% CI: 0.26–0.76), cervical (OR = 0.44; 95% CI: 0.26–0.75), or colorectal cancer screening (OR = 0.46; 95% CI: 0.26–0.80). However, these differences were not detected in respondents with LEP and with PPLC.

Conclusion

LEP is associated with lower up-to-date status on cancer screening among Asian Americans, while PPLC seems to moderate this association. These findings suggest the enhancement for language-appropriate and culturally competent healthcare for Asian Americans with LEP, which helps accommodate their communication needs and promotes cancer screening.

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Author information

Authors and Affiliations

  1. Department of Health Services Research, Management and Policy, University of Florida, PO Box 100195, Gainesville, FL, 32610-0195, USA

    Zhigang Xie, Brittney Dixon, Ara Jo & Young-Rock Hong

  2. Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA

    Guanming Chen

  3. Center for Health Systems Research, Policy & Practice, Department of Management, Policy and Community Health School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA

    Ryan Suk

  4. UFHealth Cancer Center, Gainesville, FL, USA

    Young-Rock Hong

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  1. Zhigang Xie
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  2. Guanming Chen
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  3. Ryan Suk
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  4. Brittney Dixon
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  5. Ara Jo
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Contributions

Study conception and design: All authors. Acquisition, analysis, or interpretation of data: Xie and Hong. Drafting of the manuscript: all authors. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: Xie and Hong. Administrative, technical, or material support: Xie and Hong. Study supervision: Hong.

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Correspondence to Young-Rock Hong.

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Xie, Z., Chen, G., Suk, R. et al. Limited English Proficiency and Screening for Cervical, Breast, and Colorectal Cancers among Asian American Adults. J. Racial and Ethnic Health Disparities 10, 977–985 (2023). https://doi.org/10.1007/s40615-022-01285-8

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  • DOI: https://doi.org/10.1007/s40615-022-01285-8

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