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Nativity Disparities in Colorectal Cancer Screening Among Hispanics in the United States

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Abstract

Hispanics in the United States (U.S.) have previously exhibited lower guideline-concordant colorectal cancer (CRC) screening uptake than non-Hispanic (NH) Whites, with disparities accentuated in foreign-born Hispanics, however it is unclear whether nativity-related CRC screening disparities have changed in the last two decades and whether these disparities are attenuated after adjusting for socioeconomic and demographic characteristics. We evaluated CRC screening adherence in foreign- and U.S.-born Hispanics compared to U.S.-born NH Whites. We used 2019 National Health Interview Survey data to compare the prevalence of up-to-date CRC screening per the 2019 U.S. Preventive Services Task Force recommendations among Hispanic nativity subgroups (i.e., foreign- and U.S.-born) and U.S.-born NH Whites using unadjusted and adjusted weighted log-linked binomial regression. Foreign- and U.S.-born Hispanics had a significantly lower unadjusted prevalence of up-to-date screening than U.S.-born NH Whites (47.18% and 64.18% versus 70.70%; p < 0.0001 and p = 0.0109, respectively). After adjusting for socioeconomic and demographic differences, the prevalence of up-to-date screening was lower in foreign-born Hispanics compared to U.S.-born NH Whites [adjusted prevalence ratio 0.80 (95% confidence interval 0.70–0.91)]; however, no statistically significant difference was observed between U.S.-born Hispanics and NH Whites. Our results suggest a low screening uptake in foreign-born Hispanics independent of socioeconomic and demographic differences. Future interventions should target foreign-born Hispanics to address disparities and promote early detection and prevention of CRC regardless of socioeconomic factors.

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Data Availability

The datasets generated during and/or analysed during the current study are publicly available from the the National Center for Health Statistics, National Health Interview Survey, 2019 at https://www.cdc.gov/nchs/nhis/2019nhis.htm.

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Acknowledgements

The authors would like to acknowledge the National Center for Health Statistics (NCHS) and National Health Interview Survey as the source for the data used in this paper. The analyses, interpretations, and conclusions presented in this paper are solely that of the authors (recipients of the data file) and not that of NCHS, which is responsible only for the initial data. Additionally, this research was supported by the Cancer Prevention and Research Institute of Texas (CPRIT) grant PP210007 (PI: Montealegre) and the American Cancer Society (ACS) grant RSG 21-047-01-CPPB. Additionally, Dr. Amboree is supported by the National Institute on Minority Health and Health Disparities (NIMHD) grant 3R01MD013715-04S1 (PI: Montealegre).

Funding

This research was supported by the Cancer Prevention and Research Institute of Texas (CPRIT) grant PP210007 (PI: Montealegre) and the American Cancer Society (ACS) grant RSG 21-047-01-CPPB. Additionally, Dr. Amboree is supported by the National Institute on Minority Health and Health Disparities (NIMHD) grant 3R01MD013715-04S1 (PI: Montealegre).

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Shreveport, Shreveport, LA, USA

    Victor H. Albornoz Alvarez

  2. Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Trisha L. Amboree & Jane R. Montealegre

  3. School of Medicine, Baylor College of Medicine, Houston, TX, USA

    Parker Mitchell

  4. Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    Hoda J. Badr

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  1. Victor H. Albornoz Alvarez
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  5. Jane R. Montealegre
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Contributions

All authors contributed to the study conception and design. Material preparation and data analysis were performed by Trisha L. Amboree. The first draft of the manuscript was written by Victor H. Albornoz Alvarez and Parker Mitchell, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Trisha L. Amboree.

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Alvarez, V.H.A., Amboree, T.L., Mitchell, P. et al. Nativity Disparities in Colorectal Cancer Screening Among Hispanics in the United States. J Immigrant Minority Health (2024). https://doi.org/10.1007/s10903-024-01590-w

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