title: Hispanic acculturation and utilization of colorectal cancer screening in the United States.
abstract: BACKGROUND
  Despite the evidence on the effectiveness of colorectal cancer (CRC) screening procedures, its use remains low, especially among Hispanics. Social-cultural factors may play a role in the underutilization of cancer screening. This study aimed to examine whether low acculturation was a risk factor for the underutilization of colorectal cancer screening in the Hispanic population.
  
  
  METHODS
  The subjects were adults aged 50-80 years who identified themselves as Hispanic and never were diagnosed with colorectal cancer. Colorectal cancer screening utilization was assessed based on the use of at-home Fecal Occult Blood Test (FOBT) and the use of endoscopies (sigmoidoscopy, colonoscopy, or proctoscopy). Respondents who underwent a test for diagnostic purposes were excluded from the study.
  
  
  RESULTS
  Our data showed that colorectal screening was underused in Hispanics compared to non-Hispanic Whites. There was a trend that acculturation level was inversely correlated with having an endoscopy in the past 5 years. This trend was also seen with having a FOBT in the past year or an endoscopy in the past 5 years. However, the association disappeared after adjusting for factors pertaining to utilizing other health care services. Additionally, after stratifying by gender, the association between the two variables was diluted.
  
  
  CONCLUSIONS
  The findings show that low acculturation was associated with the underutilization of endoscopic colorectal cancer screening. This association may be related to lower utilization of health care services and/or language barriers that may contribute to the lower utilization.
authors.affiliation: United States Military Cancer Institute, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA. mona.shah@na.amedd.army.mil
authors.forename: Mona
authors.initials: M
authors.lastname: Shah
authors.forename: Kangmin
authors.initials: K
authors.lastname: Zhu
authors.forename: John
authors.initials: J
authors.lastname: Potter
mesh_terms: D000069:Acculturation; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000208:ethnology; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D009780:Occult Blood; D016017:Odds Ratio; D011795:Surveys and Questionnaires; D014481:United States