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Citizenship, length of stay, and screening for breast, cervical, and colorectal cancer in women, 2000–2010

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Abstract

Background

Two factors jointly account for significant gaps in access to health care among immigrants who are present in the U.S.—legal status, and length of residence. The objective of this study is to examine the association between citizenship and length of residence in the U.S. and cancer screening (breast, cervical, and colorectal) among women.

Methods

We analyzed 11 years (2000–2010) of consolidated data from the Medical Expenditure Panel Survey linked with the National Health Interview Survey. Multivariate analyses compared cancer screening among U.S.-born citizens (n = 58,484), immigrant citizens (n = 8,404), and immigrant non-citizens (n = 6,564).

Results

Immigrant non-citizens living in the U.S. for less than 5 years were less likely to receive guideline-concordant breast (OR = 0.68 [0.53–0.88]), cervical (OR = 0.65 [0.54–0.78]), and colorectal (OR = 0.31 [0.19–0.50]) cancer screening compared to U.S.-born citizens. Immigrant citizens and non-citizens living in the U.S. for 5 years or more had higher odds of being screened for breast and cervical cancer compared to U.S.-born citizens; (OR = 1.26 [1.13–1.41] and OR = 1.17 [1.06–1.29]) for immigrant citizens, (OR = 1.28 [1.13–1.45] and OR = 1.23 [1.09–1.38]) for non-citizens. Immigrant non-citizens living in the U.S. for 5 years or more had lower odds of being screened for colorectal cancer compared to U.S.-born citizens (OR = 0.76 [0.65–0.90]).

Conclusions

Based on these findings, duration mandates in immigration policy may indirectly influence future pathways to preventive health care and cancer disparities disproportionately affecting immigrant women. We suggest that limits of duration mandates be reevaluated, as they may offer pathways to preventive health care for this vulnerable population, and prevent future cancer disparities.

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Acknowledgments

This publication was supported, in part, by Grant Nos. UL1 TR000127 and KL2 TR000126 from the National Center for Advancing Translational Sciences (NCATS), Penn State Hershey Cancer Institute, Penn State Social Science Research, and Penn State Clinical and Translational Science Institute.

Author contributions

Miranda conceptualized the study and methodology, supervised formal analysis, prepared initial draft; Yao conducted formal analysis, assisted in manuscript preparation; Snipes assisted in manuscript preparation; BeLue assisted in manuscript preparation; Lengerich assisted in manuscript preparation; Hillemeier assisted in manuscript preparation.

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Authors and Affiliations

  1. Department of Health Policy and Administration, College of Health and Human Development, Pennsylvania State University, 601-D Ford Building, University Park, PA, 16802, USA

    Patricia Y. Miranda, Rhonda BeLue & Marianne M. Hillemeier

  2. Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA

    Nengliang Yao

  3. Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, PA, USA

    S. Amy Snipes

  4. Department of Public Health Sciences, Penn State Cancer Institute, College of Medicine, Pennsylvania State University, University Park, PA, USA

    Eugene Lengerich

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  1. Patricia Y. Miranda
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  2. Nengliang Yao
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  4. Rhonda BeLue
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  6. Marianne M. Hillemeier
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Corresponding author

Correspondence to Patricia Y. Miranda.

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All of the authors report no conflicts of interest.

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Miranda, P.Y., Yao, N., Snipes, S.A. et al. Citizenship, length of stay, and screening for breast, cervical, and colorectal cancer in women, 2000–2010. Cancer Causes Control 28, 589–598 (2017). https://doi.org/10.1007/s10552-017-0887-x

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  • DOI: https://doi.org/10.1007/s10552-017-0887-x

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