title: Factors associated with Hispanic/non-Hispanic white colorectal cancer screening disparities.
abstract: BACKGROUND
  In the United States, Hispanics are less likely to undergo colorectal cancer (CRC) screening than non-Hispanic whites (whites).
  
  
  OBJECTIVE
  To examine factors associated with disparities in CRC screening between whites and Hispanic national origin subgroups.
  
  
  METHODS
  Cross-sectional analysis of 1999-2005 Medical Expenditure Panel Survey data.
  
  
  METHODS
  Respondents aged >50 years self-identifying as non-Hispanic white (18,733) or Hispanic (3686)-the latter of Mexican (2779), Cuban (336), Puerto Rican (376), or Dominican (195) origin.
  
  
  METHODS
  Dependent variable: self-report of up to date CRC screening, defined as fecal occult blood testing within 2 years and/or lower endoscopy at any time.
  
  
  METHODS
  ethnicity/race, country of origin, interview language, socio-demographics, and access to care.
  
  
  RESULTS
  Unadjusted CRC screening rates were highest in whites [mean (standard error), 55.9 (0.6) %], and lowest in Dominicans [28.5 (4.2) %]. After demographic adjustment, CRC screening was significantly lower for Mexicans [adjusted odds ratio (95% confidence interval), 0.46 (0.40, 0.53), p < 0.001)], Puerto Ricans [0.65 (0.47, 0.91), p = 0.01], and Dominicans [0.30 (0.19, 0.45), p < 0.001] versus whites. With further adjustment for language, socioeconomic factors, and access, Hispanic/white disparities were not significant, while among Hispanics, Cubans were more likely to be screened [1.57 (1.15, 2.14), p = 0.01].
  
  
  CONCLUSIONS
  Factors associated with CRC screening disparities between Hispanics and non-Hispanic whites appear similar among Hispanic sub-groups. However, the relative contribution of these factors to disparities varies by Hispanic national origin group, suggesting a need for differing approaches to increasing screening for each group.
authors.affiliation: Department of Family and Community Medicine, University of California Davis School of Medicine, Sacramento, CA 95817, USA. afjerant@ucdavis.edu
authors.forename: Anthony F
authors.initials: AF
authors.lastname: Jerant
authors.forename: Rose E
authors.initials: RE
authors.lastname: Arellanes
authors.forename: Peter
authors.initials: P
authors.lastname: Franks
mesh_terms: D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000208:ethnology*; D003430:Cross-Sectional Studies; D005260:Female; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009780:Occult Blood; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data*