Receipt of cancer screening procedures among Hispanic and non-Hispanic health maintenance organization members.
BACKGROUND
Hispanic Americans have been shown to receive fewer cancer screening procedures than nonminority populations. Although lack of insurance or a regular source of care appear to be important determinants, cultural factors also have been suggested. This study examines whether Hispanic patients receive cancer screening at the same rate as the non-Hispanic population when both groups have equivalent insurance and a regular source of care.


METHODS
Receipt of five cancer screening procedures (mammography, Pap test, fecal occult blood testing, breast examination, and rectal examination) was determined for adult health maintenance organization (HMO) members who met appropriate age and gender criteria. Rates of receipt were compared for 2 cohorts over a 2-year period: Hispanic members identified by surname and a comparison group, a 10% random sample of the non-Spanish surnamed members. Only members with at least one HMO contact over the study period were included. Logistic regression was used to test whether being in the Hispanic group was associated with decreased likelihood of receiving the procedure at least once over the 2 years, adjusting for potential confounders.


RESULTS
Among the comparison group, a high proportion received each recommended procedure at least once (0.70-0.86). The proportions were very similar for the Hispanic group (0.67-0.84). None of the rates differed statistically for the two groups.


CONCLUSIONS
Hispanic HMO members received cancer screening at the same high rate as non-Hispanics, suggesting that insurance coverage and continuity of care are more important than cultural factors in determining rates of cancer screening receipt.
Jacobs
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Collaborative Research Unit, Department of Medicine, Cook County Hospital, Chicago, Illinois 60612, USA. ejacobs@rush.edu
Lauderdale
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DS
D000328:Adult; D003266:Continuity of Patient Care; D003466:Cultural Characteristics; D005260:Female; D019538:Health Care Surveys; D006279:Health Maintenance Organizations; D006297:Health Services Accessibility; D006630:Hispanic or Latino; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis*